Journal of Experimental Child Psychology 122 (2014) 75–91

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Development of reading-related skills in Chinese and English among Hong Kong Chinese children with and without dyslexia Yanling Zhou a,*, Catherine McBride-Chang b, Ada Bui-Yan Law b, Tong Li b, Amelie Cho-Yi Cheung b, Anita M.-Y. Wong c, Hua Shu d a

Department of Early Childhood Education, Hong Kong Institute of Education, Tai Po, NT, Hong Kong Special Administrative Region Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong Special Administrative Region c Faculty of Education, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region d State Key Laboratory of Cognitive Neurosciences and Learning, Beijing Normal University, Beijing 100875, People’s Republic of China b

a r t i c l e

i n f o

Article history: Received 28 August 2012 Revised 12 December 2013 Available online 13 February 2014 Keywords: Dyslexia Word reading Bilingual Chinese and English reading RAN Phonological awareness Morphological awareness Vocabulary knowledge

a b s t r a c t This 2-year longitudinal study sought to identify a developmental pattern of Chinese and English reading skills in children with and without dyslexia from 6 to 8 years of age. Three groups of 15 children each—those with dyslexia, age-matched (AM) controls, and readingmatched (RM) controls—participated. Dyslexia was diagnosed at 8 years of age. All children were tested on phonological awareness, rapid automatized naming (RAN), morphological awareness, word reading, and vocabulary knowledge in both Chinese and English and also speed of processing skill. AM controls outperformed the group with dyslexia on all measures except for phonological awareness, English word reading, and vocabulary. However, those with dyslexia and AM controls developed at a similar rate across all reading-related skills from 6 to 8 years of age. Compared with the RM controls, the group with dyslexia scored higher in phonological awareness, morphological awareness, and vocabulary knowledge in both Chinese and English and also in English word reading but scored similarly in RAN. Children with dyslexia, thus, manifested clear difficulties in Chinese vocabulary knowledge, morphological awareness, and RAN as well as general speed of processing, representing a developmental lag in cognitive skills. Among these, RAN deficits are likely to be the most severe deficits in Chinese children with dyslexia. Ó 2013 Elsevier Inc. All rights reserved.

* Corresponding author. E-mail address: [email protected] (Y. Zhou). 0022-0965/$ - see front matter Ó 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.jecp.2013.12.003

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Introduction Dyslexia is generally regarded as a specific reading difficulty in accurate and/or fluent word recognition, spelling, and decoding abilities (e.g., Lyon, Shaywitz, & Shaywitz, 2003; Tunmer & Greaney, 2010) across different languages. Research on developmental dyslexia in Chinese currently focuses on at least two questions. First, as researchers embrace a multiple deficits model of Chinese reading difficulties (e.g., Ho, Chan, Lee, Tsang, & Luan, 2004; Ho, Chan, Tsang, & Lee, 2002), what are the important cognitive correlates of dyslexia in Chinese? Second, given that the curriculum for Hong Kong Chinese children strongly emphasizes knowledge of English as a second language from 3 years of age (e.g., Cheung & Ng, 2003), to what extent is dyslexia in Chinese as one’s first language associated with difficulties in reading English as a second language? There are several cognitive difficulties that those with dyslexia manifest, supporting the idea of multiple deficits for dyslexia. The model proposed by Pennington (2006) suggested a multi-factorial etiology of complex behavioral disorders for when no single genetic or environmental factor is sufficient to cause dyslexia. Rather than being discrete and categorical, cognitive deficits found in dyslexic children are continuous and quantitative, which consequently leads to comorbidity. Researchers have been proposing various causes for developmental dyslexia, ranging from a phonological factor (Morris et al., 1998; Stanovich, 1988, 1991), to a rapid naming speed deficit (Wolf & Bowers, 1999), to an orthographic factor (Badian, 1997), to a visual deficit (Rayner & Pollatsek, 1989; Watson & Willows, 1993; Willows, Corcos, & Kershner, 1993) or even broader language skills (e.g., Nation & Snowling, 2004); each of these is somewhat supported by evidence. Therefore, in the current study, which aimed to examine the multi-deficit hypothesis in Hong Kong children, we included assessments of the abovementioned areas in their native language (i.e., Chinese). Research on early longitudinal predictors of dyslexia (McBride-Chang, Lam, Lam, et al., 2008; McBride-Chang et al., 2011) and poor reading (Lei et al., 2011) in Chinese children has identified rapid automatized naming (RAN) and morphological awareness as particularly strong early markers in children in the age range of 4 to 7 years. Research studies on cognitive markers of primary and secondary school typically developing Chinese children in Hong Kong have also identified RAN and morphological awareness in addition to orthographic skill, an ability that is easier to measure as children’s reading knowledge progresses, as among the strongest correlates of dyslexia (Chung, Ho, Chan, Tsang, & Lee, 2011; Ho et al., 2002, 2004; Shu, McBride-Chang, Wu, & Liu, 2006). RAN can be seen as a unique construct that taps a child’s integration of lower level visual perceptual and higher level cognitive processes (Wolf & Bowers, 1999). The simple task mimics the essential core of reading, making a rapid visual–verbal connection. The RAN score correlates with variations in early reading skills both concurrently and longitudinally, even after statistically controlling children’s phonological awareness and verbal IQ (Compton, 2003; de Jong & van der Leij, 1999; Parrila, Kirby, & McQuarrie, 2004; Schatschneider, Fletcher, Francis, Carlson, & Foorman, 2004; Wagner et al., 1997; Wolf & Bowers, 1999). A significant impairment in RAN tasks has been observed in dyslexic children when matched with both age-matched controls and reading-matched controls in studies of alphabetic readers (e.g., Araujo, Pacheco, Faisca, Petersson, & Reis, 2010; Fawcett & Nicolson, 1994); similar results were found for Chinese (e.g., Chung et al., 2011; Ho & Lai, 1999). Although speeded naming deficits are often observed in children with dyslexia, some have argued that general processing speed might underpin this difficulty (Catts, Gillispie, Leonard, Kail, & Miller, 2002; Kail, Hall, & Caskey, 1999; McBride-Chang & Kail, 2002; see Savage, 2004, for a review). In some studies of both Chinese and English reading (Kail & Hall, 1994; McBride-Chang & Kail, 2002), processing time is indeed a predictor of naming speed. At the same time, however, there is more evidence that dyslexia is linked to RAN difficulties than to nonlinguistic automaticity measures (e.g., Savage, 2004). Thus, in the current study, in addition to a RAN task, we also included a measure of general processing speed—the Woodcock–Johnson Tests of Cognitive Ability (visual matching)—in early testing times to test the extent to which both RAN and general speed of processing might independently distinguish those with and without dyslexia.

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As another early marker of Chinese dyslexia, morphological awareness refers to the ability to reflect on and manipulate morphemes and employ word formation rules in one’s language (Kuo & Anderson, 2006). The morpheme, or the smallest unit of meaning within a language, corresponds to both a syllable and a character in Chinese. Moreover, in Chinese, more than 75% of words are compounds (Institute of Language Teaching & Research, 1986). Knowing how to combine individual morphemes into multi-morphemic words helps one to make educational guesses as to the meanings of words. For example, ‘‘貨車” means truck in English; this word is formed via a combination of two morphemes: ‘‘貨” (goods) and ‘‘車” (vehicle). If a child knows the morpheme vehicle, he or she will understand that this particular word means a type of vehicle. Previous studies have suggested that the awareness and manipulation of morphemes in words is key for Chinese word recognition (e.g., Chan & Wang, 2003; Ho, Yau, & Au, 2003; McBride-Chang, Shu, Zhou, Wat, & Wagner, 2003; Shu et al., 2006). For example, Shu and colleagues (2006) demonstrated that morphological awareness was the strongest cognitive correlate of character recognition, dictation, and reading comprehension across Grade 5 and 6 Mandarin-speaking Chinese children (with or without dyslexia). In addition, McBride-Chang, Lam, Lam, and colleagues (2008) pointed out a bidirectional association between morphological awareness and character recognition, suggesting that as children’s reading ability develops children become better able to understand how morphemes are related to one another. Compared with early cognitive markers for Chinese dyslexia, general language skills such as oral vocabulary knowledge itself have been examined only rarely in studies of dyslexia in Chinese children. A recent study of typically developing children demonstrated that vocabulary knowledge predicted subsequent Chinese literacy skills up to 5 years later (Pan et al., 2011), underscoring the potential importance of vocabulary skills for reading variability with development. One study of Hong Kong children in Grades 3 to 5 with dyslexia (Chik et al., 2012) and one study of fifth graders from Beijing with dyslexia (Shu et al., 2006) also showed that vocabulary knowledge was significantly lower in these children as compared with age-matched controls. However, studies of younger Chinese children with dyslexia have not typically included this variable. One study examining early oral language markers at 2 to 4 years for 7-year-old poor Chinese readers found that these children’s vocabulary knowledge at 2 years was significantly weaker than that of adequate readers (Liu, McBride-Chang, Wong, Shu, & Wong, 2013). This is of interest in a comprehensive examination of development in young Chinese children with dyslexia. Poor vocabulary knowledge may be another marker for Chinese dyslexia. It is possible that a more impoverished early vocabulary might limit the speed with which words in Chinese could be mapped to print (e.g., McBride-Chang, Liu, Wong, Wong, & Shu, 2012); it is equally possible that early difficulties in reading will curtail new words to be learned as one shifts from learning to read to reading to learn (e.g., Lyon et al., 2003). The current study examined some possible early markers of reading difficulties in Chinese children who ultimately did and did not manifest dyslexia. One somewhat controversial issue in Hong Kong is the role of phonological awareness in dyslexia in Chinese. Although some have demonstrated that Hong Kong Chinese children at risk for reading difficulties tend to score relatively poorly on tasks of phonological sensitivity (Ho, Leung, & Cheung, 2011; McBride-Chang, Tong, Shu, et al., 2008) and that Chinese children suffering from both specific language impairment and dyslexia manifest deficits in phonological awareness compared with agematched controls (Wong, Kidd, Ho, & Au, 2010), other studies of children and adolescents with dyslexia have found that phonological awareness difficulties are not particularly prominent in Chinese (e.g., Ho et al., 2002, 2004; Shu et al., 2006). In Hong Kong, where phonological skills are not as strongly linked to word reading as they are in Mainland China via Pinyin, a phonological coding system used to introduce new characters, this issue is of particular theoretical interest. Because a morpheme and a syllable unit are typically one and the same in Chinese, phonological representations of characters are not necessarily broken down into smaller units such as onset–rime in Cantonese (spoken in Hong Kong). Therefore, it is possible that phonological awareness skills are not as salient in early associations with subsequent word reading as in other societies, including other Chinese societies (e.g., McBride-Chang et al., 2012). In the current study, we revisited this question. Importantly, however, phonological awareness tends to be strongly associated with reading in English among Hong Kong Chinese children (e.g., McBride-Chang & Ho, 2005; McBride-Chang, Tong, Shu, et al., 2008), including those with dyslexia (Chung & Ho, 2010a, 2010b; Ho & Fong, 2005). Indeed,

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compared with age- and reading-matched controls, Hong Kong Chinese primary school children with dyslexia tend to have significantly lower phonological processing, word reading (Chung & Ho, 2010a; Ho & Fong, 2005), and receptive vocabulary knowledge (Ho & Fong, 2005) in English. Yet, there is also evidence that some Chinese children with dyslexia do not have particular difficulties with English learning. Ho and Fong (2005), for example, presented a case of a boy with dyslexia in Chinese with average phonological skills in English. In another study of poor readers of Chinese, English, or both (McBride-Chang et al., 2012), some 8- and 9-year-olds who were poor readers of Chinese did not have special difficulties with reading English. Methodologically, most previous studies of Chinese children with dyslexia were either cross-sectional, including both age- and reading-age-matched controls (Ho et al., 2002, 2004), or developmental without a reading-matched control (e.g., McBride-Chang et al., 2012). In the current study, we took advantage of a data set in which participants had been followed longitudinally in a statistically representative sample of Hong Kong Chinese children. Between 7 and 8 years of age, all of these children were screened for dyslexia using the three standardized literacy subtests of the Hong Kong Test of Specific Learning Difficulties in Reading and Writing (Ho, Chan, Tsang, & Lee, 2000), and 15 of them were ultimately diagnosed with dyslexia when their literacy composite scaled standard score was revealed to be at 7 or below where the range of the scale was from 1 to 19, with 10 being the mean (e.g., Ho et al., 2004; McBride-Chang et al., 2012). Because of our larger data set, we were then able to match these children with dyslexia not only to an age-matched control group but also, at the final testing time, to a reading-matched group. The reading-matched group was composed of children from the original group whose reading scores could be matched retrospectively to those of the dyslexics at Time 3. This unique design may be particularly helpful for looking at developmental trends in the early manifestation of dyslexia. For some alphabetic languages, some longitudinal studies were able to follow children with dyslexia from the early years up to adolescence and pinpointed the key deficits identified from an early age that continuously hindered the children from achieving standard reading skills (e.g., Boscardin, Muthén, Francis, & Baker, 2008; Lesaux, Rupp, & Siegel, 2007; Lyytinen et al., 2006; Shaywitz et al., 1999). A general developmental trend that these research studies identified was that over time children with dyslexia did not catch up with their peers in the normal development of reading skills. Some of the deficits were persistently predominant in their reading development. Therefore, we hypothesized that some multiple deficits were likely to emerge as typical in Chinese children with dyslexia. To summarize, the current study, focusing on the development of native reading-related skills and second-language English vocabulary knowledge and word recognition in Chinese children with dyslexia from before they entered primary school to the end of Grade 2, aimed to achieve two goals. First, it aimed to extend previous work on early longitudinal predictors of dyslexia in Chinese children (McBride-Chang et al., 2011) by comparing developmental patterns of reading-related skills in children with and without dyslexia. A second goal was to extend previous correlational work demonstrating difficulties in English reading skills in Hong Kong Chinese children with dyslexia at 9 years of age (Chung & Ho, 2010b; Ho & Fong, 2005) by looking at English skill development in younger Chinese children with dyslexia.

Method Participants Three groups of 15 Chinese children from Hong Kong were selected from a larger sample of 164 children participating in an ongoing longitudinal study of language and literacy development. The original sample was recruited from maternal and child health centers located in different areas in Hong Kong. All of the children were born and attended local schools in Hong Kong at the same time in the same grade. Chinese (Cantonese) is the medium of instruction at schools for these children. All Hong Kong local Chinese-medium primary schools follow the same school curriculum. The mean age of the children in the final testing phase was 97 months (approximately 8 years). In Hong Kong, children start to learn English as a foreign language from early kindergarten (approximately 3.5 years). ‘‘Look

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and say” teaching methods are widely practiced in English classrooms, and learning phonics is not common in either kindergarten or primary school classrooms. In addition, children’s home language is Cantonese, and the use of English in daily life is little supported. It is typically the case that Hong Kong children’s spoken English is not as good as their written English because of how they are taught. Procedure At the beginning of the longitudinal study, consent forms were obtained from participants’ parents. At the convenience of participating children and their caregivers, testing times were arranged individually during the summer months. All of the tasks were administered by trained psychology students at children’s homes, and each session lasted approximately 1 to 1.5 h at each year of testing. From year to year, the longitudinal study adopted a range of different tasks, based on both theoretical interests and practical concerns. All of the tasks, except for the visual matching task that tapped speed of processing skills, were administered at all three time points. The visual matching task was terminated at Time 3 (T3) due to time limitations. Diagnosis of dyslexia across groups was done using the Hong Kong Test of Specific Learning Difficulties in Reading and Writing (HKT-SpLD; Ho, Chan, et al., 2000). This is a standardized dyslexia screening tool that is used as the governmental standard for official diagnosis of dyslexia in Hong Kong (e.g., Ho et al., 2002; McBride-Chang, Lam, Lam, et al., 2008). The rate of dyslexia has been estimated to be approximately 9.7% in Hong Kong (e.g., Chan, Ho, Tsang, Lee, & Chung, 2007; Chung & Ho, 2010a). For this study, the screening of dyslexia was conducted for all children in the longitudinal sample at T3. Therefore, this study took a retrospective approach in studying children with and without dyslexia. The HKT-SpLD (Ho, Chan, et al., 2000) includes dable 1ographic information ups ee groups at Time 3 differences on three literacy subtests: Chinese Word Reading, One-Minute Reading, and Chinese Word Dictation. The Chinese Word Reading task comprised 150 two-character words that children were asked to read aloud one by one. Children scored 1 point for each correct naming of a word and 0 points for each incorrect naming. When children failed on 15 consecutive words, the testing stopped. For the One-Minute Reading task, children were asked to read aloud 90 simple Chinese two-character words as quickly and accurately as possible within 60 s. Finally, there were 48 Chinese two-character words in the Chinese Word Dictation task. Children were asked to write these words individually. Testing stopped when eight consecutive words were written incorrectly. Based on the HKT-SpLD standard, Children who scored an average standard score of 7 or below across these three subtests were diagnosed with dyslexia. (Task administration was done by research assistants under the supervision of clinical psychologists from the Department of Health–Child Assessment Centres in Hong Kong.) The group of children with dyslexia, therefore, consisted of 15 children (9 boys and 6 girls) with a mean age of 6 years 3 months (SD = 3 months) at the first testing time; these children were ultimately diagnosed as manifesting dyslexia at the mean age of 8 years 3 months (SD = 3 months). The HKT-SpLD standard indicated that in order to reach a standard score of 7, an 8-year-old should score between 69 and 74 on the Chinese Word Reading task, 42 to 47 on the One-Minute Reading task, and 36 to 39 on the Chinese Word Dictation task. Similarly, for a standard score of 3, an 8-year-old should reach score between 43 and 49 on the Chinese Word Reading task, 22 to 26 on the One-Minute Reading task, and 17 to 21 on the Chinese Word Dictation task. The average mean standard score across the three subtests for the group with dyslexia was 2.27 (SD = 0.83), which is significantly lower than the cutoff line score of 7. In addition, none of the children’s individual scores for each subtest exceeded a score of 7. Therefore, the identification rate of dyslexia from this longitudinal sample was 9%, which is consistent with the rate of dyslexia identified in previous studies (Chan et al., 2007; Chung & Ho, 2010a). The age-matched (AM) control group consisted of 15 typically developing readers (4 boys and 11 girls) matched on age, nonverbal IQ, and mother’s education at the first testing time. Although there were more girls than boys in the age-matched group than in the group with dyslexia, we found no significant gender effect in any of the literacy tasks included in this study. The age-matched group, as well as the reading matched (RM) controls, had an average standard score of 8 or above across the three literacy subtests administered to screen for dyslexia.

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Data from the RM control group were compared with data from the group with dyslexia on the Chinese Word Reading task at the last testing time (T3) only because only at this time were the RM controls at the level of the dyslexic children. The RM group comprised 7 boys and 8 girls from Time 1 (T1) with normal reading achievement matched to the dyslexic group on reading level, mother’s education, and nonverbal IQ. In our analyses, therefore, the RM group was 2 years younger than the group with dyslexia as a result of the matching process. In reality, the RM group was tested at the same time as the other two groups because all of the participating children were tested within the same cohort across years. The unique design feature of the current study is simply that we were able to select separate groups to serve as AM and RM controls from our total large sample. Consent forms were obtained from the parents of children involved in the current study. Children were tested individually at home in a single session at each time point per year across 3 years. All tasks described below were administered to children; their reliabilities are reported in Table 2 (see Results). Raven’s Coloured Progressive Matrices Early on in the study, the book form of the Raven’s Coloured Progressive Matrices, with 24 colored items presented in total, was administered to the whole sample as a rough estimate of children’s age 4 years nonverbal reasoning (Raven, Court, & Raven, 1995). Chinese Word Reading task The Chinese Word Reading task is the literacy subtest from the HKT-SpLD (Ho, Chan, et al., 2000) that we used for screening for dyslexia. It comprises 150 two-character words that children were asked to read aloud one by one. Children scored 1 point for each correct naming of a word and scored 0 points for each incorrect naming. When children failed on 15 consecutive words, the testing stopped. Vocabulary definitions To this point, there has not been a standardized vocabulary assessment tool for the Chinese language that can apply to all different Chinese language-speaking societies. In addition, receptive vocabulary measures can sometimes be too easy for native Chinese-speaking children above a certain age because of the semantic transparency of some terms (e.g., McBride-Chang, Tong, Shu, et al., 2008). Therefore, across all 3 years, a vocabulary definition task was included in the current study to estimate children’s vocabulary knowledge. There were 53 words in the task, with all words being adopted from Hong Kong Chinese children’s reading books (Zhuang, 2000) and piloted with children of similar ages. All words were arranged in ascending order of difficulty, and children were asked to give a definition or an explanation of each word. Answers were scored as 2, 1, or 0 according to accuracy; the maximum score was 106 for this task. English word reading A test of English word reading was administered across all three time points. It consisted of 40 English words selected from children’s textbooks at different difficulty levels; this task was intended to span across the curriculum of primary school. Children were asked to read aloud the words one by one. The test ended when children failed to read four English words consecutively. English vocabulary The Peabody Picture Vocabulary Test III (PPVT-III; Dunn & Dunn, 1997) was used to test children’s English vocabulary skills. The standard directions for the task concerning basal and ceiling rules for native English speakers were used in testing children. Only raw scores on this task are reported in Table 1 because this task has not been normed for Hong Kong Chinese children.

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Y. Zhou et al. / Journal of Experimental Child Psychology 122 (2014) 75–91 Table 1 Demographic information for all three groups. Time point

Age (in months)

Mother’s education Raven’s at age 4 years

Reliability

T1

—

T2

—

T3

—

—

—

—

0.53

Dyslexic Mean (SD)

AM control Mean (SD)

RM control (Age 6) Mean (SD)

74.73 (3.13) 90.00 (3.95) 98.73 (3.22) 3.40 (1.06) 10.93 (2.05)

75.43 (2.61) 90.50 (2.41) 99.07 (2.66) 3.73 (1.34) 11.87 (2.50)

— —

t (28)

F (2, 42)

Post hoc

0.66

—

—

0.42

—

— ⁎⁎⁎

D=AM>RM

72.40 (3.00)

—

399.20

3.47 (1.25)

—

.32

D=AM=RM

11.27 (2.92)

—

.53

D=AM=RM

Note. AM, age-matched; RM, reading-matched; D, dyslexic. *p < .05. **p < .01. ⁎⁎⁎

p < .001.

Phonological awareness Phonological awareness has been measured at both the syllable and onset–rime levels for understanding reading in Chinese as a first language and English as a second language (e.g., Goswami, 2002; Gottardo, Yan, Siegel, & Wade-Woolley, 2001; Lei et al., 2011). The phonological awareness task in the current study combined Chinese syllable deletion and syllable onset deletion to maximize variability on this measure. Initially, 29 three-syllable words were administered and children were asked to say a given word with a targeted syllable omitted. In the second section, a 22-item syllable onset deletion task was administered. Here, children were asked to say a single-syllable word without the onset consonant. Both types of items included both real words and nonwords, and all were administered orally. Testing was stopped once children failed on six consecutive trials. Rapid automatized naming The stimuli used for the RAN task consisted of a 5  5 array of numbers randomly arranged on a sheet. Before starting the task, children were asked to name all of the digits slowly from the first row to ensure that all of the digit names were familiar to them. Then, children were asked to name all 25 numbers aloud row by row as quickly as possible, from the first number in the first row to the last number in the last row. A stopwatch was used to record the total time taken for reading all numbers. This task was administered twice across time points of the study to obtain test–retest reliability estimates. Morphological awareness Multi-morpheme (i.e., two- or three-syllable) words are the majority of those found in the Chinese language lexicon. As a consequence, manipulation of morphemic information orally has sometimes been linked to word reading and vocabulary knowledge in Chinese (McBride-Chang et al., 2003; McBride-Chang, Tong, Shu, et al., 2008). Morphological awareness was tapped in the current study using a morphological construction task used in previous work (e.g., McBride-Chang et al., 2012). This task, in the form of lexical compounding, was based on studies demonstrating its relatively strong association with word recognition among both typically developing Chinese children (e.g., McBrideChang et al., 2003) and reading-impaired Chinese children (Lei et al., 2011; McBride-Chang et al., 2012; Shu et al., 2006). It focuses on children’s understanding of how to construct compound words

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in Chinese, a key component of both Chinese word recognition and vocabulary development (McBride-Chang, Tong, Shu, et al., 2008). In this task, children were verbally presented with a three-sentence scenario describing a nonexistent concept and were asked to come up with a compound word to represent it. The following is an example of an item from the task: ‘‘The scene we saw in the night from the top of a mountain is called a night scene. What would we call a scene viewed in the morning from the top of a mountain?” The correct answer would be morning scene. This task consisted of 27 items. Testing stopped when children failed on four consecutive testing items. Speed of processing Following previous studies that tested processing speed and reading (e.g., Kail & Hall, 1994; Kail et al., 1999), a visual matching task was used to test processing speed (Kail & Hall, 1994); it was adopted from the Woodcock–Johnson Tests of Cognitive Ability (Woodcock & Johnson, 1989). We administered this only at Times 1 and 2, when children were roughly 6 and 7 years of age. This task was administered following standard directions, that is, with a 3-min time limit. Children were presented with rows consisting of six numbers each, with two of the numbers in each row being identical. Children were asked to circle the identical numbers in each row as quickly as possible. Results There was one missing value in RAN for the AM controls at T3 and one missing value for the vocabulary definitions task in the dyslexic group at Time 2 (T2). The missing values were replaced by the mean value of the respective measure of the respective group at the respective time point. Descriptive statistics for the dyslexic group and the AM and RM control groups on all measures are shown in Tables 2 and 3. Due to the small sample size of the study, we sought to detect whether there might be any outliers in the data that might confuse the results. We used a Bonferroni correction of the Z-score for a sample size of 10 at the level of .01 (Cousineau & Chartier, 2010), which dictates that when a Zscore is larger than 3.29, an outlier is then identified. In the current study, where each group had a sample size of 15, we used this criterion for the Z-scores of all the measures and identified one outlier at the high end from the group with dyslexia for the measure of T1 English word reading only. However, this outlier did not affect the following analyses in relation to which groups differed statistically; therefore, this outlier was left uncorrected. A one-way between-participants analysis of variance (ANOVA) was conducted to compare the mother’s educational levels across the three groups (i.e., dyslexia, AM, and RM). The mother’s educational levels did not differ among the three groups, F(2, 42) = 0.32, p > .05. On average, the mother’s educational level was equivalent to that of a secondary school graduate (Form 5 in the British system). In addition, the groups did not differ in their means for the nonverbal reasoning score (Raven’s), F(2, 42) = 0.53, p > .05. For the RM control group, the measures for all of the tasks are shown in comparison with the measures for the other two groups only at T3 because the measures of the RM group were determined at T1, at which time their character reading score was matched to that of the group with dyslexia. Repeated-measures factorial analyses of the general linear model were first used to investigate the main group effect (i.e., dyslexic, AM, or RM) on all measures of reading-related abilities and speed of processing separately as well. The group effect was significant for all reading-related abilities (i.e., Chinese word reading, Chinese vocabulary definitions, Chinese phonological awareness, Chinese morphological awareness, visual matching, Chinese RAN, English word reading, and English vocabulary), F(7, 22) = 10.62, p < .001, and for speed of processing, F(1, 28) = 8.95, p < .01. To determine the overall Time Point  Group interaction, a 3 (Time: 1, 2, or 3)  2 (Group: dyslexic or AM) repeated-measures ANOVA was conducted. The overall Time Point  Group interaction was significant, F(14, 100) = 2.76, p < .01, and Chinese character recognition was the only measure on which the Time Point  Group interaction was significant, F(2, 56) = 16.55, p < .001. The results demonstrated that the developmental trends of the dyslexia and AM groups were generally parallel to each other on all tasks except for Chinese character recognition. Although the interaction effect for the two groups on Chinese character

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Table 2 Means, standard deviations, and developmental patterns on reading-related skills for group with dyslexia as compared with agematched control group. Time point Reliability Dyslexic

Visual matching

T1 T2 Chinese vocabulary T1 T2 T3 Chinese word T1 reading T2 T3 RAN T1 T2 T3 Phonological T1 awareness T2 T3 Morphological T1 awareness T2 T3 English word T1 reading T2 T3 English vocabulary T1 T2 knowledge T3

– – .85 .93 .93 .99 .99 .99 .97 .91 .94 .95 .95 .94 .85 .85 .89 .97 .98 .99 .96 .96 .93

AM control

M (SD)

F

Effect size M (SD)

F

Effect size

103.67 (15.26) 117.33 (17.95) 17.20 (8.09) 29.14 (14.81) 28.80 (11.20) 7.53 (6.90) 31.20 (14.99) 51.00 (21.68) 18.42 (6.47) 16.02 (5.22) 13.47 (4.24) 24.00 (5.53) 26.93 (6.54) 32.80 (8.48) 12.15 (3.58) 17.47 (3.94) 19.60 (3.42) 2.67 (6.84) 16.40 (14.11) 25.53 (11.36) 32.67 (16.45) 42.93 (21.88) 46.20 (16.37)

7.35⁎

.36

1.34

.06

6.65⁎⁎

.42

11.92⁎⁎⁎ .41

65.03⁎⁎⁎ .75

6.98⁎⁎

.74

9.17⁎⁎

.45

47.31⁎⁎⁎ .65

32.68⁎⁎⁎ .64

8.62⁎⁎

.28

123.53 (11.49) 127.73 (22.04) 25.13 (7.89) 38.07 (15.48) 40.67 (14.89) 41.93 (29.10) 99.40 (24.59) 109.27 (17.32) 13.84 (2.99) 10.69 (3.40) 9.34 (1.66) 28.27 (7.67) 32.27 (9.55) 37.27 (9.74) 16.33 (4.51) 21.53 (4.79) 21.33 (6.49) 5.00 (8.45) 18.60 (10.27) 28.07 (9.24) 32.23 (18.25) 41.27 (14.86) 53.80 (12.95)

120.73⁎⁎⁎ .75

12.42⁎⁎⁎

.30

6.86⁎⁎

.12

5.63⁎⁎

.14

40.86⁎⁎⁎

.50

26.10⁎⁎⁎

.24

Note. AM, age-matched. p < .05. p < .01. ⁎⁎⁎ p < .001. ⁎

⁎⁎

recognition was significant, the gap between the two groups on the task across the three time points remained wide. As Fig. 1 shows, while the dyslexia group progressed steadily across the three time points, the AM group took a leap on the task from T1 to T2 and the progress slowed down slightly from T2 to T3. Across the three time points, dyslexic children performed significantly worse than their AM controls on visual matching, F(1, 28) = 7.75, p < .01, on Chinese vocabulary knowledge, F(1, 28) = 8.17, p < .01, on Chinese character recognition, F(1, 28) = 66.48, p < .001, on RAN, F(1, 28) = 13.84, p < .01, and on morphological awareness, F(1, 28) = 7.13, p < .05, whereas there was a marginally significant difference on phonological awareness, F(1, 28) = 4.20, p = .05. However, there were no differences between the two groups on English word reading, F(1, 28) = 0.60, p > .05, or on English vocabulary, F(1, 28) = 0.11, p > .05. As shown in Tables 2 and 3, repeated measures of the general linear model were used to examine the general developmental changes of dyslexics and AM controls across all measures on Chinese and English reading-related skills and speed of processing. Except for the AM group’s performance on visual matching, F(1, 14) = 1.34, p > .05, children of the two groups exhibited significant improvement across the 3 years (all ps < .05). Independent-samples t tests were used to compare the difference between the dyslexic and AM groups in the testing across the three time points. On two tasks, namely Chinese word reading and RAN, dyslexic children exhibited poorer performance than the AM controls at all three time points: for Chinese word reading, T1 t(28) = 4.46, T2 t(28) = 9.17, and T3 t(28) = 8.13, ps < .001; for RAN, T1 t(28) = 2.49, p < .05, T2 t(28) = 3.31, p < .01, and T3 t(28) = 3.51, p < .01. In addition, on several other tasks, the group with dyslexia performed significantly more poorly as compared with the AM group at some, but not all, time points: on the visual matching task at T1, t(28) = 4.01, p < .001; on Chinese vocabulary definitions at T1, t(28) = 2.72, p < .05, and T3, t(28) = 2.47, p < .05; and on

84

Table 3 Group comparisons of the reading-related skills for group with dyslexia as compared with age- and reading-matched controls.

Chinese vocabulary

Chinese word reading

RAN

Phonological awareness

Morphological awareness

English word reading

English vocabulary knowledge

RM control (age 6 years) M (SD)

t1(28) Dyslexia vs. AM group

Effect size

t2(28) Dyslexia vs. RM group

Effect size

T1 T2 T1 T2 T3 T1 T2 T3 T1 T2 T3 T1 T2 T3 T1 T2 T3 T1 T2 T3 T1 T2 T3

– – – – 19.93 (8.35) – – 53.13 (24.60) – – 13.12 (3.12) – – 25.87 (7.65) – – 14.53 (5.58) – – 4.80 (9.41) – – 29.33 (12.33)

–4.01⁎⁎⁎ –1.42 –2.72⁎ –1.61 –2.47⁎ –4.46⁎⁎⁎ –9.17⁎⁎⁎ –8.13⁎⁎⁎ 2.49⁎ 3.31⁎⁎ 3.51⁎⁎ –1.75 –1.78 –1.34 –2.81⁎⁎ –2.54* –0.92 –0.83 –0.49 0.67 0.07 0.24 1.41

.60 .26 .46 .29 .42 .64 .87 .84 .43 .53 .55 .31 .32 .25 .47 .43 .17 .15 .09 .13 0 0 .26

– – – – 2.46⁎ – – –0.25 – – 0.25 – – 2.35⁎ – – 3.00⁎⁎ – – 5.45⁎⁎⁎ – – 3.19⁎⁎

– – – – .42 – – .05 – – .05 – – .41 – – .49 – – .72 – – .52

Note. AM, age-matched; RM, reading-matched. p < .05. ⁎⁎ p < .01. ⁎⁎⁎ p < .001. ⁎

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Visual matching

Time point

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Fig. 1. Line charts showing the estimated marginal means of visual search, RAN, Chinese word reading, and Chinese vocabulary across the three time points.

morphological awareness at T1, t(28) = 2.81, p < .01, and T2, t(28) = 2.54, p < .05. However, on English word reading and English vocabulary tasks, there were no differences between the two groups. The RM group was compared with the group with dyslexia at T3. Given their similar performance on the Chinese reading task, we hoped to identify any skills in dyslexic children that might be similar to their younger counterparts (i.e., those in the RM group). If such a pattern could be identified, it might suggest a developmental deficit in particular skills. Independent-samples t tests were used in identifying group difference on the tasks between the dyslexia and RM groups at T3. Except for a similar performance on the RAN task, on all of the other tasks, the dyslexic group outperformed the RM group: on Chinese vocabulary definitions, t(28) = 2.46, p < .05; on phonological awareness, t(28) = 2.35, p < .05; on morphological awareness, t(28) = 3.00, p < .01; on English word reading, t(28) = 5.45, p < .001; and on English vocabulary knowledge, t(28) = 3.19, p < .01. Considering the age gap between the two groups, the better performance of the group with dyslexia on all of the other reading-related tasks except for RAN demonstrated that the group with dyslexia had relatively typical development on those skills. However, the fact that these children’s RAN skill remained the same as that of their counterparts who were 2 years younger suggested a RAN deficit in the group with dyslexia in this study. The estimated marginal means of visual search, RAN, Chinese word reading, and Chinese vocabulary across the three time points are shown in Fig. 1 separately for the groups with dyslexia and those

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that were age matched. Because our sample size was small (15 for each group), we also examined the distribution of data of each group and found that a few measures at different time points for different groups did not show normal distributions. For the group with dyslexia, the kurtosis value reached 3.99 for T1 phonological awareness and 13.84 for T1 English word reading. For the AM group, there were large kurtosis values of 3.49 for T2 and 2.71 for T3 Chinese word reading as well as 2.92 for T3 morphological awareness. For the RM group, the kurtosis value was at 3.96 for T3 Chinese word reading. Such distribution patterns are perhaps partially attributable to the nature of this research design, which focused on a targeted group with a common deficit matched with selected groups, leading to a small size. Therefore, to be cautious about the analyses, we used a nonparametric test, the Mann– Whitney U test, to analyze the samples manifesting skewness and kurtosis that were too great, that is, with values that did not fall in the area of 2 SE. We found that results of t tests and Mann–Whitney U tests were in line with each other on all measurements.

Discussion By testing the sample groups over three time points, we were able to examine how some underlying cognitive deficits and general language skills change over time for those with dyslexia as compared with AM controls. In the current study, similar to their AM peers, Chinese children with dyslexia showed growth across most of the reading-related skills. Although a general lag was found for Chinese reading-related tasks (i.e., speed of processing, Chinese vocabulary, Chinese word reading, RAN, Chinese phonological awareness, and Chinese morphological awareness), our data did not show that the development of dyslexic children is deviant as opposed to delayed. In fact, the dyslexic children had progressed in the tested areas at a normal rate, as had the AM controls (Fig. 1). A similar pattern was observed by Manis, Custodio, and Szeszulski (1993), who followed a group of 21 dyslexic children between 9 and 15 years of age over a 2-year period. The dyslexic children had progressed in reading at a normal rate during the 2-year period, making an average gain of 2.2 grades on the Word Identification subscale of the Woodcock Reading Mastery Test. Yet, a different picture emerged from a study by Stanovich, Nathan, and Zolman (1988). These authors reported poor progress over 2 years in a group of less skilled readers relative to more skilled controls who were matched on initial reading skill. The poor readers had made only 1.5 grades of progress in reading, whereas the skilled readers had made greater than average progress and improved by 2.8 grades. The cognitive profiles of the poor readers in that study were similar to those of the skilled readers on tests tapping vocabulary knowledge, RAN, phonological awareness, and memory. These results suggested that the poor readers experienced a slower rate in their reading development. In the current study, the group with dyslexia closed the gap between themselves and the AM group on speed of processing skills at T2 and on morphological awareness skills at T3. They differed from the AM group only marginally on Chinese phonological awareness skills across all three time points. However, the group with dyslexia was consistently weaker than the AM group on Chinese word reading, Chinese vocabulary, and Chinese RAN tasks. Such a developmental pattern suggests that Chinese children with dyslexia continue to have basic difficulties with word reading and vocabulary knowledge, which reinforce one another over time, both in Chinese (Liu et al., 2013; Tong & McBride-Chang, 2010) and in English (e.g., Ouellette, 2006; Wise, Sevcik, Morris, Lovett, & Wolf, 2007). This pattern also demonstrates that Chinese children with dyslexia showed deficits not only in domain-specific areas such as RAN but also in broader language skills. A similar pattern was found for typical native English-speaking children (Nation & Snowling, 2004) and English-speaking children with dyslexia (Lyytinen & Lyytinen, 2004). Perhaps this suggests that for opaque orthographies such as English and Chinese, children with dyslexia are likely to manifest deficits in general oral language skills, a trend that is not usually found in children learning to decode relatively shallow orthographies such as German and Italian (Paulesu et al., 2001). Although a strong association was found between morphological awareness and vocabulary knowledge previously (McBride-Chang, Tong, Shu, et al., 2008), the improvement of morphological awareness skills does not necessarily predict growth in vocabulary knowledge. As an early marker of Chinese dyslexia (e.g., Lam et al., 2008, 2011; McBride-Chang, Lam, Lam, et al., 2008;

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McBride-Chang et al., 2012; Shu et al., 2006), morphological awareness was lower in the group with dyslexia as compared with the AM group in the current study. However, the two groups performed similarly on the task by T3 in the current study, as found in previous work on Chinese children with reading difficulties (e.g., Lei et al., 2011; McBride-Chang et al., 2012; Wong et al., 2010). Such a pattern seems to suggest that with age and acquisition, Chinese children with dyslexia can improve their morphological awareness, or at least compounding awareness, to the level of the typical reader. It is also possible that with development, morphological skills become less important relative to orthographic skills in the reading process (e.g., Chung et al., 2011). We did not include orthographic processing skills in the current study, but perhaps for older children basic lexical compounding abilities are subsumed under more subtle orthographic markers. One of the important findings in this study was the confirmation of a RAN deficit in Chinese children with dyslexia. When looking at our data at a single testing time, overall, the results of the comparisons between the children with dyslexia and the AM group confirmed some previous findings of the dominant cognitive deficit in Chinese children with dyslexia across different ages (e.g., Ho & Lai, 1999; Ho et al., 2002, 2004; McBride-Chang et al., 2012; Shu et al., 2006). In addition, when compared with the RM group on these skills at the final testing time, although they were significantly better on most tasks (as expected) because they were 2 years older than the RM group, the dyslexic children were found to show an equivalent performance on RAN, suggesting a developmental lag in this skill. This design took a retrospective approach to tracing back potential indicators of difficulties in reading development of children with dyslexia. Such an approach might help to confirm early risk factors that have also been identified through other research designs (Chung et al., 2011; Ho & Lai, 1999; Ho et al., 2004). Indeed, regardless of the language in which children learn to read, there have been several studies showing that RAN is associated not only with normal reading acquisition but also with reading disabilities (e.g., Bishop & League, 2006; Christodoulou & Alivisatos, 2004; de Jong & van der Leij, 2003; Di Filippo et al., 2006; Ho & Lai, 1999; Korhonen, 1995; Lyytinen et al., 2006; McBride-Chang & Manis, 1996; Shu et al., 2006; Wimmer, 1993). As suggested by Wolf and Bowers (1999), RAN can be regarded as a separate cognitive construct. Therefore, collectively, these findings with both a longitudinal AM comparison group and an RM comparison group confirm that a speeded naming deficit at an early age may be an important early cognitive indicator of later reading difficulties not only for alphabetic languages but also for Chinese. As a more basic processing skill to RAN, the general speed of processing in Chinese children with dyslexia was also found to be significantly slower than that in the AM group, although our data on general speed of processing covered only the first 2 years of testing in the current study for logistical reasons. The word decoding process is affected by the general visual processing speed in that rapid access allows children to integrate individual information of a word fast enough that they can capitalize on their limited working memory span to recognize each word (Kail & Hall, 1994). Deficits in both general speed of processing and RAN seem to suggest that, like those results for dyslexia in alphabetic languages such as English and German (e.g., Blachman, 1997; Bowers & Wolf, 1993; Snowling, 2000; Wimmer, 1993; Wolf, Bowers, & Biddle, 2000), this cognitive deficit may be an impairment in children with dyslexia and a reliable indicator of Chinese developmental dyslexia. In addition, across the three time points, children with dyslexia did not differ substantially from their AM peers on phonological awareness skills. Although the phonological deficit hypothesis (Stanovich, 1988, 1991) is by far the most popular one, in contrast to earlier findings for the English language (e.g., Hulme & Snowling, 1992; McDougall, Hulme, Ellis, & Monk, 1994; Olson, Rack, & Forsberg, 1990; Shankweiler, Liberman, Mark, Fowler, & Fischer, 1979), our study did not show that dyslexic children have in common deficiencies in the phonological domain when compared with their non-dyslexic counterparts. This suggests that although phonological difficulties likely are developmentally important for the emergence of reading difficulties, they do not necessarily constitute a single core deficit in Chinese children with dyslexia. Of course, this conclusion may be affected partly by the kinds of tasks used to tap phonological awareness and also the fact that Hong Kong Chinese children do not make use of phonological skills as directly as do Chinese children growing up in other places via Pinyin or Zhuyin Fuhao, rendering the importance of phonological awareness skills potentially less important in Hong Kong as compared with elsewhere.

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Along with the aforementioned findings, the current study also failed to find clear evidence for developmental difficulties in processing English as a second language in children with dyslexia. Although previous studies have demonstrated that Chinese children with dyslexia at 9 years of age also had difficulties in learning English as a second language (Chung & Ho, 2010b; Ho & Fong, 2005), our study identified such difficulties neither in English word reading nor in English vocabulary knowledge in our dyslexic samples across all three testing times. Ho and Fong (2005) suggested that any difficulties of Chinese children with dyslexia in English might be attributable to their core difficulties in English phonological awareness skills. However, such difficulties might not be inevitable in the Hong Kong educational context as these authors themselves demonstrated in a case study of a boy with dyslexia in Chinese whose performance in English did not lag behind those of his peers without reading difficulties. Unfortunately, in the current study, we did not test for English phonological awareness skills in these children. However, our Chinese phonological awareness measure included deletion tasks at both the syllable and phoneme levels. Previous studies have also demonstrated that a focus on native phonological awareness skills tends to be best in explaining variability in reading skills in both Chinese and English as a foreign language in Chinese children and that phonological awareness in Chinese and English in these children tends to be relatively strongly associated (McBride-Chang & Ho, 2005; Wang, Perfetti, & Liu, 2005). Thus, future studies should continue to examine the relationship of native Chinese and English as a foreign language in Chinese children with dyslexia, particularly in Hong Kong, where English language learning is highly valued from kindergarten onward. To summarize, in the current study, we have compared developmental patterns of reading Chinese and English in children with and without dyslexia from 6 to 8 years of age. The longitudinal comparison approach goes beyond previous correlational studies, allowing a trajectory view of reading development in Chinese dyslexia. The findings extend the available evidence related to a theory of multiple deficits in the manifestation of dyslexia in Chinese children (Ho et al., 2002), potentially to include vocabulary knowledge and speed of processing. Perhaps early identification of dyslexia in the Hong Kong context should also include measures of vocabulary knowledge and general speed of processing. We also demonstrated that dyslexia in Chinese does not necessarily ensure difficulties with English as a second language, at least in very young children. Importantly, at least one limitation of the current study was the small sample size of each group due to the cohort size. However, this study is one of the first to examine developmental patterns of Chinese and English reading skills in children with dyslexia as compared with children who do not have dyslexia but who are of the same age and of the same reading ability longitudinally. Future studies should further examine the cognitive differences, particularly in morphological and phonological awareness, that may underpin dyslexia in Chinese and their associations with (second language) English word reading.

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