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Combing accelerated theta burst simulation with reading instruction: A RARE treatment model for persistent dyslexia
Poster Session B, Friday, September 12, 4:30 - 6:00 pm, Field House
This poster is part of the Sandbox Series.
C Nikki Arrington1, Lincoln Haugh1, Rachael M Harrington1, Adianes Herrera-Diaz1, Robin Morris1; 1Georgia State University
Developmental dyslexia (DD) is a neurodevelopmental disorder that results in poor reading proficiency due to atypical neurobiological attributes. Despite many opportunities to learn, the most resistant cases of DD can still have severe reading problems that persist into adulthood. Although there are several remediation techniques that can be effective for children with DD, there are no additional treatment options for adults with persistent, treatment-resistant DD. In addition, making changes in reading behaviors in adults with DD is challenging due to their age-related decreased potential for neuroplasticity in neural circuits that support reading. This population may be ideally suited for a neuromodulatory adjunct to traditional education-based treatment. The current study aims to assess the impact of a combined accelerated theta burst stimulation (aTBS) and an individualized educational intervention paradigm to improve reading outcomes in young adults with persistent DD. Specifically, we utilized aTBS as a tool to modulate cortical excitability to enhance reading outcomes in response to reading intervention. This multiple baseline, single-subject design is the first to assess the effectiveness of combining aTBS and an individualized reading intervention program for the treatment of DD. The current, ongoing pilot study included native English speakers between 18 and 30 years of age (mean age = 21.25) with a documented or suspected history of DD or other reading disability. All subjects met study-based criteria for reading impairment as identified by scoring below age-norm expectations on at least one subtest of a standardized reading measure (TOWRE-2, WJ-IV) and tested into the study reading intervention curriculum (level B2 or C on SRA Corrective Reading Decoding Placement Test). Two to four subjects were run concurrently in a cohort design. Each cohort participated in 10 nonconsecutive treatment days over five weeks, with two to three treatment days per week, each with two treatment sessions per day (20 sessions). Treatment days consisted of two sessions that included an aTBS session immediately followed by a one-on-one 30-minute reading intervention administered by a trained reading specialist. Each subject received a minimum of two baseline days which included sham aTBS plus reading intervention. Subjects were then randomized into active stage start day which included active aTBS plus reading intervention. Daily oral reading fluency assessments, completed at the beginning of each treatment day, included a selection of passages from the Texas Middle School Fluency Assessment designed to measure growth in reading. Passages were identified to be consistent with subjects’ Lexile reading level (mean = 1120.5). Words read per minute and total errors were calculated as measures of oral reading fluency and accuracy. Preliminary results indicate that combined aTBS and behavioral reading intervention improves oral reading fluency and accuracy above reading intervention alone. Those with more active aTBS sessions showed great gains in reading. Additionally, those subjects with a lower reading level at baseline (SRA B2) showed greater gains than those who tested at a higher reading level. As such, increasing neuroplastic potential with aTBS may help to improve reading in those with persistent DD, when used as an adjunct to behavioral intervention.
Topic Areas: Reading, Disorders: Developmental