Investigating the Behavioral and Neural Impact of Skill and Goal-based Interventions in Adults with Dyslexia
Creators: Cheema, Kulpreet
Publisher: name: University of Alberta Library
Year: 2023

<p>Developmental dyslexia is a neurodevelopmental disorder that is characterized by persistent reading and spelling difficulties despite adequate intelligence and educational opportunities. In addition to literacy-based difficulties, individuals with dyslexia also have difficulties with their psychosocial health, including low self-efficacy and self-esteem, and high anxiety and depression. The majority of intervention programs for dyslexia target the literacy skills of reading and writing (i.e., skill-based interventions), while ignoring the psychosocial outcomes of self-efficacy, anxiety, and motivation (i.e., psychosocial-based interventions). Furthermore, the neurobiological mechanisms behind the brain organization following training in adults with dyslexia is not well-known.<br>
In this dissertation, the overall objective was to investigate the behavioral and neural impact of skill-based and psychosocial-based interventions in adults with dyslexia. The behavioural impact of the interventions was assessed with a combination of standardized literacy measures and patient-centered outcome measure called Goal Attainment Scaling. The neurobiological impact of intervention was assessed with a neuroimaging methodology called Functional Near-Infrared Spectroscopy (fNIRS).<br>
    These objectives were achieved by a combination of behavioral experiments, feasibility studies and intervention studies. In the first study, we found that adults with dyslexia faced persistent difficulties with sound, orthographic and morphological awareness. Furthermore, sound and morphological awareness were positively related to reading and spelling performance in adults with dyslexia. These results formed the basis of the content of the skill-based training (as covered in studies 3 &amp; 4).</p>

<p>The second study aimed to assess the feasibility and efficacy of a psychosocial-based intervention called bibliotherapy intervention. This bibliotherapy-based intervention consisted of participants reading a self-help book called 10 Days to Self-Esteem for four weeks. The feasibility analysis revealed a low-to-moderate adherence and completion of the intervention. The feedback from study participants indicated certain limitations in the training that were addressed in the development of the skill- and goal-based training programs in the next chapters.<br>
This was followed by the third study, in which we assessed the feasibility of the two online intervention programs that were developed in-house. The first intervention program was called the Skill-based intervention, which involved training and development of literacy skills in form of weekly video lessons and assignments. An online platform was designed to deliver the intervention, and feedback from user testing was incorporated before the launch of the training platform. The second intervention program was called the Goal-based intervention, which was a type of psychosocial-based intervention. In this training, participants completed strategies and activities to fulfil their personalized goals. Another pilot study with individuals with dyslexia was performed to assess the feasibility of the program. The study procedure of both programs was modified in response to the feedback. <br>
In the fourth and fifth studies, the effectiveness of two intervention programs on behavioural (literacy and psychosocial outcomes) and neural-based outcomes was assessed in adults with dyslexia in an eight-week intervention study. Results revealed significant improvements in reading performance, comprehension and reading motivation for both intervention groups. In terms of brain activation results, there was evidence for both normalizing (i.e., increased activation in brain regions of reading network) and compensatory (i.e., increased activation in brain areas outside of reading network) patterns of change, but these were restricted to the Skill-based group. These results add to the evidence for the possibility of plasticity in brain areas in adulthood and provide information about the specific brain regions for future intervention studies. Overall, this dissertation has revealed important insights into the behavioural and neurobiological underpinnings of intervention in adults with a persistent history of reading difficulties.</p>