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Neurological Foundations and Technological Interventions for Dyslexia: Advancements and Challenges

Piper Hutson and James Hutson

Lindenwood University, USA
ORCID: https://orcid.org/0000-0002-0578-6052

*Corresponding author

*Piper Hutson , Lindenwood University, USA. ORCID: https://orcid.org/0000-0002-0578-6052

Abstract

Dyslexia, a complex neurological condition affecting reading and language processing, is intricately tied to variations in brain structure and function. This article explores the neurological underpinnings of dyslexia, emphasizing phonological, visual, and attention-related impairments. Furthermore, the analysis highlights various types of dyslexia—phonological, surface, rapid automatized naming, and visual—while addressing their neurological correlations. It also investigates the relationship between dyslexia and other neurodivergent conditions, such as autism and ADHD, focusing on the neurological overlap and differences. To mitigate the challenges associated with dyslexia, advanced technologies such as virtual reality (VR) and eye-tracking are discussed for their diagnostic and intervention potential. These tools allow for immersive assessments, personalized interventions, and dynamic text adjustments tailored to dyslexic individuals’ needs. The article also delves into the systemic barriers to dyslexia diagnosis and intervention, advocating for insurance coverage reforms and alternative financial tools like Health Savings Accounts (HSAs) and ABLE accounts. By providing a comprehensive overview of dyslexia's neurological and technological dimensions, this study contributes to a deeper understanding of the condition and explores how emerging innovations can address both diagnostic and intervention gaps.

Key words: Dyslexia, Neurological foundations, Virtual reality, Eye-Tracking, Assistive technology

Introduction

Dyslexia is a multifaceted neurological disorder, characterized by difficulties in reading and language processing that are unrelated to overall cognitive ability or educational opportunity. Historically viewed as a primarily visual impairment, contemporary research has established that dyslexia stems from complex neurological underpinnings, particularly involving the phonological and visual processing systems. Phonological deficits, or difficulties in processing the sounds of language, are central to most cases of dyslexia, impairing word decoding, spelling, and fluent reading. Additionally, some studies have identified a role for deficits in visual attention span and visual processing, which contribute to impaired reading abilities (Kibby et al., 2015). These neurological disruptions affect the brain’s language networks, including the left occipitotemporal region, which plays a critical role in word recognition and reading fluency (Kim, 2021).

Recent studies continue to expand our understanding of the neurobiological roots of dyslexia, particularly its impact on white matter connectivity. For example, altered structural connectivity in brain regions associated with phonological processing, such as the left middle temporal gyrus and frontal networks, has been found to correlate with the severity of phonological deficits in dyslexic individuals (Sihvonen et al., 2021). In parallel, visual processing challenges, particularly those related to visual motion processing in the dorsal stream, contribute to reading difficulties in some dyslexic populations, suggesting a multifactorial etiology (Liu et al., 2022). The convergence of phonological and visual processing deficits underscores the need for individualized interventions tailored to each dyslexic person's neurological profile.

Recent advancements in technology have led to the development of innovative interventions aimed at mitigating the challenges posed by dyslexia. One of the most promising tools is virtual reality (VR), which creates immersive learning environments that facilitate engagement and motivation for students with dyslexia. VR systems, combined with eye-tracking and other assistive technologies, have shown potential in promoting reading fluency and comprehension by simulating real-world reading tasks in a controlled and motivating setting (Corona-González et al., 2024). These systems enable educators to monitor eye movements, allowing for tailored interventions that address specific visual processing deficits, thereby improving reading abilities in children diagnosed with dyslexia (Saunier et al., 2022).

Eye-tracking technology is another pivotal innovation in the assessment and intervention of dyslexia. It provides detailed insights into visual strategies and reading behaviors by tracking eye movements during reading tasks. Studies have demonstrated that eye-tracking systems, when integrated with virtual environments, can identify specific visual challenges such as fixation patterns and saccadic movements, which are common in dyslexic individuals (Le et al., 2023). Through an analysis these movements, educational software can adjust text presentation in real-time, offering personalized learning experiences that cater to each student’s unique needs. Furthermore, the integration of text-to-speech (TTS) tools with eye-tracking has been found to significantly improve reading comprehension by synchronizing auditory and visual inputs (Schiavo et al., 2021).

To mitigate the challenges associated with dyslexia, advanced technologies such as VR and eye-tracking are discussed for their diagnostic and intervention potential. These tools allow for immersive assessments, personalized interventions, and dynamic text adjustments tailored to the needs of dyslexic individual. The article also looks into the systemic barriers to dyslexia diagnosis and intervention, advocating for insurance coverage reforms and alternative financial tools like Health Savings Accounts (HSAs) and ABLE accounts. By providing a comprehensive overview of the neurological and technological dimensions of the condition, this study contributes to a deeper understanding of the condition and explores how emerging innovations can address both diagnostic and intervention gaps.

Literature Review

Developmental dyslexia is a complex neurodevelopmental disorder characterized by deficits in reading, spelling, and phonological processing, despite normal cognitive abilities and adequate education. Neurologically, dyslexia has been associated with structural and functional brain differences, particularly in regions involved in language processing. Research has shown that individuals with dyslexia tend to have reduced grey matter density in the left hemisphere, specifically in areas such as the posterior superior temporal gyrus and the planum temporale, which are critical for phonological processing (González-Valenzuela & Martín-Ruiz, 2021). These structural differences are thought to disrupt the phonological decoding process, a key component of reading, and have been linked to the profound difficulty dyslexics experience with tasks that require phonological awareness and manipulation (Smirni et al., 2020).

In addition to phonological deficits (Figure 1), dyslexia is also associated with visual processing impairments, particularly in the dorsal visual stream, which is responsible for motion detection and spatial attention. Studies have found altered connectivity in the magnocellular system, a pathway within the dorsal stream, suggesting that visual processing anomalies may contribute to the difficulties dyslexics have with the rapid decoding of text (Liu et al., 2022). This is further supported by findings that children with dyslexia exhibit weaker brain activation in the middle temporal visual areas (V5/MT+), areas critical for visual motion processing, which are less active during reading tasks in dyslexic individuals compared to typical readers (Caldani et al., 2020). These neurological deficits, spanning both phonological and visual processing systems, highlight the multifactorial nature of dyslexia, with attention deficits further compounding the reading difficulties experienced by individuals with this condition (Taran et al., 2022).

The condition manifests in various forms, each characterized by distinct cognitive deficits. Phonological dyslexia is perhaps the most researched, where individuals struggle primarily with phonological processing—decoding and manipulating the sounds of language (Uema et al., 2022). These difficulties impede accurate word recognition and spelling, making it challenging for affected individuals to read fluently. In contrast, surface dyslexia affects the ability to recognize whole words by sight, making individuals rely heavily on phonetic decoding. This subtype leads to difficulty reading irregular words that do not follow typical phonological rules (Bartha-Doering et al., 2024). Another significant subtype is rapid automatized naming (RAN) dyslexia, where individuals exhibit difficulty retrieving the names of familiar items, such as letters or numbers, quickly. This impairment disrupts reading fluency, which is vital for comprehension (Araújo, Huettig, & Meyer, 2021). Lastly, visual dyslexia is characterized by deficits in visual processing, where individuals face challenges with tracking text or perceiving letters and words accurately, leading to difficulties in reading fluidly (Kristjansson & Sigurdardottir, 2023).

Dyslexia often co-occurs with other neurodevelopmental conditions. Research shows a significant overlap between dyslexia and autism spectrum condition (ASC), particularly regarding visual processing difficulties and attention-related challenges (Meilleur et al., 2020). Individuals with autism often display heightened attention to detail and rigid patterns of thought, which can exacerbate the visual and attentional deficits seen in dyslexia (Petrolini, Jorba, & Vicente, 2023). Similarly, dyslexia frequently co-occurs with ADHD, with estimates suggesting that up to 50% of individuals with dyslexia also have ADHD. In these cases, the combined challenges of poor attention regulation and executive functioning deficits—hallmarks of ADHD—make reading tasks even more difficult for dyslexic individuals (Fernández-Andrés, Tejero, & Vélez-Calvo, 2021).

The role of visual processing in dyslexia has garnered significant attention, particularly regarding visual crowding, impaired contrast sensitivity, and the magnocellular theory. Visual crowding refers to the difficulty individuals with dyslexia experience in distinguishing letters and words when surrounded by other text, contributing to reading difficulties. Impaired contrast sensitivity, a feature linked to the magnocellular pathway, further exacerbates these issues, making it difficult for dyslexic individuals to process visual information quickly and efficiently. The magnocellular theory posits that dysfunction in this visual system contributes to the deficits in reading speed and accuracy commonly observed in dyslexia (Vilhena et al., 2021). Additionally, studies have shown that dyslexic individuals exhibit differences in eye movements, including an increased number of fixations and regressions, as well as mirror writing tendencies, which overlap with similar characteristics in autistic individuals (Jafarlou et al., 2020).

Systemic barriers to the diagnosis and intervention of dyslexia pose significant challenges. Financial obstacles, such as the high cost of specialized assessments, hinder access to timely diagnoses, especially for families without adequate insurance coverage. Moreover, there is often resistance to self-diagnosis, with many healthcare systems denying services based on self-reported symptoms or observations. This creates a gap in early intervention opportunities, further complicating the educational and social outcomes for individuals with dyslexia. The lack of systemic support for affordable, accessible diagnostic services calls for policy changes, such as the inclusion of dyslexia screenings in standard insurance coverage or the utilization of HSAs to offset costs (Ji & Bi, 2020). Without such interventions, many individuals are left to navigate the complexities of dyslexia without appropriate resources.

Previous research has consistently highlighted the multifactorial nature of dyslexia, encompassing phonological and visual processing deficits. Studies focusing on the magnocellular system have underscored the significance of impaired visual processing in the condition, while research on eye movement differences has revealed that individuals with dyslexia struggle with reading fluency due to disruptions in ocular motor control. Furthermore, systemic barriers to diagnosis persist, limiting access to essential support. Addressing these barriers through technological and policy innovations could provide more comprehensive solutions for individuals with dyslexia.

Figure 1: Routes impaired in surface and phonological dyslexia (CC 3.0).

Methodology

Technological advancements have revolutionized dyslexia assessment and intervention, with VR and eye-tracking technologies offering promising solutions. VR provides an immersive environment where dyslexic individuals can engage with reading material in a highly interactive and controlled manner. The immersive technology also enables the simulation of real-world reading tasks, allowing for a dynamic and engaging assessment of the reading ability of an individual. This type of intervention has shown promise in boosting motivation, as it creates a more enjoyable learning experience compared to traditional methods. Studies have demonstrated that dyslexic students who undergo VR-based interventions display improved word recognition and comprehension skills due to the active and exploratory nature of the environment (Rodríguez-Cano et al., 2021).

Eye-tracking technology (Figure 2) complements VR by providing insights into the specific visual and cognitive challenges dyslexic individuals face while reading. Eye-tracking systems monitor patterns such as fixations and saccadic movements, which are often disrupted in individuals with dyslexia. These systems enable personalized interventions by identifying the exact moments when a dyslexic person experiences difficulty. Integrating eye-tracking into VR environments has been found to significantly enhance the precision of interventions, as it allows for real-time adjustments based on an individual’s visual processing needs (Saunier et al., 2022). The combination of these two technologies offers a comprehensive approach to diagnosing and addressing dyslexia, providing educators with detailed data to tailor their teaching methods.

Beyond the technological tools themselves, financial and systemic barriers remain significant challenges in dyslexia diagnosis and treatment. High costs associated with specialized testing often limit access for many families, exacerbating educational inequalities. To address these barriers, the use of financial instruments such as HSAs and ABLE accounts has been explored as a way to offset the financial burden of testing and therapy. These accounts allow families to save and use pre-tax income for medical expenses, including dyslexia-related diagnostics and interventions. While promising, these financial tools are not universally accessible and depend on employment status and specific tax brackets (Ji & Bi, 2020).

In addition to financial strategies, potential insurance reforms could offer more inclusive coverage for dyslexia testing and treatment. Current insurance policies often exclude or limit coverage for learning disabilities, requiring reforms to ensure that dyslexia is recognized as a condition that warrants comprehensive support. Proposals include mandatory low-cost screening programs in schools and clinics, along with expanded insurance coverage that includes neuropsychological evaluations and therapeutic interventions. These changes could make dyslexia diagnosis more accessible and affordable for families across socioeconomic strata, ultimately improving educational outcomes for children with dyslexia (Stokes et al., 2022).

Figure 2: Percept eye tracking (CC 4.0).

Recommendations

Designing neuroinclusive workspaces for dyslexic individuals requires careful attention to sensory and cognitive factors that affect their productivity. Using color-coding and high-contrast materials can significantly enhance visual clarity, reducing the strain of processing written information. Dyslexia-friendly fonts, such as OpenDyslexic, can further aid readability by preventing the letters from appearing distorted or jumbled. Creating quiet spaces is equally essential, as dyslexic individuals often face heightened challenges with auditory processing, which can be exacerbated by noisy environments. The integration of assistive technology tools such as text-to-speech software and mind mapping tools can help reduce cognitive load, allowing individuals to process information more efficiently (Bhola, 2022; Patnoorkar et al., 2023).

In addition to physical workspace design, technology tools such as Microsoft's Immersive Reader provide dyslexic individuals with innovative ways to manage cognitive overload. This tool, integrated into platforms like Microsoft Word and OneNote, offers features such as line focus, which reduces the amount of text visible at one time, and the ability to change text spacing and fonts for enhanced readability. Text-to-speech software, as shown in various studies, improves reading comprehension by allowing users to hear written material, thus enhancing their ability to retain information (Destoky et al., 2021). Additionally, mind mapping tools help users visually organize information, fostering better understanding and memory retention, particularly in tasks that require multi-step problem-solving (Almgren Bäck et al., 2024).

In educational settings, the use of assistive technologies can transform the learning experiences of dyslexic students. Tools like reading tutors, text-to-speech applications, and visual aids are increasingly being integrated into classrooms to support literacy development. Text-to-speech software allows students to listen to the material, which not only aids comprehension but also reduces the cognitive load associated with decoding written language (Bhola, 2022). Reading tutors provide structured guidance tailored to individual needs, while visual aids break down complex information into more accessible formats. Studies have shown that the use of assistive technologies in education leads to substantial improvements in reading and writing skills among dyslexic students (Lerga et al., 2021).

Creating personalized and dynamic learning experiences further enhances dyslexic student ability to engage with academic content. Adaptive assessments and VR reading programs allow educators to customize the learning process based on each student’s specific needs. VR systems, for example, offer immersive experiences that can improve reading skills by presenting material in an interactive and engaging format, which has been shown to improve both comprehension and motivation (Maresca et al., 2022). Customized captions, meanwhile, provide real-time adjustments to the presentation of text, making the material more accessible to students with visual and cognitive challenges (Saunier et al., 2022).

Addressing the digital divide in virtual tutoring is critical to ensuring that all dyslexic students have access to the necessary tools for success. Public internet programs for low-income families can help bridge this gap, providing students with the resources needed for online learning. Partnerships between educational institutions and telecom providers could offer discounted or free internet access to families, particularly in under-resourced areas. Hybrid learning models, which combine in-person and virtual learning, have also proven effective, allowing students to access high-quality tutoring regardless of their location (El Kah et al., 2021).

Ensuring that virtual learning platforms are accessible to all students requires further collaboration between schools, government agencies, and private corporations. Telecom partnerships could ensure that low-income students have reliable access to virtual tutoring and other online resources, while government programs could subsidize the cost of essential technologies like laptops and internet routers. Additionally, educational initiatives should focus on training teachers to effectively use these digital tools, maximizing their potential to support dyslexic learners (Ji & Bi, 2020).

Discussion

The neurological and behavioral implications of dyslexia extend beyond mere difficulties in reading and spelling. Research demonstrates that dyslexia is closely tied to disruptions in both phonological and visual processing systems. Phonological processing, a critical component of language acquisition, is impaired in dyslexic individuals, affecting their ability to decode and manipulate sounds in language. Visual processing, particularly in the dorsal stream, further exacerbates reading difficulties due to issues like visual crowding and impaired contrast sensitivity (Prabha & Bhargavi, 2020). Moreover, studies suggest that boredom and reduced visual stimulation can worsen dyslexic symptoms, as individuals often struggle to maintain engagement with text when the visual and cognitive demands become overwhelming (Stokes et al., 2022).

Dyslexia also frequently co-occurs with other neurodevelopmental disorders, such as autism and ADHD, placing it within the broader neurodivergent spectrum. Individuals with autism often exhibit overlapping traits, including visual processing challenges and attention deficits, which can complicate dyslexia diagnosis and treatment. Similarly, ADHD, characterized by attention regulation difficulties, co-occurs with dyslexia at a high rate, further complicating the ability to focus and engage in reading tasks (Zhou et al., 2022). The co-occurrence of these conditions underscores the need for holistic interventions that address both attention and visual processing deficits.

Technological interventions, particularly virtual reality (VR) and eye-tracking, present promising solutions for diagnosing and supporting individuals with dyslexia. VR enables immersive, interactive assessments that make learning more engaging, while eye-tracking offers precise insights into the visual processing difficulties faced by dyslexic individuals. These tools allow for real-time adjustments to educational content, making it more accessible and personalized (Maresca et al., 2022). However, challenges remain in the implementation of these technologies, particularly in terms of cost and accessibility. Moreover, while eye-tracking can provide valuable data on reading behavior, its integration into educational settings is still limited due to logistical and technical barriers (Vajs et al., 2022).

Despite these challenges, the potential for dynamic and personalized interventions is immense. Studies have shown that customized VR environments can improve reading outcomes and reduce the stress associated with traditional educational settings. By tailoring learning experiences to the unique needs of each dyslexic individual, these technologies not only enhance literacy but also foster greater engagement and motivation (Saunier et al., 2022). The use of gamified learning environments within VR, for example, has been found to improve adherence to therapy by making the learning process enjoyable, ultimately leading to better educational outcomes.

Future Research

The magnocellular theory has been instrumental in understanding the visual processing deficits observed in dyslexia, yet further research is needed to refine its implications for diagnostic and therapeutic interventions. The magnocellular pathway, responsible for processing visual motion and spatial attention, has been shown to function inefficiently in individuals with dyslexia, contributing to reading difficulties (Vilhena et al., 2021). Researchers have begun exploring how this visual dysfunction manifests in different languages and across various developmental stages. Studies using frequency-doubling perimetry and eye-tracking have identified significant correlations between magnocellular deficits and ocular motor skills, suggesting that interventions targeting the magnocellular system may improve reading performance (Stein, 2021). However, more robust longitudinal studies are needed to confirm these findings and determine the optimal timing for interventions.

Advanced eye-tracking technologies offer promising opportunities for future research, particularly in classroom and workplace settings. These technologies can provide real-time data on eye movements, enabling educators and employers to understand the specific visual challenges faced by dyslexic individuals. Eye-tracking has been shown to improve the accuracy of dyslexia diagnosis by detecting anomalies in fixation and saccadic movements, which are often disrupted in dyslexic readers (Ji & Bi, 2020). Implementing these technologies in practical settings, however, requires overcoming logistical challenges, such as the cost and complexity of integrating eye-tracking into existing educational systems. Future research should focus on developing scalable and affordable eye-tracking solutions that can be used in both urban and rural environments, especially in under-resourced communities.

Technological innovations, particularly the combination of VR and eye-tracking, have the potential to revolutionize dyslexia diagnosis and intervention. The technology creates immersive environments where dyslexic individuals can engage with reading material in a more interactive way, while eye-tracking data can pinpoint specific moments of visual or cognitive difficulty (Saunier et al., 2022). These tools can provide a more holistic understanding of the cognitive and visual processing challenges associated with dyslexia, offering tailored interventions that go beyond traditional reading strategies. However, there remain significant barriers to implementing these technologies on a broad scale, including the high cost of VR equipment and the need for specialized training for educators and clinicians.

The scalability of these advanced technologies in under-resourced communities is a critical area for future research. While VR and eye-tracking offer immense potential for improving dyslexia diagnosis and intervention, their accessibility in low-income areas remains limited. Addressing this gap requires innovative solutions, such as partnerships between educational institutions, tech companies, and government agencies to provide subsidized technology and training programs. Research should explore the feasibility of implementing low-cost versions of these technologies, possibly through the development of mobile-based VR systems and simplified eye-tracking devices (Meng et al., 2022). By focusing on the needs of under-resourced communities, future studies can help bridge the digital divide and ensure that all individuals with dyslexia have access to cutting-edge diagnostic and intervention tools.

Conclusion

Addressing dyslexia requires a comprehensive understanding of its neurological underpinnings and the implementation of innovative technological solutions to mitigate its effects. Key findings in neurological research have identified that dyslexia involves significant deficits in both phonological and visual processing, often linked to disruptions in the brain's magnocellular pathway. Reduced grey matter in language-processing regions and impaired visual motion detection further compound the challenges individuals with dyslexia face in reading and language tasks (Stein, 2021). These insights underscore the need for tailored interventions that address the multifaceted nature of dyslexia and provide personalized support for individuals based on their specific neurological profiles.

Emerging technologies, such as virtual reality (VR) and eye-tracking, offer transformative possibilities for improving dyslexia diagnosis and intervention. VR creates immersive learning environments that engage dyslexic individuals in ways traditional methods cannot, while eye-tracking provides real-time feedback on visual processing deficits, enabling more precise and individualized interventions (Saunier et al., 2022). These technologies hold the potential to bridge existing gaps in dyslexia care, making it possible to tailor learning experiences to individual needs while providing more comprehensive diagnostic tools that capture both cognitive and visual challenges.

Moving forward, there is an urgent need to advocate for more accessible and inclusive dyslexia testing and support. Policy changes are necessary to ensure that insurance companies cover diagnostic assessments and interventions for dyslexia. Additionally, workplace accommodations that integrate assistive technologies, such as text-to-speech tools and dyslexia-friendly fonts, must become standard practice to support neurodiverse employees. As technological innovations continue to advance, it is imperative that these tools are made accessible to all individuals with dyslexia, regardless of socioeconomic status. By addressing these systemic barriers, we can create a more inclusive society where individuals with dyslexia can thrive.

Data Availability: Data available upon request.

Conflicts of Interest: The authors declare that there is no conflict of interest regarding the publication of this paper.

Funding Statement: NA

Authors’ Contributions: Conceptualization, P. Hutson; Methodology, P. Hutson; Validation, P. Hutson; Investigation, J. Hutson – Original Draft Preparation, J. Hutson; Writing – Review & Editing, J. Hutson.; Visualization, J. Hutson.

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