Biomedical Engineering Reference
In-Depth Information
As Figure 14.5 shows, it is difficult to find one reading disorder with the same underly-
ing problems as another. In fact, with reference to reading as a third-type module, it can be
seen from the diagram that the malfunction, which results ultimately in a reading disor-
der, may concern any one of the modules or submodules concerned (in generally different
ways): the attentional resources and executive functions (central processor), language
(language) or any of its components (e.g., perception of elementary sounds), visuopercep-
tual aspects (e.g., coordination of perceived unities), and visuospatial attention. In other
words, the malfunctioning of one or more of the processes indicated above will be man-
ifested according to different profiles, thus demonstrating the notable heterogeneity of
reading disorders.
From the model we are able to say that a reading disorder may depend upon the hypode-
velopment of or damage to one or more of the several subcomponents (the central proces-
sor, dedicated processor, and several first- or second-type modules in various percentages).
In reality, the situation is even more complex if one considers the complete functional
architecture of reading: I refer to the two-way model (e.g. Shallice 1988). The graphic/pho-
nological system of conversion alone, according to Moscovitch and Umiltà (1990), would
already constitute a third-type module.*
With reference to dyslexia, given the neuropsychological complexity of the process,
the moment of assessment is extremely delicate. The etiology of the disorder, although
still not yet perfectly known (Esgate et al. 2005), in the light of the most recent theories,
is multifactorial (Manis et al. 1996; Segalowitz and Rapin 2002; Esgate et al. 2005) and it
would therefore be necessary in the assessment to define a profile of neuropsychological
function that could (as previously illustrated) vary considerably from case to case.
In the case of a child diagnosed with dyslexia, the disorder could be based on linguistic
difficulties (for example, phonological or metaphonological) or visuoperceptual (for exam-
ple, visual search, visuospatial attention with consequent crowding effect), or both of
the above, thus considerably aggravating the clinical picture. There could also be (again
according to the model previously set forth) difficulties at the level of attentional resources
and executive functions necessary for the assemblage of the submodules (for example,
working memory, inhibition and control of irrelevant stimuli, and planning).
From this perspective it is possible to identify an effective treatment, specific and tar-
geted, making use of all that AT can offer nowadays. In England (HMSO 1995) and in the
United States (US 2004), a SLD such as dyslexia is considered a true disability: “A disability
can arise from a wide range of impairments which can be: developmental, such as autistic
spectrum disorders (ASD), dyslexia and dyspraxia, learning difficulties” (HMSO 1995 A6)
and is therefore considered as falling within the purview of the general law on disability:
The term “child with a disability” means a child with—mental retardation, hearing
impairments (including deafness), speech or language impairments, visual impair-
ments (including blindness), serious emotional disturbance (hereinafter referred to
as “emotional disturbance”), orthopedic impairments, autism, traumatic brain injury,
other health impairments, or specific learning disabilities (US 2004, Sec. 620).
On the contrary, in Italy, from a legal point of view a SLD is not considered a disability,
and so a specific law was passed (No. 170) in October 2010 with the aim of protecting the
* In Italy, this research is being performed by Professor F. Benso (University of Genova), whose publications
on the subject are currently available only in Italian: Benso, F. (2010).
Sistema Attentivo-Esecutivo e Lettura. Un
Approccio Neuropsicologico alla Dislessia
. Torino, IT: Il Leone Verde; Idem (2004).
Neuropsicologia Dell'Attenzione.
Teoria e Trattamenti nei Disturbi dell'Apprendimento
. Pisa, Italy: Edizioni del Cerro.
