Feng Guoyan, Shen Linling, Shi Liping, Yan Xiaohui, Liang Yuqiong, Zhang Lili, Zuo Shuyi, Wu Yu, Cao Fan
School of Public Administration, Guangzhou City Polytechnic, Guangzhou, China.
Department of Psychology, Sun Yat-Sen University, Guangzhou, China.
Dev Sci. 2025 Jul;28(4):e70038. doi: 10.1111/desc.70038.
Most behavioral interventions on reading disability (RD) have been developed in alphabetic languages and are phonologically-based. Chinese is a morpho-syllabic language in which each character represents a morpheme and a syllable. Therefore, phonologically-based interventions may not be most helpful in Chinese. In this study, we compared a phonological and a morphological intervention (MI) in Chinese children with RD both behaviorally and neurologically. We recruited 80 fifth-grade Chinese children, including 18 typically developing children as age controls (AC), and 62 children with RD, 22 of whom received the phonological intervention (PI), 22 of whom received the MI, and 18 served as waiting-list controls (WL). An auditory rhyming task and a visual spelling task were employed to examine brain activation before and after the intervention. We found that the PI and MI both effectively improved character naming, sentence reading fluency, one-minute irregular character reading and phonological awareness compared with the WL group. At the brain level, the PI group showed greater increase of brain activation in the right middle temporal gyrus than the MI and WL following the intervention in an auditory rhyming task, suggesting compensatory phonological strategies developed in PI. The MI group showed greater increase of brain activation in the left middle frontal gyrus, left inferior frontal gyrus and left fusiform gyrus than the PI and the WL group following the intervention in a visual spelling task, suggesting functional normalization, because these regions were less activated in children with RD than typical controls before the intervention. These findings suggest intervention-specific brain changes with otherwise similar effectiveness in the behavior. It provides important insights in understanding brain mechanisms underlying behavioral intervention in children with RD. Trial Registration: This study's design was preregistered at the Chinese Clinical Trial Registry (ChiCTR2300067536), see [https://www.chictr.org.cn].
大多数针对阅读障碍（RD）的行为干预措施是基于字母语言开发的，且以语音为基础。中文是一种形音义结合的语言，每个汉字代表一个语素和一个音节。因此，基于语音的干预措施对中文阅读障碍儿童可能并非最有帮助。在本研究中，我们从行为和神经学方面比较了针对中文阅读障碍儿童的语音干预和形态干预（MI）。我们招募了80名五年级中国儿童，其中包括18名发育正常的儿童作为年龄对照组（AC），以及62名阅读障碍儿童，其中22名接受语音干预（PI），22名接受形态干预，18名作为等待名单对照组（WL）。采用听觉押韵任务和视觉拼写任务来检查干预前后的大脑激活情况。我们发现，与等待名单对照组相比，语音干预和形态干预均有效提高了汉字命名、句子阅读流畅性、一分钟不规则汉字阅读和语音意识。在大脑层面，在听觉押韵任务干预后，语音干预组右侧颞中回的大脑激活增加幅度大于形态干预组和等待名单对照组，这表明语音干预中发展出了补偿性语音策略。在视觉拼写任务干预后，形态干预组左侧额中回、左侧额下回和左侧梭状回的大脑激活增加幅度大于语音干预组和等待名单对照组，这表明功能正常化，因为在干预前，阅读障碍儿童的这些区域比正常对照组激活程度更低。这些发现表明，在行为效果相似的情况下，干预措施会导致特定的大脑变化。这为理解阅读障碍儿童行为干预背后的大脑机制提供了重要见解。试验注册：本研究的设计已在中国临床试验注册中心（ChiCTR2300067536）进行预注册，见[https://www.chictr.org.cn] 。
