Brain and Cognition 2012-Libre

Brain and Cognition 80 (2012) 311327
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Brain and Cognition

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Project DyAdd: Visual attention in adult dyslexia and ADHD

Marja Laasonen a,b,, Jonna Salomaa a, Denis Cousineau c, Sami Leppmki d, Pekka Tani d,
Laura Hokkanen a, Matthew Dye e
a
Institute of Behavioural Sciences, Division of Cognitive and Neuropsychology, University of Helsinki, Helsinki, Finland
Department of Phoniatrics, Helsinki University Central Hospital, Helsinki, Finland
c
cole de psychologie, Universit dOttawa, Canada
d
Department of Psychiatry, Clinic for Neuropsychiatry, Helsinki University Central Hospital, Helsinki, Finland
e
Department of Speech & Hearing Science, University of Illinois at Urbana-Champaign, USA
b
a r t i c l e
i n f o
Article history:
Accepted 9 August 2012
Available online 6 October 2012
Keywords:
ADHD
Attentional blink
Dyslexia
Multiple object tracking
Spatial attention
a b s t r a c t
In this study of the project DyAdd, three aspects of visual attention were investigated in adults (18
55 years) with dyslexia (n = 35) or attention deficit/hyperactivity disorder (ADHD, n = 22), and in healthy
controls (n = 35). Temporal characteristics of visual attention were assessed with Attentional Blink (AB),
capacity of visual attention with Multiple Object Tracking (MOT), and spatial aspects of visual attention
with Useful Field of View (UFOV) task. Results showed that adults with dyslexia had difficulties performing the AB and UFOV tasks, which were explained by an impaired ability to process dual targets, longer
AB recovery time, and deficits in processing rapidly changing visual displays. The ADHD group did not
have difficulties in any of the tasks. Further, performance in the visual attention tasks predicted variation
in measures of phonological processing and reading when all of the participants were considered
together. Thus, difficulties in tasks of visual attention were related to dyslexia and variation of visual
attention had a role in the reading ability of the general population.
2012 Elsevier Inc. All rights reserved.
1. Introduction
Dyslexia and attention deficithyperactivity disorder (ADHD)
are two of the most common developmental disabilities (Polanczyk,
de Lima, Horta, Biederman, & Rohde, 2007; Snowling & Maughan,
2006), both of which affect at least 5% of a population (Faraone,
Sergeant, Gillberg, & Biederman, 2003; Katusic, Colligan, Barbaresi,
Schaid, & Jacobsen, 2001). The conditions also often co-occur; up
to 45% of those with ADHD or dyslexia fulfill the diagnostic criteria
of the other disability (Carroll, Maughan, Goodman, & Meltzer,
2005; Dykman & Ackerman, 1991; Willcutt & Pennington, 2000).
Accordingly, it has been suggested that the disabilities may be
related at some level of analysis.
At the biological level of analysis, dyslexia and ADHD have been
shown, for example, to share genetic influences (Gayn et al., 2005;
Gilger, Pennington, & DeFries, 1992; Willcutt, Pennington, &
DeFries, 2000; Willcutt et al., 2002) and fatty acid status characteristics (Horrobin, 1998; Horrobin & Bennett, 1999; Horrobin, Glen, &
Hudson, 1995; Laasonen, Hokkanen, Leppmki, Tani, & Erkkil,
2009a, 2009b). At the clinical neuropsychological level, individuals
often display symptoms of both disabilities even without a double
Corresponding author. Address: Institute of Behavioural Sciences, P.O. Box 9
(Siltavuorenpenger 1), FIN-00014 University of Helsinki, Finland. Fax: +358 9
19129443.
E-mail address: Marja.Laasonen@helsinki.fi (M. Laasonen).
0278-2626/$ - see front matter 2012 Elsevier Inc. All rights reserved.
http://dx.doi.org/10.1016/j.bandc.2012.08.002
diagnosis. Impaired phonological processing (Bradley & Bryant,

1978, 1983) and poor word identification or reading (Critchley,
1970; Orton Dyslexia Society, 1994), which characterize developmental dyslexia, have been found to be affected also in ADHD
(Laasonen, Lehtinen, Leppmki, Tani, & Hokkanen, 2010). On the
other hand, the behavioral symptoms of ADHD, that is, hyperactivity, impulsivity, and inattention (American Psychiatric Association,
1994; World Health Organization, 1998), are often elevated in individuals diagnosed with dyslexia (Carroll et al., 2005). Finally at the
cognitive level of analysis, those with dyslexia have been shown to
suffer from impairments in, for example, temporal processing or
acuity (Laasonen, Service, & Virsu, 2001, 2002; Tallal, 1980), attention (Hari & Renvall, 2001; Hari, Renvall, & Tanskanen, 2001),
short-term and working memory (Siegel, 1994), and learning
(Nicolson, Daum, Schugens, Fawcett, & Schulz, 2002; Vicari,
Marotta, Menghini, Molinari, & Petrosini, 2003). In ADHD research,
cognitive deficits have been suggested, for example, in executive
functions (Barkley, 1997; Castellanos & Tannock, 2002; Pennington
& Ozonoff, 1996; Schachar, Mota, Logan, Tannock, & Klim, 2000),
delay aversion (Sonuga-Barke, 2003), regulation of arousal and
activation (Sergeant, 2000), and temporal processing (Barkley,
Murphy, & Bush, 2001; Toplak, Rucklidge, Hetherington, John, &
Tannock, 2003).
Thus, there seems to be similarities between the two disabilities
at several levels of analysis, but the shared and differentiating
312
M. Laasonen et al. / Brain and Cognition 80 (2012) 311327
characteristics are yet to be determined. The general aim of the

DyAdd project (Adult Dyslexia and Attention Deficit Disorder in
Finland) is to find such differentiating and shared characteristics
at each of these levels of analysis, using biological and clinical neuropsychological methods, and experimental studies of cognition
(Laasonen, Hokkanen, et al., 2009a, 2009b; Laasonen, Lehtinen,
et al., 2010; Laasonen, Leppmki, Tani, & Hokkanen, 2009). The focus of the study reported here is on investigations of visual attention skills in adults with dyslexia and ADHD.
1.1. Visual attention, dyslexia, and reading impairment
Developmental dyslexia is a learning disability presumably
neurological in origin that is characterized by deficits in accurate,
fluent word recognition, and weaknesses in spelling and print
decoding (Sawyer, 2006), with diagnosis often based upon a significant discrepancy between observed reading skills and those expected on the basis of IQ, age, and level of education (Shovman &
Ahissar, 2006). Dyslexia often persists into adulthood and can present secondary problems such as poor reading comprehension, disordered handwriting, clumsiness, forgetfulness, distractibility, and
weak phonological processing. Furthermore, there is a significant
co-morbidity between dyslexia and other learning disabilities such
as ADHD (Shovman & Ahissar, 2006).
The most widely accepted theory of the proximal cause of dyslexia is the phonological deficit theory, which posits that people
with dyslexia cannot encode phonemes as well as typical readers
can, resulting in reading difficulties (Shovman & Ahissar, 2006).
However, some authors have suggested that dyslexia could be
caused by deficits or differences in visual attention processes
(e.g., Bosse, Tainturier, & Valdois, 2007; Facoetti, Lorusso, Cattaneo,
Galli, & Molteni, 2005; Facoetti et al., 2010; Hari & Renvall, 2001;
Hari et al., 2001; Valdois, Bosse, & Tainturier, 2004). Visual deficit
theories propose that reading is a demanding task for the visual
system, requiring fine spatial discrimination and rapid temporal
processing. Further, it suggests that some individuals with dyslexia
may have a visual processing deficit, making the task of reading
more difficult (Shovman & Ahissar, 2006). The magnocellular deficit
theory expands upon this further by suggesting that this deficit occurs along the magnocellular visual pathway, which is more sensitive to direction of movement, direction of gaze, visuospatial
attention, eye movements, and peripheral vision (Stein & Walsh,
1997). Deficiencies in this system can be detected when testing visual motion sensitivity at low contrast and light levels, and is usually found to be mildly affected in dyslexia, if at all. However,
according to some research, this mild deficit in magnocellular
function or organization multiplies up to greater deficits in the
posterior parietal cortex, which is dominated by magnocellular
properties (Stein & Walsh, 1997). Further evidence for the importance of the posterior parietal cortex in reading ability can be
found in cases of acquired reading disorders that resulted from injury to the posterior parietal cortex (Stein & Walsh, 1997). While
some studies have failed to find evidence of a magnocellular deficit, it has been suggested that there are multiple subtypes of dyslexics, some with more phonological deficits (dysphonetic
dyslexia), some with more visual deficits (dyseidetic dyslexia),
and some with both (dysphoneidetic dyslexia) (Stein & Walsh,
1997).
In recent years, two research groups have taken novel approaches in developing a visual deficit theory that takes into account the reported magnocellular deficits. Sylviane Valdois and
colleagues have suggested that dyseidetic dyslexia stems from
reading problems due to limitations in the number of distinct visual
elements that can be processed in parallel from a multi-element
array. Valdois refers to this as a limitation in the size of the visual
attention span in dyseidetic dyslexics (Bosse et al., 2007). This visual
attention span deficit hypothesis proposes that there is a deficit in

the distribution of visual attention across a string of letters of
symbols, which limits the number of letters that can be processed
during reading. In support of this hypothesis, they found that as a
group, dyslexic children perform worse on visual-attention span
tasks than non-dyslexic children. Furthermore, they found that
the dyslexic groups performance on visual attention tasks was a
significant predictor of their performance on the reading accuracy
tests (Bosse et al., 2007). Similarly, Facoetti and colleagues have
proposed that dyseidetic dyslexics have a visual attention deficit,
but stemming from a graduated change in how visual attention
is distributed across words (Facoetti & Molteni, 2001). Their
studies have reported an abnormal and asymmetric distribution
of attention across words in dyslexic children and adults, suggesting inattention to letters left of fixation and an over-emphasis on
letters to the right of fixation (Facoetti & Molteni, 2001). Unlike
Valdois, who focuses only on the number of items in a letter string,
Facoetti perceives the spatial distance between the fixation point
and the target letters to be important.
In addition to this research implicating compromised spatial visual attention in individuals with dyslexia, there have also been
suggestions that temporal aspects of visual attention are impaired.
One task that has been used widely in dyslexia research, with
conflicting results, is the Attentional Blink (AB) task (Raymond,
Shapiro, & Arnell, 1992). Children and adults with dyslexia have
often been interpreted to differ from their controls in attentional
blink (see however, Badcock, Hogben, & Fletcher, 2008; Buchholz
& Davies, 2007; Facoetti, Ruffino, Peru, Paganoni, & Chelazzi,
2008; Hari, Valta, & Uutela, 1999; Lacroix et al., 2005; Lallier,
Donnadieu, & Valdois, 2010; McLean, Castles, Coltheart, & Stuart,
2010; Visser, Boden, & Giaschi, 2004). Most often, this has been
suggested to result from a prolonged blink (Buchholz & Davies,
2007; Facoetti et al., 2008; Hari et al., 1999; Visser et al., 2004).
However, as recently reviewed by McLean and colleagues (2010),
most of the evidence is for poorer dual-target task performance
in those with dyslexia and not for a specific attentional blink
deficit. McLean and colleagues (2010) concluded that previous
research does not support a prolonged attentional blink since the
detect-if-identified performance has recovered by 600 ms. They
suggest further, that there is no evidence for a deeper attentional
blink either, since previous research has resulted only in significant
main effects of group, not group by lag interactions, for the T2
detection accuracy in the dual target condition. This is true with
two exceptions. First, Lacroix and colleagues (2005) found a
significant group lag interaction but in their sample dyslexic
adolescents tended to perform better than their controls. Second,
Lallier and colleagues (2010) found in small groups of dyslexic
and fluently reading children a significant main effect of group
together with a significant interaction of group lag and a poorer
attentional blink minimum in those with dyslexia (Cousineau,
Charbonneau, & Jolicoeur, 2006). Large age variation within the
dyslexic group and various exclusion criteria make interpretation
of the results of the latter study difficult. Previous research has also
suggested that the AB task correlates with phonological processing,
especially Rapid Automatized Naming (RAN), in combined samples
of dyslexic children or adults and their healthy controls (Badcock
et al., 2008; Lallier et al., 2010; McLean et al., 2010) and within
samples of healthy developing readers or adults (Arnell, Joanisse,
Klein, Busseri, & Tannock, 2009; McLean, Stuart, Visser, & Castles,
2009). Further, AB task performance has been found to correlate
and predict reading ability in combined samples of dyslexic children and their healthy controls or within healthy developing readers (Facoetti et al., 2008; Lallier et al., 2010; McLean et al., 2009).
Thus, there is some evidence for deficits in spatial and temporal
aspects of visual attention that may contribute to some of the
reading difficulties experienced by individuals with dyslexia.
Specifically, dyslexic individuals appear to differ from typical readers in how they allocate their visual attention spatially across text,
and in how successfully they can attend to multiple targets in rapid, transient visual inputs.
1.2. Visual attention, ADHD, and inattention
ADHD is a behavioral disorder with onset usually occurring in
childhood. It is characterized by lack of persistence, impulsivity,
and excessive activity (American Psychiatric Association, 1994;
World Health Organization, 1998). Behavioral difficulties related
to inattention are one of the bases of ADHD diagnosis (American
Psychiatric Association, 1994; World Health Organization, 1998),
although it has been suggested that perhaps not all people with
ADHD suffer from such neuropsychological or cognitive deficits
(Nigg, Willcutt, Doyle, & Sonuga-Barke, 2005). Studies that have
examined visual attention in children with ADHD have reported
possible differences in visuospatial orienting of attention (Nigg,
Swanson, & Hinshaw, 1997; Swanson et al., 1991), accompanied
by inattention to the left visual field (Jones, Craver-Lemley, &
Barrett, 2008; Nigg et al., 1997). However, there is some evidence
that deficits on visuospatial attention tasks in those with ADHD
could be attributed to an inability to sustain attention to the task
(Dobler et al., 2005; George, Dobler, Nicholls, & Manly, 2005). In
the temporal domain, previous research with both children and
adults has suggested a prolonged attentional blink associated with
ADHD (cf. significant group lag interactions, Armstrong &
Munoz, 2003; Hollingsworth, McAuliffe, & Knowlton, 2001; Li,
Lin, Chang, & Hung, 2004). However, there is a corresponding number of studies suggesting that the attentional blink is not elongated
in those with ADHD compared to the controls (Carr, Henderson, &
Nigg, 2010; Carr, Nigg, & Henderson, 2006; Mason, Humphreys, &
Kent, 2005). Further, the control groups in the studies suggesting
an impairment have been poorly characterized those with ADHD
have had comorbid conditions, or those with ADHD have had
difficulties with the baseline task or in the T1 identification component of the dual task (Armstrong & Munoz, 2003; Hollingsworth
et al., 2001; Li et al., 2004).
1.3. Characterizing visual attention deficits in dyslexia and ADHD
The current study focuses on three separate aspects of visual
attention, looking at group differences between adults with dyslexia or ADHD, and the relationships between visual attention task
performance and various clinical neuropsychological measures in
these populations. Tasks were selected to provide measures of visuospatial attention (Useful Field of View or UFOV; Ball, Beard,
Roenker, Miller, & Griggs, 1988), temporal attention (Attentional
Blink or AB; Raymond et al., 1992) and visuospatial attentional
capacity (Multiple Object Tracking or MOT; Pylyshyn & Storm,
1988). Previous research with children and adults has suggested
that these three tasks measure separable, relatively independent
aspects of attention in the visual modality (Dye & Bavelier, 2010).
The UFOV task consisted of two experimental conditions. In the
first, each participant made a two alternative forced choice decision requiring discrimination of a central stimulus, while simultaneously localizing a peripheral stimulus. In the second condition,
the peripheral targets was embedded in a field of distractors. Ball
and colleagues (Ball et al., 1988; Okonkwo, Wadley, Ball, Vance,
& Crowe, 2008) have defined these conditions as reflecting divided
attention (the condition without distractors) and selective attention
(the condition with distractors). Work by Bavelier, Dye, and colleagues (Dye & Bavelier, 2010; Dye, Hauser, & Bavelier, 2009;
Green & Bavelier, 2006a) has further characterized how the UFOV
task provides an index of how visual selective attention is distrib-
313
uted across a spatial scene when attention has to be divided or

allocated across central and peripheral locations.
The AB task was conducted using two conditions, and with letters as stimuli. In the first, baseline, condition, each participant had
to detect the presence or absence of a black target letter X within a
stream of rapidly changing black letters. In the second dual-task
condition, the participant had to both identify a white letter and
then to detect the presence or absence of the black target. The
attentional blink measures the capacity (or lack of) to switch attention rapidly to a second object while keeping the first in working
memory. Some models of AB suggest that the second target is perceived but is not processed as long as the processing of the first target is incomplete (Jolicoeur, 1999).
Finally, in the MOT task, participants were required to track a
variable number of blue dots. They had to simultaneously track
1, 3, 5, or 7 blue dots within a larger set of yellow dots. Various
models of MOT have been suggested (for reviews, see Cavanagh
& Alvarez, 2005; Oksama & Hyn, 2004; Scholl, 2009) that try to
explain how the tracking of multiple objects is enabled. One of
the main differences between the models is whether there are a
single or multiple foci of attention. For example, the targets could
be mentally grouped together and followed with a single focus of
attention, a single focus of attention could be rapidly moved from
one target to another, or each target could attract an index that
are serially followed by a single focus of attention. Alternatively,
each target could attract one focus of a multifocal attention or
there could be object files that track and process the moving targets with multiple foci. It is also possible that both parallel and serial processes are required in the process of tracking (Oksama &
Hyn, 2004, 2008). Previous research has suggested that MOT
performance is related to various aspects of visuospatial memory
(e.g., short-term memory (STM): Oksama & Hyn, 2004, 2008;
WM, Zhang, Xuan, Fu, & Pylyshyn, 2010) and attention (attention
switching, Oksama & Hyn, 2004, 2008; inhibition, Pylyshyn,
2006; e.g., Scholl, 2009). While this task has not been used in dyslexia or ADHD research before, it provides one measure of how
well visual attention can be allocated to multiple objects. However,
the visual attention span deficit theory of dyslexia (e.g., Bosse et al.,
2007) predicts that some individuals with dyslexia have problems
encoding multiple letters in visual working memory during the
reading process. To the extent that MOT performance provides
an index of this ability, it is possible that dyslexic individuals will
perform more poorly.
1.4. Aims and hypotheses
The first aim of the current study was to compare the performance of dyslexic, ADHD, and healthy control adults on these three
aspects of visual attention. We aimed to determine whether the
participants with dyslexia or ADHD suffer from difficulties compared to the healthy controls, and to clarify whether the possible
difficulties were shared between or specific to the clinical groups.
Based upon the literature reviewed above, we predicted that individuals with dyslexia would perform worse than healthy controls
on all measures of visual attention (UFOV, AB, and MOT). We also
expected broad deficits stemming from general inattention in individuals with ADHD to manifest as an impairment relative to
healthy controls on all three visual attention tasks. Of interest is
whether the observed patterns of deficits serve to differentiate
individuals with dyslexia from those with ADHD.
The second aim was to investigate relationships between these
different aspects of visual attention and performance on clinical
neuropsychological measures that are typically used to characterize dyslexia or ADHD. We predicted that performance in
attentional tasks that are impaired in individuals with dyslexia
would be related to phonological processing, reading, spelling,
314
and arithmetic (difficulties often comorbid with dyslexia, Landerl &

Moll, 2010), and performance in attentional tasks that are impaired
in individuals with ADHD would be related to executive functions
and attention.
2. General material and methods
A full description of the methods used in the project DyAdd can
be found in a previous article (Laasonen, Leppmki, et al., 2009).
2.1. Participants
All participants were volunteers and provided their informed
consent. The appropriate ethical committee of Helsinki University
Central Hospital approved the project.
2.1.1. Dyslexia
Participants (n = 35) in the dyslexia group were required to
have a prior diagnosis of dyslexia as an inclusion criterion. Their
diagnoses were based on achievement criteria that varied slightly
across recruitment sites. Therefore, the current phonological processing and reading status of each participant in this group was
checked against the age-corrected values of our previous (Laasonen, 2002) and current control data. Participants in the dyslexia
group performed more than 1 standard deviation below average
in phonological processing and reading as assessed with phonological naming (rapid alternate stimulus naming (RAS) speed/accuracy, Wolf, 1986), phonological awareness (phonological
synthesis accuracy, Laasonen et al., 2002), phonological memory
(WAIS digit span forward length, Wechsler, 2005), and reading
(oral reading speed/accuracy, task details in, Laasonen et al.,
2002). See Appendix A for the values. One participant with diagnosed dyslexia and a history of reading difficulties was impaired
only in phonological processing. We chose to include this participant in the dyslexia group, since it has been suggested that childhood dyslexia could manifest itself only in phonological difficulties
in adulthood (Daryn, 2000; Felton, Naylor, & Wood, 1990). Thus, in
this paper the label dyslexia refers to the common form reading
difficulty that combines with phonological difficulties, not, for
example, to attentional dyslexia, letter position dyslexia, or neglect
dyslexia. Diagnosis of ADHD and/or a history of ADHD-related difficulties were exclusion criteria for the dyslexia group.
2.1.2. ADHD
Participants (n = 22) in the ADHD group were required to have a
prior diagnosis of ADHD as an inclusion criterion. They were all
diagnosed according to DSM-IV criteria (American Psychiatric
Association, 1994) using CAADID (Epstein, Johnson, & Conners,
2001) by a medical doctor specialized in neuropsychiatry (author
SL or PT in most cases). Confounding psychiatric disorders were excluded by SCID-I (First, Spitzer, Gibbon, & Williams, 1996) and
SCID-II interviews (First, Gibbon, Spitzer, Williams, & Benjamin,
1997). Thus, hyperactivity was not a required characteristic, and
also those with only inattention were included. Therefore, in this
paper the label ADHD refers both to those with attention deficit
disorder (ADD) and those with ADHD. Diagnosis of dyslexia and/
or a history of reading difficulties were exclusion criteria for the
ADHD group.
2.1.3. Comorbid
The current sample included also eight comorbid participants,
that is, they had both dyslexia and ADHD diagnoses. This group
was included only in the regression analyses relating visual attention task performance to clinical neuropsychological measures, due
to its small size.
2.1.4. Control
Diagnosis of ADHD, diagnosis of dyslexia, a history of reading
difficulties, or history of ADHD-related difficulties were exclusion
criteria for the control group (n = 35).
2.1.5. General inclusion and exclusion criteria
Finnish as a native language and age 1855 years were inclusion criteria for all the groups. General exclusion criteria were
brain injury, a somatic or psychiatric condition affecting cognitive
functions (including major depression), psychotropic drugs affecting cognitive functions, and substance abuse. Blood samples were
collected to rule out endocrinopathies (e.g., dysfunction of the thyroid gland), diabetes, renal dysfunction, abuse of alcohol, and similar somatic states which might compromise cognitive functions.
Laboratory tests included hemoglobin, RBC, WBC, platelet count,
thyroid stimulating hormone, serum creatinine, alanine aminotransferase, gamma-glutamyltransferase, and fasting blood glucose. Patients with ADHD participated in the project
unmedicated. If they were currently using methylphenidate, a
wash-out period of at least 1 week was required before and during
the study appointments. ADHD participants with medication with
a longer half-life than methylphenidate were excluded from the
project. WASI full intelligence quotient (FIQ) (Wechsler Abbreviated Scale of Intelligence, Wechsler, 2005) was required to be at
least 70 (that is, within 2 standard deviations from the average)
due to the ICD-10 criteria for specific reading disorder (World
Health Organization, 1998).
Demographic characteristics of the participants are presented in
Table 1. The groups did not differ statistically in terms of age,
F(3, 96) = 1.367, p = .257, gender, v2(3) = 4.112, p = .250, educational level, v2(6) = 9.383, p = .153, or handedness, v2(3) = 2.641,
p = .450. This was achieved by screening the participants into balanced cohorts according to the first three characteristics. The
groups differed in their FIQ, F(3, 96) = 3.043, p = .033, with the
ADHD group having statistically significantly lower FIQs than the
controls (p = .028). FIQ was used as a covariate in analyses when
comparing differences between ADHD and control groups, but in
no case did it have an effect on statistical significance of other factors or interactions.
2.2. General apparatus and procedures in tasks of visual attention
Stimuli were presented with a computer (Power Mac G4,
256 MB; Mac OS 9) that was attached to an LCD touchscreen (1900
Elo Touchsystems 1925L; refresh rate 75 Hz, resolution
1280 1024). Tasks were administered with Psychtoolbox version
2.55 (Brainard, 1997; Pelli, 1997) run by Matlab version 5.2.1. Responses were accepted via a standard keyboard and a chin rest was
used to control both viewing distance (36 cm) and vertical position
(eyes and point of fixation lined). Participants were tested individually and the experimenter was blind to the participants group
(control, ADHD, dyslexic, or comorbid). The order of the three visual attention tasks was counterbalanced, and each was administered as the first, second, or third task the same amount of times
within each group.
2.3. Neuropsychological tasks
The neuropsychological tasks were part of a larger neuropsychological battery, which is described in more detail in previous
studies (Laasonen, Hokkanen, et al., 2009a; Laasonen, Lehtinen,
et al., 2010). The current study focused on domains that characterize dyslexia or ADHD, that is, phonological processing, technical
reading, reading comprehension, spelling, arithmetic, executive
functions, and attention. The variables are described below and
in Table 2. A more detailed description of the tasks and group com-
315
Table 1
Demographic characteristics of the participants.
Group
Control
ADHD
Dyslexia
Comorbid
35
22
35
Age (years)
FIQ
Gender
Mean (SD)
Mean (SD)
Female n (%)
37.51 (11.14)
109.91 (8.56)
19 (54%)
32.09 (8.71)
102.55 (10.48)
8 (36%)
36.11 (10.64)
106.31 (8.78)
16 (46%)
33.38 (10.70)
104.00 (13.14)
6 (75%)
Handedness
Right n (%)
Left n (%)
Ambidextrous n (%)
30 (86%)
5 (14%)
0 (0%)
19 (86%)
3 (14%)
0 (0%)
33 (94%)
2 (6%)
0 (0%)
8 (100%)
0 (0%)
0 (0%)
Educational level
Basic n (%)
Middle n (%)
High n (%)
11 (31%)
11 (31%)
13 (37%)
14 (67%)
2 (10%)
5 (24%)
18 (51%)
10 (29%)
7 (20%)
5 (63%)
2 (25%)
1 (13%)
parisons in them can be found in previous studies (Laasonen,

Hokkanen, et al., 2009a; Laasonen, Lehtinen, et al., 2010).
results based on A0 are presented only if they differed from the original analyses with percent correct variables.
2.4. Approach to statistical analyses
2.4.2. Clinical neuropsychological composite variables

For the sake of simplicity and to reduce the error variance related to individual task scores, the neuropsychological variables
were analyzed as composite variables that were averages of individual task scores (see Table 2). The composite variables were
the following: phonological processing (average of (1) phonological
awareness accuracy, (2) phonological memory accuracy, and (3)
phonological naming speed); technical reading (average of (4) technical reading speed and (5) accuracy); reading comprehension
(average of (6) reading comprehension speed and (7) accuracy);
spelling accuracy; arithmetic accuracy; executive functions (average
of (8) set shifting, (9) inhibition, and (10) planning); and attention
(average of (11) sustained and (12) divided aspects).
The scores of all participants were transformed based on the
age-corrected performance of the control group. This was achieved
by using age as an independent variable and a given neuropsychological task score as a dependent variable in a linear regression
analysis within the control group. The age corrected values, that
is residuals, were z-score standardized within the control group
and then converted to consistently indicate better performance
with larger positive values. After this, the variables were transformed to have a mean of 10 and a standard deviation of 3 and
2.4.1. Group differences in visual attention task performance

The overall group differences were tested with mixed ANOVAs
and ANCOVAs (with FIQ as a covariate). Separate ANOVAs and ANCOVAs (with FIQ) were conducted depending on the interactions
and main effects. The alpha level was set at p = .05. Post hoc tests
were conducted with Bonferroni corrected t-tests, or Tamhanes T
when the homogeneity of variance could not be confirmed. Many
of the variables had distributions that departed from normality.
These were also analyzed with nonparametric methods (KruskallWallis ANOVA and MannWhitney/Wilcoxons rank-sum test
with p-values corrected for the number of multiple comparisons).
The results of the ANCOVAs are reported if the significance of the
group difference between those with ADHD and controls changed
with FIQ as a covariate. The results of the nonparametric analyses
are reported if their level of significance differed from those of the
original parametric analyses. Due to response bias in both the AB
and MOT tasks, which resulted from differing amounts of true positive compared to true negative, and false positive compared to
false negative responses, the nonparametric measure of sensitivity
A0 was calculated when possible (Snodgrass & Corwin, 1988). The
Table 2
Neuropsychological domains used in the analyses, together with composite variables reflecting their sub-components (numbered), individual tasks, and variables (in
parentheses).
Phonological processing, average of
1.
Awareness, accuracy (synthesis (correct), Laasonen, 2002; Pig Latin (correct), Nevala et al., 2006)
2.
Memory, accuracy (pseudoword span length (correct), Service, Maury, & Luotoniemi, 2007; WMS-III digit span forward length (correct), Wechsler, 2008)
3.
Naming, speed (Stroop color naming (speed), Lezak, Howieson, Loring, Hannay, & Fischer, 2004; RAS (speeds for two trials), Wolf, 1986)
Technical reading, average of
4.
Speed (narrative text (speed), Laasonen, 2002; word list and pseudoword list reading (speed), Nevala et al., 2006)
5.
Accuracy (segregating word chains (correct) and searching for misspellings (correct), Holopainen et al., 2004; narrative text (correct), Laasonen, 2002; word list
and pseudoword list reading (correct), Nevala et al., 2006)
Reading comprehension, average of
6.
Speed (searching for incorrect words within a story (speed), Holopainen et al., 2004; forced choice task (speed), Nevala et al., 2006)
7.
Accuracy (searching for incorrect words within a story (correct), Holopainen et al., 2004; forced choice task (correct), Nevala et al., 2006)
Spelling, accuracy (pseudoword writing (correct), Holopainen et al., 2004)
Arithmetic, accuracy (RMAT (correct), Rsnen, 2004; WAIS-III Arithmetic (correct), Wechsler, 2005)
Executive functions, average of
8.
Set shifting (CANTAB Intra-extra dimensional set shifting (stages completed, total errors adjusted), Cambridge Neuropsychological Test Automated Battery, 2004)
9.
Inhibition (Color Trails Test (difference score), DElia, Satz, Uchiyama, & White, 1996; Stroop (inhibition errors, difference score), Lezak et al., 2004)
10. Planning (CANTAB Stockings of Cambridge (mean initial thinking time 5 moves, problems solved in minimum moves), Cambridge Neuropsychological Test
Automated Battery, 2004)
Attention, average of
11. Sustained (Color Trails Test (speed for first trial), DElia et al., 1996; Dual task (sustained attention for dots, sustained attention for numbers), Lezak et al., 2004)
12. Divided (Color Trails Test (speed for second trial), DElia et al., 1996; Dual task (divided attention for dots, divided attention for numbers), Lezak et al., 2004)
316
averaged into the composite variables. The raw scores of other

groups were transformed based on the values of the control group.
Thus, in every variable, 10 indicates the age-corrected control
mean, 13 indicates performance that is one standard deviation better than the control mean, and 7 indicates performance that is one
standard deviation poorer than the control mean (a scale similar to
the WAIS subtests, Wechsler, 2005). The grouping of the variables
was based on that presented in the manuals of the standardized
batteries (Holopainen, Kairaluoma, Nevala, Ahonen, & Aro, 2004;
Nevala, Kairaluoma, Ahonen, Aro, & Holopainen, 2006). For other
tasks, the grouping was based on theoretical grounds. The specific
characteristics of the neuropsychological composite variables are
presented in an Appendix B.
2.4.3. Relationships between visual attention measures and composite

neuropsychological variables
Sequential regression analyses were conducted in order to
investigate the relationships between the measures of visual attention task performance and the composite neuropsychological domains detailed in Table 2. These analyses were conducted using
the total sample of participants that also included those with a
comorbid diagnosis (n = 8). A regression analysis was computed
for each combination of composite neuropsychological variable
and visual attention task variable. The neuropsychologicial composite score was the dependent variable (phonological processing,
technical reading, reading comprehension, spelling, arithmetic,
executive functions, or attention), and a performance measure that
Useful Field of View (UFOV)

(A) Fixation
(B1) Control condition
OR
(B2) No distractors condition
(B3) Distractor condition
(C) Noise
(D) Answer
Fig. 1. Structure of the Useful Field of View (UFOV) task. For details, see Section 3.1.
3. Spatial characteristics of visual attention: Useful Field of View

(UFOV)
3.1. Material and methods
3.1.1. Stimuli
The background of the screen was black (RGB 0, 0, 0, luminance
2.5 cd/m2) with a gray filled circle in the middle of the screen (RGB
128, 128, 128, luminance 56 cd/m2, diameter 79.8). A black fixation dot with a white outline was located in the middle of the black
screen/gray circle (diameter 0.3). There were two central smiley
face target stimuli (yellow background; R 250, G 250, B 1, luminance 180 cd/m2, diameter 2; with black outlined eyes, mouth,
and hair). One had longer and the other shorter hair, with only
one of these stimuli appearing on any one trial. The peripheral target stimulus was a white circle (outline width 0.3, diameter 2)
with a gray background (RGB 128, 128, 128, luminance 56 cd/m2)
and a five-pointed filled white star within it (RGB 0, 0, 0, luminance
182 cd/m2). When present, the peripheral distractor stimuli were
white squares (outline width 0.3, diameter 2) with a gray background (RGB 128, 128, 128, luminance 56 cd/m2).
3.1.2. Procedure
The participant was asked to fixate on the fixation dot and instructed, with a written sentence below the dot, to begin the trial
by pressing any key (height 1.8, font: Tunga). After this, the first
stimulus appeared with a random 2001000 ms delay. There were
three conditions (see Fig. 1). In the first, control condition, participants had to discriminate whether the central smiley face target
had long or short hair. The response was given by pressing a keyboard button (S for short or X for long hair) with the index finger of the left hand. The buttons were marked with a smiley face
with short or long hair, respectively. After the response, another
target stimulus appeared when the participant pressed any key.
In the second condition, the experimental condition without distractors, participants had to perform the smiley face discrimination
task and simultaneously localize a peripheral star target that appeared along one of eight possible invisible axes (tilt angles: 0/
360, 45, 90, 135, 180, 225, 270, and 315). In the first part
of the experiment, the eccentricity of the peripheral target was
7, and in the second part, the eccentricity was 21 from the central
fixation dot. The order of administration of the eccentricity manipulation was counterbalanced across subjects. The central and
peripheral targets appeared and disappeared simultaneously.
Then, the screen was filled with a black-and-white noise mask
for 26 ms. After this, the eight possible axes were represented as
visible white lines (outline width 0.3) and the participant had to
touch the axis that the peripheral target had appeared on with
their right index finger. The discrimination task was answered as
described above and the order of the discrimination and localization responses was not restricted.
The third condition, the experimental condition with distractors,

was similar to the experimental condition without distractors with
the following exception: distractor squares were presented along
the eight axes at peripheral eccentricities of 7, 14, and 21 from
the central fixation dot. That is, there was one peripheral star target and 23 square distractors. Again, in the first part the distance of
the peripheral target was 7 and in the second part 21 from the
central fixation dot. The order of the tasks was counterbalanced
across subjects.
The presentation duration of the stimuli was controlled with a
1:3 adaptive algorithm that resulted in a 79.3% correct threshold
estimation (Wetherill & Levitt, 1965). At the beginning of each condition, the stimuli were presented for 146.3 ms. The refresh rate of
the screen (75 Hz) resulted in 13.3 ms steps. Participants had to
correctly answer both the discrimination and localization tasks
for three consecutive times in order to shorten the presentation
duration. One incorrect answer to either task resulted in a longer
presentation duration. The task was terminated after 12 reversals,
10 consecutive correct responses at the shortest possible presentation duration, or 72 trials. The 79.3% accuracy threshold was estimated by averaging the presentation durations of the last ten
correct trials. Before each condition, the participant rehearsed with
very easy trials (stimulus presentation duration 399 ms).
3.2. Results
3.2.1. Group comparisons
The average thresholds in milliseconds for correct performance
in the different conditions for the participants are presented in
Fig. 2.
First, we analyzed the center task with group (control, ADHD,
dyslexic) as a between subjects factor and accuracy threshold
as the dependent variable. The main effect of group was not
significant (F(2, 89) = 1.796, p = .172, partial g2 = .039, observed
power = .367).
Second, the experimental conditions without distractors were
analyzed with a 2 3 mixed ANOVA with eccentricity of peripheral target (7/21) as within subjects factor, group (control, ADHD,
dyslexic) as a between subjects factor, and accuracy threshold as
Useful Field of View (UFOV)
Threshold in ms (mean +/- SEM)
best differentiated between the groups from a visual attention task

(UFOV AB, or MOT) was entered at the first step as an independent
variable. Group was converted into two dummy variables (presence or absence of ADHD or dyslexia) and entered at the second
step. The first focus was on whether the given visual attention task
performance measure alone resulted in a significant R2 at step 1
(alpha = .01, two-tailed, due to the large number of comparisons).
Then, the changes in the significance levels (overall R2 and betas
of the visual attention variables) were examined when the participant group covariate was added at step 2. The additional significant findings with individual neuropsychological task variables as
dependent variables are presented in an Appendix B.
317
Control
ADHD
Dyslexia
150
100
50
0
Control
21
No distractors
21
Distractors
Task
Fig. 2. Threshold in milliseconds for correct performance of the control (black),
ADHD (gray), and dyslexia (white) groups in the Useful Field of View (UFOV) task
assessing the spatial aspects of visual attention. The bars indicate the group mean
with 1 SEMs in the control task and in the experimental tasks without and with
distractors, with separate conditions with close (at 7) and distant targets (at 21).
318
the dependent variable. This resulted in a non-significant main effect of eccentricity (F(1, 86) = .196, p = .659, partial g2 = .002, observed power = .072). The main effect of group was almost
significant (F(2, 86) = 3.013, p = .054, partial g2 = .065, observed
power = .570). Post hoc tests indicated that dyslexia group was
poorer than the controls (Tamhane T, p = .032). The interaction between group and eccentricity was not significant (F(2, 86) = .741,
p = .480, partial g2 = .017, observed power = .172). Thus, the groups
differed from each other but, overall, localization time did not differ between distant compared to close peripheral targets.
Last, the experimental conditions with distractors were analyzed with a 2 3 mixed ANOVA with eccentricity of peripheral
target (7/21) as within subjects factor, group (control, ADHD,
dyslexic) as a between subjects factor, and accuracy threshold as
the dependent variable. This resulted in a significant main effect
of eccentricity (F(1, 86) = 80.684, p < .0001, partial g2 = .484, observed power = 1.000) with more distant targets being more difficult to locate. The main effect of group was not significant
(F(2, 86) = 1.920, p = .153, partial g2 = .043, observed power = .389),
nor was the interaction between group and eccentricity
(F(2, 86) = 1.071, p = .347, partial g2 = .024, observed power = .232).
Thus, the groups did not differ from each other and, overall, all
groups required longer presentation time to localize distant compared to close peripheral targets.
3.2.2. Relations between the variables
The UFOV measure that best differentiated between the groups
was used in the regression analysis (main effect of group in oneway ANOVA, F(2, 60) = 3.269, p = .045). UFOV variable 21 without
distractors was not significantly related to any of the neuropsychological domains with the criterion of p < .01 (phonological processing, technical reading, reading comprehension, spelling, arithmetic,
executive functions, or attention; see Table 2). However, the accuracy threshold data for the UFOV task 21 without distractors entered at the first step in a sequential regression analysis almost
significantly predicted variation in technical reading (R2 = .057,
F(1, 95) = 5.709, p = .019). When the group was entered as a covariate at step 2, R was not significantly different from zero anymore
(R2 = .079, F(3, 93) = 2.658, p = .053) and the R2 change was not significant (R2 change = .022, Finc(2,93) = 1.125, p = .329), that is, adding the group membership did not improve the prediction beyond
that provided by the UFOV variables. Thus, performance in the
UFOV task tended to predict that in the dyslexia-related domain
of technical reading.
3.3. Discussion
Dyslexic readers were slow in the experimental tasks without
distractors. That is, they had difficulties with processing rapidly
presented material in their central vision. However, the selective
attention component of the task did not differentiate between
the groups as indicated by the nonsignificant group differences.
Further, closer targets accompanied by distractors were easier
(i.e., faster) to locate than the more distant targets with distractors.
These results are in line with the study by Ball and colleagues who
showed that the ability to localize a peripheral target decreases
with eccentricity, distraction, and when the center task is made
more difficult (Ball et al., 1988).
To our knowledge, there are no previous UFOV studies on ADHD
and only two with participants with dyslexia. In children, a meeting abstract by Edwards and colleagues suggests UFOV difficulties
in those with dyslexia: they processed information more slowly,
were more affected by distractors, and made more errors of localization (Edwards & Ball, 1995). However, university students with
mainly compensated (n = 21) but some with a persistent form of
dyslexia (n = 7) were not impaired in an UFOV task (Edwards,
Walley, & Ball, 2003). The authors concluded that the UFOV
impairment of those with dyslexia may have improved with development, reflecting a developmental lag. However, Edwards and
colleagues (2003) conducted only tasks with distractors and, thus,
could not assess the possible difficulties in the easier conditions of
center task and experimental task without distractors.
The regressions between UFOV and various neuropsychological
domains suggested that UFOV performance is possibly related to
the dyslexia-related domain of technical reading. UFOV performance has been investigated mainly in the elderly and in various
clinical populations and has been shown, for example, to predict
various driving outcomes in older adults (Clay et al., 2005). Correlations between UFOV performance and sensation/perception have
usually been lower than those between UFOV and various cognitive tasks, for example, overall cognitive ability (Fiorentino, 2008;
Okonkwo et al., 2008), processing speed (Edwards et al., 2006),
and visual search (Edwards et al., 2006). Thus, there remains some
controversy as to whether the UFOV should be considered to be
more than just a task of visual attention, for example, a task reflecting processing speed (Lunsman et al., 2008; Okonkwo et al., 2008).
Facoetti and collleagues have suggested a multisensory spatial
attention deficit hypothesis for dyslexia (Facoetti et al., 2010),
which suggests that sluggish attentional shifting affects sublexical
mechanisms that are essential for reading. The results of the current study do not contradict this suggestion, since those with dyslexia were disproportionally slow in the experimental task without
distractors and spatial attention was related to reading.
Taken together, adults with dyslexia experienced difficulties
with the temporal requirements of the UFOV task. However, the
dyslexic group was not observed to differ from the ADHD and control groups in terms of their peripheral selective visuospatial attention. Variation in UFOV predicted performance in the dyslexiarelated domain of technical reading.
4. Temporal characteristics of visual attention: Attentional

Blink (AB)
4.1.1. Stimuli
The background of the screen was gray (RGB 50, 50, 50, luminance 5.1 cd/m2) with a black fixation cross in the center (1.4,
RGB 0, 0, 0, luminance 2.5 cd/m2). The stimuli were upper case letters A, B, C, D, E, F, G, H, J, K, L, M, N, P, Q, R, S, T, U, V, W, X, Y, and Z
(height 1.8, font: Tunga). One of the letters was white (RGB 255,
255, 255, luminance 81 cd/m2) and the remainder were black
(RGB 0, 0, 0, luminance 2.5 cd/m2).
4.1.2. Procedure
The attentional blink procedure was similar to that employed
by Green and Bavelier (2003, see Fig. 3). The participant was instructed, with a written sentence below the fixation cross (height
0.5, font: Tunga, RGB 255, 255, 255, luminance 81 cd/m2), to begin
the trial by pressing the space key. Immediately after this, 715
black letters appeared randomly at the same location as the fixation cross, before the white target letter to be identified was presented (henceforth, target 1 or T1). Then, another 0, 1, 2, 3, 4, 6,
8, or 10 black letters were presented (referred to as the T1T2
lag), before the black target letter X to be detected (henceforth, target 2 or T2) was presented. T2 was present in 50% of the trials. The
trial ended by presenting all the black letters still available, so that
all the letters were presented once within the trial. Thus, a trial
consisted of 1624 letters in which each letter was presented no
more than once. The presentation length of the letter stimuli was
319
Attentional Blink (AB)
Attentional Blink (AB)

Frame 27 ms
100
Control
90
ISI 107 ms
80
70
7-15 letters
0-10 letters
T2: detect
(50% probability)
X
L
Remaining letters
50
100
90
ADHD
T1: identify
Percent correct (mean +/- SEM)
60
80
70
60
50
100
90
80
Fig. 3. Structure of the Attentional Blink (AB) task. For details, see Section 4.1.
70
Task
baseline detect
dual detect if identified
dual identify
60
26.7 ms (two frames) with an ISI of 106.7 ms (eight frames) for an

SOA of 133.3 ms.
First of all, a baseline task was conducted where the participant
had to detect the presence or absence of T2, but was given no
instruction with respect to the white letter (T1), which was to be
ignored. After each of 32 trials, the participant was asked, with a
written sentence presented on the screen (height .5, font: Tunga,
RGB 0, 0, 0, luminance 2.5 cd/m2), whether they had seen the letter
X or not. The response was given by pressing a keyboard button
marked yes or no with the index finger of the right hand. After
the response, the fixation cross appeared again.
After this, in the dual task, the participant had to both identify
T1 and to detect the presence/absence of T2. After each of the 32
trials, the participant was asked with a written sentence presented
at the screen (height .5, font: Tunga, RGB 0, 0, 0, luminance 2.5 cd/
m2), first, to indicate the identity of the white letter (T1) and, then,
to indicate whether or not they saw the letter X. The response was
given by pressing, first, the keyboard letter corresponding to T1,
and then a keyboard button marked yes or no with index finger
of the right hand to indicate whether or not T2 was detected. After
the responses, the fixation cross appeared again. Before the baseline and dual conditions, the tasks were rehearsed with very easy
trials (933.3 ms SOA).
4.2. Results
Percent correct performance as a function of the T1T2 lag in
the baseline task (detect only) and dual task (identify and detect if
identified) is illustrated in Fig. 4.
4.2.1.1. Attentional blink. The attentional blink is characterized by a
change in T2 detection accuracy as a function of T1T2 lag when T1
must be identified (dual task), relative to T2 detection accuracy
when T1 is to be ignored (baseline task).
For the dual task, T2 detection accuracy was determined based
solely upon trials where T1 was correctly identified. A mixed ANOVA was conducted with group (control, ADHD, dyslexia) as a between subjects factor, task (baseline, dual) and T1T2 lag (133,
267, 400, 533, 667, 933, 1200, or 1466 ms after the first target)
50
Dyslexia
40
133 267 400 533 667
933
1200
1466
T1-T2 lag in milliseconds

Fig. 4. Percent correct performance of the control (upper panel), ADHD (middle
panel), and dyslexia (lower panel) groups in the Attentional Blink (AB) task
assessing the temporal aspects of visual attention. The line indicates the group
mean with 1 SEMs as a function of lag in milliseconds between the first (T1, white
letter to be identified) and second target (T2, black letter X to be detected) in the
baseline detection task (T2, gray), dual task identification (T1, dotted black), and
dual task detection after a correct identification (T2, solid black).
as within subjects factors, and T2 detection accuracy as the dependent variable. This resulted in a trend for a main effect of group
Post hoc comparisons were nonsignificant. There was a significant
main effect of task (F(1, 87) = 102.924, p < .0001, partial g2 = .542,
observed power = 1.000) and T1T2 lag (F(7, 609) = 23.667, p <
.0001, partial g2 = .214, observed power = 1.000). The interaction
between task and T1T2 lag was also significant (F(7, 609) =
25.835, p < .0001, partial g2 = .229, observed power = 1.000). This
interaction between task and lag is the hallmark of AB, but it did
not interact with participant group. This last interaction is difficult
to target with an omnibus ANOVA since it is based on means, and
as seen in Fig. 4, all mean performances are roughly of the same
magnitude across groups. If there is a difference, it is more in the
shape of the curves rather than in the precise mean values.
For that reason, we recoded the individual results in the dual
task using the four parameters suggested by Cousineau and
colleagues (2006). The first parameter (lag-1 sparing) indicates
the leftright position of the curve. A group difference on that
parameter would indicate that the worst performance is occurring
at different lags. The second parameter, the width, indicates the
width of the AB, that is, how long the blink lasts. The third and
the fourth parameters indicate the amount of accuracy lost in
the blink (amplitude) and the level of accuracy reached in the
worst part of the curve (minimum). These last two parameters
are expressed in proportion correct. They are estimated using
best-fitting procedures as explained in Cousineau et al. (2006).
320
Table 3
Cousineau parameters for the attentional blink task.
Group
Control
ADHD
Dyslexia
Lag1 sparing
Mean (SD)
Width
Mean (SD)
Minimum
Mean (SD)
Amplitude
Mean (SD)
0.549 (0.034)
0.519 (0.102)
0.568 (0.127)
0.403 (0.100)
0.413 (0.375)
0.691 (0.050)
0.561 (0.172)
0.512 (0.135)
0.528 (0.159)
0.332 (0.175)
0.319 (0.151)
0.323 (0.150)
Cousineau parameters for AB
Percent correct
100
90
80
70
Group
Control
ADHD
Dyslexia
60
50
40
133 267 400 533 667
933
1200
1466
T1-T2 lag in milliseconds

Fig. 5. Attentional blink effect for the dual task as captured by the parameters of
Cousineau et al. (2006), in the same format as in Fig. 4. This curve is based on the
average parameters of the participants in each group, as listed in Table 3.
Table 3 shows the mean parameter results for the three groups
as well as the standard deviation in the parameters across participants. Fig. 5 shows the idealized curve drawn from the mean
parameter values across participants for each group. The three
groups differed significantly regarding the width parameter
(F(2, 89) = 3.51, p = .033, partial g2 = 0.079). A look at Table 3 shows
that the dyslexic group took longer to recover from the attentional
blink compared to the controls (p < .0001) and also compared to
those with ADHD (p < .0001). One easy way to see this is to draw
a horizontal line at 75% correct (a level suggested by Hari et al.
(1999)); the dyslexic group is the last group whose performances
rise above this level.
The three groups did not differ significantly regarding the lag-1
sparing parameter (F(2, 89) = 0.204, p = .816, partial g2 = 0.004), the
minimum performance (F(2, 89) = 1.021, p = 0.364, partial
g2 = 0.023), or the amplitude (F(2, 89) = 0.339, p = 0.713, partial
g2 = 0.007).
4.2.1.2. Control analysis: dual task (detect T2). T2 detection accuracy
was determined based upon trials where T1 was correctly identified. A mixed ANOVA on this data with participant group (control,
ADHD, dyslexia) as a between subjects factor and T1T2 lag as a
within subjects factor revealed a significant main effect of group
Post hoc tests indicated that those with dyslexia were poorer than
controls in their T2 detection (p = .042). There was also a significant main effect of T1T2 lag (F(7, 609) = 41.212, p < .0001, partial
g2 = .321, observed power = 1.000). The interaction between group
and T1T2 lag was not significant (F(14, 609) = 1.052, p = .400, partial g2 = .024, observed power = .671). Thus, the dyslexic participants had lower overall T2 detection accuracies.
4.2.1.3. Control analysis: dual task (identify T1). There was no evidence for the groups performing differently at identifying T1 in
the dual task condition. A mixed ANOVA on T1 identification accuracy with group (control, ADHD, dyslexia) as a between subjects
factor and T1T2 lag as a within subjects factor revealed a trend

for a significant main effect of group (F(2, 87) = 2.783, p = .067, partial g2 = .060, observed power = .535). Post hoc comparisons were
not significant. The main effect of T1T2 lag (F(7, 609) = 1.028,
p = .410, partial g2 = .012, observed power = .448) and the interaction between group and T1T2 lag were non-significant
(F(14, 609) = 1.106, p = .349, partial g2 = .025, observed power =
.699). Thus, there was no evidence that any one group placed a
greater premium on T1 accuracy or was poorer in identifying T1.
4.2.1.4. Control analysis: baseline task (detect T2 only). In the baseline detection task, the groups performed at the same level and
performance did not vary as a function of T1T2 lag. A mixed ANOVA on T2 detection accuracy with group (control, ADHD, dyslexia) as a between subjects factor and T1T2 lag as a within
subjects factor resulted in non-significant main effects of group
(F(2, 87) = .327, p = .722, partial g2 = .007, observed power = .101)
and T1T2 lag (F(7, 609) = 1.755, p = .094, partial g2 = .020, observed power = .716), and a non-significant interaction between
group and lag (F(14, 609) = .625, p = .845, partial g2 = .014, observed power = .403). Thus, no evidence was obtained that the
groups differed in their ability to detect T2 when T1 was to-beignored.
4.2.1.5. Relations between the variables. The AB measure that best
differentiated between the groups was used in the regression analysis (main effect of group in one-way ANOVA, F(2, 60) = 4.219,
p = .019). AB performance at lag 4 was not significantly related to
any of the neuropsychological domains (phonological processing,
technical reading, reading comprehension, spelling, arithmetic,
executive functions, or attention; see Table 2) when it was entered
as an independent variable into sequential regression analyses.
Thus, performance in the AB task was not related to any of the neuropsychological domains.
4.3. Discussion
Lag 1 sparing refers to the phenomenon where the detection of
T2 is better at a T1T2 lag of one item than it is at a T1T2 lag of 2
items. This phenomenon was not observed in the current study,
nor did the groups differ from each other in the parameter of lag
1 sparing (Cousineau et al., 2006).
Attentional blink refers to the phenomenon where the detection
of the T2 is impaired when it follows the T1 within approximately
200500 ms or at lags 23 in the current study (Armstrong &
Munoz, 2003; Badcock et al., 2008; Carr et al., 2006; Facoetti
et al., 2008; Lacroix et al., 2005; Visser et al., 2004). A sizeable
attentional blink effect was confirmed for all groups. Although
there was no group lag interaction in the ANOVA for T2 detection
accuracy as a function of task, the AB parameters detected a difference in the shapes of the AB curves: the dyslexic took longer to
recover from the blink effect than the other two groups.
Hari and Renvall (Hari & Renvall, 2001) have suggested that
those with developmental dyslexia would suffer from sluggish
attentional shifting (i.e., engaging and disengaging of attention)
that would manifest in impaired processing of rapid stimulus sequences, that is, a prolonged attentional blink. This kind of difficulty would result in prolonged sensory input chunks in various
modalities and, for example, distorted phonological representations, phonological awareness, and, thereafter, impaired reading.
The current study did partly support these suggestions: Those with
dyslexia had prolonged attentional blink, but the AB was not related to phonological processing or reading.
Some additional group differences emerged, unrelated to the
attentional blink per se. Although those with dyslexia were as good
as the other groups in detecting a single target (T2) when the first
321
Multiple Object Tracking (MOT)

(A) Fixation
(C) Dots move for for 5 sec, all yellow
(B) Dots move for 2 sec, some blue
(D) Was the white dot blue?
Fig. 6. Structure of the Multiple Object Tracking (MOT) task. For details, see Section 5.1.
target (T1) was to-be-ignored (baseline) and in identifying the first

letter target (T1) in the dual task condition, they were overall
poorer than the controls in detecting the second target (T2) in
the dual task condition. That is, those with dyslexia had difficulties
in processing two targets across all T1T2 lags. Our results with
adult participants therefore provide support to the suggestions of
McLean and colleagues (2010) that individuals with dyslexia have
a difficulty in processing two targets, which manifests also by a
longer recovery time when processing two targets.
The control and ADHD participants were thoroughly assessed
(Laasonen, Virsu, et al., 2010; Laasonen, Leppmki, et al., 2009)
and comorbid learning difficulties were excluded. Further, the
adults with ADHD in our study were not impaired on the baseline
task or dual task T1 identification. Neither was there evidence of
difficulties in dual task T2 detection or attentional blink. Thus,
we cannot confirm that the attentional blink is impaired in adults
in ADHD.
The relationships between AB task performance and neuropsychological measures were inspected with sequential regression
analyses. These analyses were conducted over all the participants,
including those with a comorbid diagnosis. None of the neuropsychological measures were related to the AB. Based on previous and
current results, AB task performance does not appear to predict
phonological processing, technical reading, reading comprehension, spelling, arithmetic, executive functions, or attention in adult
samples.
Taken together, the group with ADHD did not differ from the
healthy controls in their attentional blink, but those with dyslexia
had prolonged blink and exhibited impairment when the AB task
required processing of two targets. However, AB performance did

not predict performance in any of the neuropsychological domains.
5. Capacity of visual attention: Multiple Object Tracking (MOT)
5.1.1. Stimuli
The background of the screen was white (RGB 0, 0, 0, luminance
182 cd/m2) with a filled gray central circle (RGB 128, 128, 128,
luminance 56 cd/m2, diameter 20). A smaller gray fixation circle
with a white outline (RGB 128, 128, 128, luminance 56 cd/m2,
diameter 1) was located in the middle of the gray circle. Stimuli
were small (diameter 1) blue (R 0, G 0, B 255, luminance 20 cd/
m2), yellow (R 255 G 255 B 0, luminance 180 cd/m2), and white
dots (RGB 0, 0, 0, luminance 182 cd/m2).
5.1.2. Procedure
The participant was asked to fixate on the fixation ring during
the experiment and instructed, with a written sentence below
the ring, to begin the trial by pressing any key. Immediately after
pressing a key, 16 moving dots appeared on the gray circle. 1, 3,
5, or 7 of these were randomly blue and the remainder of the 16
were yellow (See Fig. 6). All dots moved within the gray circle at
a speed of 5 deg/s for 2 s. Target movement was random but restricted so that the dots did not collide with each other or cross
the border of the gray circle. After 2 s of movement all dots turned
yellow and continued to move for another 5 s. Then the movement
322
stopped and one of the dots turned white. The participants task
was to indicate whether the white dot was one of the blue target
dots. The response was given by pressing a keyboard button
marked yes or no with the index finger of the right hand (arrow buttons left and right). After the response, another trial began.
There were 80 trials altogether, 20 with each amount of target
dots. Before the task, the participant rehearsed with very easy trials
(1 or 2 moving dots).
5.2. Results
Tracking accuracy as a function of the number of dots to-betracked is presented in Fig. 7. Increasing the number of dots tobe-tracked resulted in poorer performance but there was no evidence that the groups differed from each other. A mixed ANOVA
on tracking accuracy data with group (control, ADHD, dyslexic)
as a between subjects factor and number of dots to-be-tracked as
a within subjects factor resulted in a significant main effect of dots
to-be-tracked (F(3, 264) = 201.806, p < .0001, partial g2 = .696, observed power = 1.000). Post hoc tests indicated that tracking accuracy decreased each time the number of dots to-be-tracked was
increased, all ps 6 .0001. The main effect of group was not significant (F(2, 88) = 1.235, p = .296, partial g2 = .027, observed
power = .263), nor was its interaction with the number of dots
to-be-tracked (F(6, 264) = .434, p = .856, partial g2 = .010, observed
power = .178).
5.2.2. Relations between the variables
The MOT measure that best differentiated between the groups
was used in the regression analysis (main effect of group in oneway ANOVA, F(2, 61) = 3.783, p = .028). MOT performance in the
one-dot-condition was significantly related to the neuropsychological domains of phonological processing and reading comprehension and tended to predict the attention domain as well. The
tracking accuracy data for 1 dot entered at the first step in a
sequential regression analysis significantly predicted variation in
the neuropsychological domain of phonological processing
(R2 = .104, F(1, 99) = 11.395, p = .001). When group was entered as
Multiple Object Tracking (MOT)

Control
ADHD
Dyslexia
Percent correct (mean +/- SEM)
100
90
80
70
60
50
1
Targets
Fig. 7. Percent correct performance of the control (black), ADHD (gray), and
dyslexia (white) groups in the Multiple Object Tracking (MOT) task assessing the
capacity of visual attention. The bars indicate the group mean with 1 SEMs as a
function of the number of targets to track.
a predictor at step 2, R2 was still significantly different from zero

(R2 = .128, F(3, 96) = 4.691, p = .004) but the R2 change was not significant (R2 change = .024, Finc(2,96) = 1.304, p = .276), that is, adding the group membership did not improve the prediction beyond
that afforded by the MOT variables. MOT performance also significantly predicted variation in the neuropsychological domain of
reading comprehension (R2 = .121, F(3, 96) = 13.528, p < .0001).
With the group as a covariate, R2 was still significantly different
from zero (R2 = .172, F(3, 96) = 6.634, p < .0001) but the R2 change
was not significant, that is, again, adding the group did not improve
the prediction (R2 change = .050, Finc(2,96) = 2.921, p = .059). Last,
MOT performance tended to predict variation in attention
(R2 = .054, F(1, 98) = 5.615, p = .0198). With the group as a covariate, R2 was still significantly different from zero (R2 = .121,
F(3, 96) = 4.411, p = .006) and the R2 change tended to be significant, that is, adding the group tended to improve the prediction
(R2 change = .067, Finc(2,96) = 3.657, p = .029; unique variance explained by the dyslexia status, b = -.964, t(2, 96) = -2.498,
p = .014). Thus, accuracy of tracking predicted variability in the
dyslexia-related domains of phonological processing and reading
comprehension, and perhaps attention.
5.3. Discussion
Overall, the participants were more accurate when tracking
fewer dots. Their performance was nearly perfect in the one dot
condition. In the three and five dots conditions, the controls level
of performance was comparable to previous research (Oksama &
Hyn, 2004; Pylyshyn & Storm, 1988). However, even in the seven
dots condition, the performance of all the groups was clearly above
chance. This is at odds with suggestions that the maximum number of objects that can be successfully tracked is approximately
four (e.g., Pylyshyn, 2000; Pylyshyn & Storm, 1988) and supports
more recent findings that task and subject characteristics can affect
tracking performance (Alvarez & Franconeri, 2007; Bettencourt &
Somers, 2009; Dye & Bavelier, 2010; Green & Bavelier, 2006b;
Horowitz et al., 2007).
To our knowledge, the MOT task has not been used in dyslexia
or ADHD research prior to this study. The current results provide
no evidence that adults with dyslexia, ADHD, and their healthy
controls differ in the capacity of visual attention as estimated by
MOT.
The relationships between MOT performance and neuropsychological test scores were inspected with sequential regression analyses that were conducted over all the participants, including also
those with a comorbid diagnosis. Previous research with healthy
participants has suggested that MOT performance is related to various aspects of visuospatial memory (e.g., short-term memory
(STM): Oksama & Hyn, 2004, 2008; WM, Zhang et al., 2010)
and attention or executive functions (attention switching, Oksama
& Hyn, 2004, 2008; inhibition, Pylyshyn, 2006; e.g., Scholl, 2009).
MOT performance tended to predict variation in the domain of
attention. However, dyslexia-status, not that of ADHD, tended to
predict the attention domain variation. Further, MOT performance
predicted the dyslexia-related domains of phonological processing
and reading comprehension.
Valdois and colleagues have put forward a visual attention span
deficit hypothesis of developmental dyslexia (Bosse et al., 2007).
Visual attention span refers to the amount of visual elements that
can be processed in parallel and they suggest that this capacity
predicts reading, independently of phonological skills. Our results
do not support the suggestion of a limited capacity of visual attention in those with dyslexia (we found no group differences), nor do
they support the suggestion that capacity of visual attention would
be independent of phonological processing (visual attention predicted phonological processing).
Taken together, the current groups with dyslexia or ADHD did

not differ from the healthy controls in their MOT performance,
but MOT predicted performance in the neuropsychological domains of phonological processing and reading comprehension.
6. General discussion
The current study investigated three aspects of visual attention
in adults with dyslexia or ADHD and in healthy controls. Temporal
characteristics of visual attention were investigated with an AB
(Attentional Blink) task, capacity of visual attention with a MOT
(Multiple Object Tracking) task, and spatial characteristics of visual
attention with a UFOV (Useful Field of View) task. The first aim was
to resolve whether participants with dyslexia or ADHD suffer from
difficulties of visual attention, and whether the possible difficulties
are shared between or specific to the clinical groups. The second
aim was to investigate the relations between the different aspects
of visual attention and performance in the clinical neuropsychological domains that characterize dyslexia (phonological processing,
reading, spelling, and arithmetic) or ADHD (executive functions
and attention) in the combined sample of adult participants.
6.1. Visual attention in dyslexia and ADHD
The group differences between adults with dyslexia, ADHD, and
their healthy controls in tasks of visual attention were few and it
was those with dyslexia who suffered from difficulties. When the
temporal characteristics of visual attention were investigated
(AB), the group with dyslexia was poorer than the other groups
when the task required processing of two targets, and, because
those with dyslexia recovered from the blink later than the other
groups. Assessment of the capacity of visual attention (MOT) did
not differentiate between the groups. Finally, investigating the spatial characteristics of visual attention (UFOV) indicated that those
with dyslexia had difficulties with the temporal requirements of
the task but no problems with their peripheral selective visuospatial attention emerged.
These results have at least two important implications. First,
those with a behaviorally diagnosed attention deficit disorder
(i.e., ADHD) do not necessarily have deficits in their attention skills
as estimated with experimental tasks. This is in line with the views
that ADHD is a multifactorial and heterogeneous disability and
neuropsychological deficits are not necessary or sufficient causal
factors for every case (Nigg, 2005; Nigg et al., 2005; Willcutt, Doyle,
Nigg, Faraone, & Pennington, 2005). Furthermore, since the difficulties of those with dyslexia were not shared with the ADHD
group, they are not likely to result from comorbid or subclinical
ADHD but, instead, reflect a genuine and perhaps specific characteristic of dyslexia.
Pennington has suggested in his multiple deficit model of developmental disorders that the various disabilities share cognitive difficulties, none of the difficulties is unique to or a sufficient
condition for a specific learning disability, but the combination of
the deficits determines the diagnostic category (Pennington,
2006; Pennington & Bishop, 2009). That is, there are multiple cognitive risk factors for both dyslexia and ADHD and some of them
are shared. Based on the current results, impaired visual attention
is not one of the characterizing factors of ADHD or a shared factor
for dyslexia and ADHD.
6.2. Visual attention and clinical neuropsychological domains
The regression analyses including the temporal, capacity, and
spatial aspects of visual attention and the various neuropsychological domains suggested no strong relationships with the domains
323
traditionally related to ADHD (attention and executive functions).

Instead, UFOV and especially MOT performance predicted variation
in the dyslexia-related domains of phonological processing and
reading. Thus, those with dyslexia were impaired in tasks of visual
attention and visual attention predicted phonological processing
and reading. Based on this, difficulties in visual attention could
associate with dyslexia and variation in the capacity and spatial aspects of visual attention may also have a role in the reading ability
of the general population.
6.3. Representational deficit of dyslexia
All the current tasks of visual attention had one common
denominator. They relied somehow on temporal processing of
multiple targets. In the AB task, the stimuli were presented briefly
and in rapid succession. In the MOT task, the targets moved around
at a fast rate. In the UFOV task, the dependent variable was the presentation time required for correct localization of one of the
stimuli.
Closer inspection of the regression analyses, at the level of individual variables (see Appendix B), revealed that there was no clear
pattern between the visual attention tasks and the predicted variable type (temporal or non-temporal). If anything, most of the predicted variables were non-temporal. However, most of the tasks
included both accuracy and temporal variables and, thus, could
be considered to be time-constrained in their general nature. With
this in mind, a clear picture emerged that emphasizes the association between visual attention tasks and temporal aspects of reading and phonological processing.
The models put forward for AB and UFOV might enlighten what
could explain the dual processing and temporal processing difficulties of those with dyslexia in these tasks. Dux and Marois have synthesized different models of AB in their recent review (2009).
Following their thinking, we suggest that when participants are
presented with stimuli that change in time, that is, appear or disappear rapidly, they form bottom-up preliminary perceptual and
conceptual representations of all the stimuli (congruent with,
Cousineau & Shiffrin, 2004, results in a visual search task). Because
of the temporal dynamics, the representations have to be constantly updated. Top-down task instructions lead to enhancement
of the relevant stimulus representations and inhibition of irrelevant stimulus representations. We suggest that difficulties at these
early stages could include impairments in the (1) formation and
modulation of the dynamic input representations, (2) maintenance
of the internal target representation in working memory, (3)
matching of the internal target and the dynamic input representations, and/or (4) rapid enhancement/inhibition of the dynamic input target/distractor representations.
If a target is detected, it is admitted to later stages of processing,
that is, episodic registration, working memory consolidation, and
response selection (Dux & Marois, 2009). These processes require
attention and, therefore, targets in close temporal proximity after
the first target cannot have the same attentional enhancement
and distractors the same attentional inhibition as stimuli encountered further away from the first target in the stimulus stream. Difficulties at these later stages could include processing taking
longer, requiring more of the capacity-limited resources, or being
more involved in compensating for possible difficulties at the earlier stages.
The difficulties of the dyslexia group point to an impairment at
the later stages of processing, but in a way that may also involve
the early processing stages. First in the AB task, dyslexic readers
had prolonged blink but also difficulties in T2 detection at much
longer T1T2 intervals than would have been expected based on
a mere attentional blink impairment. Second in the UFOV task, dyslexic readers were also slow in detecting abrupt stimulus changes.
324
The current results fit also well with our earlier suggestion that
developmental dyslexia is associated with, and may result from,
a generalized representational deficit. That is, those with dyslexia
are suggested to suffer from an impairment in tasks that require
either the simultaneous representation of multiple items, representing one item and then turning it off to represent a different
item, that is, mentally switching between two or more representations, or representation of a whole temporal pattern of stimulation
that unravels incrementally over time (Laasonen, Service, Lipsanen,
& Virsu, 2012; Laasonen et al., 2001; Laasonen, Virsu, et al., 2010).
6.4. Conclusion
We showed that adults with dyslexia, but not those with ADHD,
have difficulties in tasks of visual attention, which were explained
by an impaired ability to process dual targets, prolonged attentional blink, and deficits in processing rapidly changing visual displays. Further, variation in tasks of visual attention predicted
phonological processing and reading performance. Thus, impaired
visual attention associated with dyslexia and variation in visual
attention had a role in the reading ability of the more general
population.
Acknowledgments
We thank Academy of Finland (Projects 108410, 217065, and
217998), Emil Aaltonen Foundation, and Otologic Research Foundation for financial support. The authors thank Professor Daphne
Bavelier for providing the experimental tasks and for her invaluable comments, Emma Hietarinta, Sasa Kivisaari, Minna Kuivalainen, Maisa Lehtinen, Mirva Reuhkala, and Meeri Sivonen for
participating in gathering of the psychometric data, and Professors
Elisabet Service and Veijo Virsu for helpful discussions.
Appendix A. Performance of the groups in the
neuropsychological tasks
Group
Control
Mean
(SD)
Phonological processing, average of
1. Awareness, accuracy
Synthesis (correct)
10.21
(12.94)
Pig Latin (correct)
10.00
(13.00)
2. Memory, accuracy
Pseudoword span length
10.09
(correct)
(12.97)
WMS-III digit span forward
10.30
length (correct)
(13.00)
3. Naming, speed
Stroop color naming (speed)
9.94
(13.03)
RAS (speed for 1st trial)
10.03
(12.97)
RAS (speed for 2nd trial)
10.06
(13.09)
Technical reading, average of
4. Speed
Narrative text (speed)
10.12
(13.00)
ADHD
Mean
(SD)
Dyslexia
Mean
(SD)
9.16
(12.91)
8.41
(14.47)
8.47
(13.45)
7.30
(14.38)
9.10
(12.46)
8.44
(14.08)
8.65
(12.31)
7.51
(13.30)
8.92
(13.93)
10.51
(12.46)
10.09
(12.25)
6.52
(14.98)
6.28
(14.80)
5.92
(14.08)
8.53
(13.54)
4.42
(14.68)
Performance of the groups in the neuropsychological tasks

(continued)
Group
Word list reading (speed)

Pseudoword list reading (speed)
5. Accuracy
Segregating word chains
(correct)
Searching for misspellings
(correct)
Narrative text (correct)
Word list reading (correct)
Pseudoword list reading
(correct)
Control
Mean
(SD)
ADHD
Mean
(SD)
Dyslexia
Mean
(SD)
9.94
(13.00)
10.24
(12.97)
8.77
(13.66)
7.39
(16.33)
0.58
(27.67)
0.76
(19.57)
10.36
(12.94)
10.33
(12.67)
10.12
(13.00)
10.82
(13.18)
10.00
(13.12)
7.66
(13.75)
6.88
(13.75)
8.47
(13.51)
9.25
(13.66)
6.76
(14.38)
5.47
(14.05)
4.27
(14.77)
4.33
(14.77)
7.03
(16.27)
3.43
(17.14)
Reading comprehension, average of

6. Speed
Forced choice task (speed)
9.97
(13.00)
Searching for incorrect words
10.12
within a story (speed)
(12.61)
7. Accuracy
Forced choice task (correct)
9.76
(13.12)
Searching for incorrect words
10.27
within a story (correct)
(12.85)
10.51
(12.97)
11.02
(11.62)
6.04
(15.37)
8.26
(13.78)
8.35
(14.26)
8.71
(14.68)
7.12
(15.16)
9.34
(13.21)
Spelling, accuracy: pseudoword

writing (correct)
5.57
(11.80)
1.54
(12.53)
-1.39
(18.04)
10.27
(12.85)
10.21
(12.91)
7.63
(13.66)
8.14
(13.39)
7.36
(12.76)
8.32
(13.33)
8.43
(7.25)
9.56
(2.40)
9.89
(2.54)
9.89
(3.06)
10.35
(2.30)
10.37
(2.49)
10.07
(3.12)
10.12
(2.96)
10.13
(3.28)
8.92
(3.05)
9.77
(2.85)
9.33
(3.98)
8.40
(3.21)
6.94
(5.86)
7.78
(4.42)
10.41
(3.18)
11.01
(3.16)
10.03
(3.19)
9.08
(4.14)
9.59
(2.76)
10.67
(2.54)
Arithmetic, accuracy
RMAT (correct)
WAIS-III Arithmetic (correct)
Executive functions, average of
8. Set shifting
CANTAB Intra-extra
dimensional set shifting
(stages completed)
CANTAB Intra-extra
dimensional set shifting (total
errors adjusted)
9. Inhibition
Color Trails Test (difference
score)
Stroop (inhibition errors)
Stroop (difference score)
10. Planning
CANTAB Stockings of Cambridge
(mean initial thinking time 5
moves)
CANTAB Stockings of Cambridge
(problems solved in
minimum moves)
Performance of the groups in the neuropsychological tasks

(continued)
Table 5
Non-significant correlations within the sub-composite variables.
Executive functions: inhibition
Group
Control
Mean
(SD)
Attention, average of
11. Sustained
Color Trails Test (speed for first
trial)
Dual task (sustained attention
for dots)
Dual task (sustained attention
for numbers)
12. Divided
Color Trails Test (speed for
second trial)
Dual task (divided attention for
numbers)
Dual task (divided attention for
dots)
325
ADHD
Mean
(SD)
Dyslexia
Mean
(SD)
Color Trails Test,

difference score
Stroop, inhibition
errors
Stroop, inhibition
errors
Stroop, difference score
.028 (p = .786)
.182 (p = .071)
.301
Attention: sustained
10.49
(3.31)
8.85
(4.08)
8.23
(3.83)
9.03
(4.31)
7.14
(3.21)
6.37
(4.32)
9.98
(4.56)
7.06
(4.66)
6.10
(4.72)
10.70
(3.71)
10.32
(2.97)
10.17
(3.04)
7.83
(5.02)
10.48
(2.49)
8.15
(2.08)
10.56
(4)
9.05
(4.02)
7.94
(2.85)
Color Trails Test, speed

for first trial
Dual task, sustained
attention for dots

attention for dots

attention for numbers
.193 (p = .054)
.169 (p = .094)
.637
Attention: divided
Dual task, divided
attention for dots
Color Trails Test, speed
for second trial
Dual task, divided
attention for dots
.016 (p = .873)
Dual task, divided

attention for numbers
.012 (p = .907)
.177 (p = .078)
NB. Significance of Pearson product moment correlations:
p < .01,
p < .001.
Table 6
Significant regressions based on the individual variable analyses.
Domain
Task
temporal
R2
UFOV WMS-III digit

span forward
length (correct)
Narrative text
(speed)
Word list
reading (speed)
Pseudoword list
(speed)
Segregating
word chains
(correct)
Searching for
misspellings
(correct)
Narrative text
(correct)
Forced choice
task (correct)
No
Phonological
processing
.077 7.819
.006
Yes
Technical
reading
Technical
reading
Technical
reading
Technical
reading
.172 19.484
<.0001
No
Technical
reading
Yes
Technical
.179 20.436
reading
Reading
.194 22.583
comprehension
<.0001
AB
RAS (speed for

2nd trial)
Narrative text
(speed)
Segregating
word chains
(correct)
Searching for
misspellings
(correct)
Narrative text
(correct)
Pseudoword list
reading (correct)
Yes
Phonological
processing
Technical
reading
Technical
reading
.090 9.487
.003
.068 6.983
.0096
.103 11.043
.001
No
Technical
reading
.090 9.474
.003
Yes
Technical
reading
Technical
reading
.071 7.392
.008
.170 19.651
<.0001
RAS (speed for

2nd trial)
Forced choice
task (correct)
Searching for
incorrect words
within a story
(correct)
Yes
Task
Appendix B. Neuropsychological variables and additional

analyses
The grouping of the neuropsychological composite variables
was based on that presented in the manuals of the standardized
batteries (Holopainen et al., 2004; Nevala et al., 2006). For other
tasks, the grouping was based on theoretical grounds. We inspected the internal consistency of the composite variables at a detailed level further. First, all the sub-composite variables
(numbered in Table 2 of the main paper) correlated significantly
with their main composites (Appendix B Table 4). For example,
phonological awareness accuracy, phonological memory accuracy,
and phonological naming speed variables correlated with the phonological processing variable. Second, all individual variables within the sub-composites correlated with each other (e.g., within the
phonological awareness variable, Synthesis correct and Pig Latin
correct correlated with each other) with few exceptions in the domains of executive functions and attention (see Appendix B Table 5
for non-significant correlations). Thus, we conducted the regression analyses also at the level of individual variables. The significant results are presented in Appendix B Table 6 and are
commented in the Discussion section of the main paper.
Table 4
Correlations between sub-composite and main composite variables.
Awareness
Memory
Naming
Phonological processing
.720
.641
.279
Technical reading
Speed
.327
Accuracy
.937
Reading comprehension
Speed
.407
Accuracy
.832
Executive functions
Set shifting
.581
Inhibition
.600
Attention
Sustained
.833
Divided
.495
NB. Significance of Pearson product moment correlations:
p < .01,
MOT
Planning
650
p < .001.
Significantly
predicted
variable
Yes
Yes
No
Yes
Yes
No
Yes
Yes
Yes
.601 141.476 <.0001

.277 36.091
<.0001
.102 10.720
.001
.121 12.910
.001
Phonological
.079 8.358
processing
Reading
.077 8.106
comprehension
Reading
.083 8.731
comprehension
<.0001
.005
.005
.004
NB. Task temporal indicates, whether the given task includes also temporal
variables.
326
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Brain and Cognition 80 (2012) 311327

Contents lists available at SciVerse ScienceDirect

Brain and Cognition

Project DyAdd: Visual attention in adult dyslexia and ADHD

diagnosis. Impaired phonological processing (Bradley & Bryant,

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

characteristics are yet to be determined. The general aim of the

attention span deficit hypothesis proposes that there is a deficit in

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

uted across a spatial scene when attention has to be divided or

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

and arithmetic (difficulties often comorbid with dyslexia, Landerl &

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

parisons in them can be found in previous studies (Laasonen,

2.4. Approach to statistical analyses

2.4.2. Clinical neuropsychological composite variables

2.4.1. Group differences in visual attention task performance

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

averaged into the composite variables. The raw scores of other

2.4.3. Relationships between visual attention measures and composite

Useful Field of View (UFOV)

(B1) Control condition

(B2) No distractors condition

(B3) Distractor condition

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

3. Spatial characteristics of visual attention: Useful Field of View

The third condition, the experimental condition with distractors,

Useful Field of View (UFOV)

Threshold in ms (mean +/- SEM)

best differentiated between the groups from a visual attention task

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

4. Temporal characteristics of visual attention: Attentional

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

Attentional Blink (AB)

Attentional Blink (AB)

Percent correct (mean +/- SEM)

26.7 ms (two frames) with an ISI of 106.7 ms (eight frames) for an

T1-T2 lag in milliseconds

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

Cousineau parameters for AB

T1-T2 lag in milliseconds

factor and T1T2 lag as a within subjects factor revealed a trend

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

Multiple Object Tracking (MOT)

(C) Dots move for for 5 sec, all yellow

(B) Dots move for 2 sec, some blue

(D) Was the white dot blue?

target (T1) was to-be-ignored (baseline) and in identifying the first

required processing of two targets. However, AB performance did

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

Multiple Object Tracking (MOT)

Percent correct (mean +/- SEM)

a predictor at step 2, R2 was still significantly different from zero

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

Taken together, the current groups with dyslexia or ADHD did

traditionally related to ADHD (attention and executive functions).

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

Performance of the groups in the neuropsychological tasks

Word list reading (speed)

Reading comprehension, average of

Spelling, accuracy: pseudoword

M. Laasonen et al. / Brain and Cognition 80 (2012) 311327

Performance of the groups in the neuropsychological tasks

Color Trails Test,