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1.  Developmental Changes in the Visual Span for Reading 
Vision research  2007;47(22):2889-2900.
The visual span for reading refers to the range of letters, formatted as in text, that can be recognized reliably without moving the eyes. It is likely that the size of the visual span is determined primarily by characteristics of early visual processing. It has been hypothesized that the size of the visual span imposes a fundamental limit on reading speed (Legge, Mansfield, & Chung, 2001). The goal of the present study was to investigate developmental changes in the size of the visual span in school-age children, and the potential impact of these changes on children’s reading speed. The study design included groups of 10 children in 3rd, 5th, and 7th grade, and 10 adults. Visual span profiles were measured by asking participants to recognize letters in trigrams (random strings of three letters) flashed for 100 ms at varying letter positions left and right of the fixation point. Two print sizes (0.25° and 1.0°) were used. Over a block of trials, a profile was built up showing letter recognition accuracy (% correct) versus letter position. The area under this profile was defined to be the size of the visual span. Reading speed was measured in two ways: with Rapid Serial Visual Presentation (RSVP) and with short blocks of text (termed Flashcard presentation). Consistent with our prediction, we found that the size of the visual span increased linearly with grade level and it was significantly correlated with reading speed for both presentation methods. Regression analysis using the size of the visual span as a predictor indicated that 34% to 52% of variability in reading speeds can be accounted for by the size of the visual span. These findings are consistent with a significant role of early visual processing in the development of reading skills.
PMCID: PMC2052928  PMID: 17845810
Letter Recognition; Reading speed; Development
2.  The case for the visual span as a sensory bottleneck in reading 
Journal of vision  2007;7(2):9.1-915.
The visual span for reading is the number of letters, arranged horizontally as in text, that can be recognized reliably without moving the eyes. The visual-span hypothesis states that the size of the visual span is an important factor that limits reading speed. From this hypothesis, we predict that changes in reading speed as a function of character size or contrast are determined by corresponding changes in the size of the visual span. We tested this prediction in two experiments in which we measured the size of the visual span and reading speed on groups of five subjects as a function of either character size or character contrast. We used a “trigram method” for characterizing the visual span as a profile of letter-recognition accuracy as a function of distance left and right of the midline (G. E. Legge, J. S. Mansfield, & S. T. L. Chung, 2001). The area under this profile was taken as an operational measure of the size of the visual span. Reading speed was measured with the Rapid Serial Visual Presentation (RSVP) method. We found that the size of the visual span and reading speed showed the same qualitative dependence on character size and contrast, reached maximum values at the same critical points, and exhibited high correlations at the level of individual subjects. Additional analysis of data from four studies provides evidence for an invariant relationship between the size of the visual span and RSVP reading speed; an increase in the visual span by one letter is associated with a 39% increase in reading speed. Our results confirm the visual-span hypothesis and provide a theoretical framework for understanding the impact of stimulus attributes, such as contrast and character size, on reading speed. Evidence for the visual span as a determinant of reading speed implies the existence of a bottom–up, sensory limitation on reading, distinct from attentional, motor, or linguistic influences.
PMCID: PMC2729064  PMID: 18217824
vision; contrast; character size; visual span; low vision; reading; reading speed
3.  Dependence of Reading Speed on Letter Spacing in Central Vision Loss 
Crowding, the difficulty in recognizing a letter in close proximity with other letters, has been suggested as an explanation for slow reading in people with central vision loss. The goals of this study were (1) to examine whether increased letter spacing in words, which presumably reduces crowding among letters, would benefit reading for people with central vision loss; and (2) to relate our finding to the current account of faulty feature integration of crowding.
Fourteen observers with central vision loss read aloud single sentences, one word at a time, using rapid serial visual presentation (RSVP). Reading speeds were calculated based on the RSVP exposure durations yielding 80% accuracy. Letters were rendered in Courier, a fixed-width font. Observers were tested at 1.4× the critical print size (CPS), three were also tested at 0.8× CPS. Reading speed was measured for five center-to-center letter spacings (range: 0.5–2× the standard spacing). The preferred retinal locus (PRL) for fixation was determined for nine of the observers, from which we calculated the horizontal dimension of the integration field for crowding.
All observers showed increased reading speed with letter spacing for small spacings, until an optimal spacing, beyond which reading speed either showed a plateau, or dropped as letter spacing further increased. The optimal spacing averaged 0.95±0.06× [±95%CI] the standard spacing for 1.4× CPS (similar for 0.8× CPS), which was not different from the standard. When converted to angular size, the measured values of the optimal letter spacing for reading show a good relationship with the calculated horizontal dimension of the integration field.
Increased letter spacing beyond the standard size, which presumably reduces crowding among letters in text, does not improve reading speed for people with central vision loss. The optimal letter spacing for reading can be predicted based on the PRL.
PMCID: PMC3429790  PMID: 22842309
reading; crowding; central vision loss; low vision; age-related macular degeneration
4.  Spatial-frequency requirements for reading revisited 
Vision research  2012;62:10.1016/j.visres.2012.03.025.
Blur is one of many visual factors that can limit reading in both normal and low vision. Legge et al. [Legge, G. E., Pelli, D. G., Rubin, G. S., & Schleske, M. M. (1985). Psychophysics of reading. I. Normal vision. Vision Research, 25, 239–252.] measured reading speed for text that was low-pass filtered with a range of cutoff spatial frequencies. Above 2 cycles per letter (CPL) reading speed was constant at its maximum level, but decreased rapidly for lower cutoff frequencies. It remains unknown why the critical cutoff for reading speed is near 2 CPL. The goal of the current study was to ask whether the spatial-frequency requirement for rapid reading is related to the effects of cutoff frequency on letter recognition and the size of the visual span. Visual span profiles were measured by asking subjects to recognize letters in trigrams (random strings of three letters) flashed for 150 ms at varying letter positions left and right of the fixation point. Reading speed was measured with Rapid Serial Visual Presentation (RSVP). The size of the visual span and reading speed were measured for low-pass filtered stimuli with cutoff frequencies from 0.8 to 8 CPL. Low-pass letter recognition data, obtained under similar testing conditions, were available from our previous study (Kwon & Legge, 2011). We found that the spatial-frequency requirement for reading is very similar to the spatial-frequency requirements for the size of the visual span and single letter recognition. The critical cutoff frequencies for reading speed, the size of the visual span and a contrast-invariant measure of letter recognition were all near 1.4 CPL, which is lower than the previous estimate of 2 CPL for reading speed. Although correlational in nature, these results are consistent with the hypothesis that the size of the visual span is closely linked to reading speed.
PMCID: PMC3653576  PMID: 22521659
Reading; Letter recognition; Spatial-frequency bandwidth; Visual span; Peripheral vision; Low vision; Blur
5.  Letter-recognition and reading speed in peripheral vision benefit from perceptual learning 
Vision research  2004;44(7):695-709.
Visual-span profiles are plots of letter-recognition accuracy as a function of letter position left or right of the midline. Previously, we have shown that contraction of these profiles in peripheral vision can account for slow reading speed in peripheral vision. In this study, we asked two questions: (1) can we modify visual-span profiles through training on letter-recognition, and if so, (2) are these changes accompanied by changes in reading speed? Eighteen normally sighted observers were randomly assigned to one of three groups: training at 10° in the upper visual field, training at 10° in the lower visual field and a no-training control group. We compared observers’ characteristics of reading (maximum reading speed and critical print size) and visual-span profiles (peak amplitude and bits of information transmitted) before and after training, and at trained and untrained retinal locations (10° upper and lower visual fields). Reading speeds were measured for six print sizes at each retinal location, using the rapid serial visual presentation paradigm. Visual-span profiles were measured using a trigram letter-recognition task, for a letter size equivalent to 1.4 × the critical print size for reading. Training consisted of the repeated measurement of 20 visual-span profiles (over four consecutive days) in either the upper or lower visual field. We also tracked the changes in performance in a sub-group of observers for up to three months following training. We found that the visual-span profiles can be expanded (bits of information transmitted increased by 6 bits) through training with a letter-recognition task, and that there is an accompanying increase (41%) in the maximum reading speed. These improvements transferred, to a large extent, from the trained to an untrained retinal location, and were retained, to a large extent, for at least three months following training. Our results are consistent with the view that the visual span is a bottleneck on reading speed, but a bottleneck that can be increased with practice.
PMCID: PMC2729075  PMID: 14751554
Reading; Letter-recognition; Peripheral vision; Perceptual learning; Low vision; Visual rehabilitation
6.  Comparing Reading Speed for Horizontal and Vertical English Text 
Journal of vision  2010;10(2):21.1-2117.
There are three formats for arranging English text for vertical reading—upright letters arranged vertically (marquee), and horizontal text rotated 90° clockwise or counterclockwise. Previous research has shown that reading is slower for all three vertical formats than for horizontal text, with marquee being slowest. It has been proposed that the size of the visual span—the number of letters recognized with high accuracy without moving the eyes—is a visual factor limiting reading speed. We predicted that reduced visual-span size would be correlated with the slower reading for the three vertical formats. We tested this prediction with uppercase and lowercase letters. Reading performance was measured using two presentation methods: RSVP (Rapid Serial Visual Presentation) and flashcard (a block of text on four lines). On average, reading speed for horizontal text was 139% faster than marquee text and 81% faster than the rotated texts. Size of the visual span was highly correlated with changes in reading speed for both lowercase and uppercase letters and for both RSVP and flashcard reading. Our results are consistent with the view that slower reading of vertical text is due to a decrease in the size of the visual span for vertical reading.
PMCID: PMC2921212  PMID: 20462322
Visual span; Letter recognition; Reading speed; Vertical reading
7.  Relationship between visual span and reading performance in Age-Related Macular Degeneration 
Vision research  2008;48(4):577-588.
Visual-span profiles are plots of letter-recognition accuracy as a function of letter position left and right of the point of fixation. Legge, Mansfield & Chung (2001) proposed that reduced size of the visual span is a spatial factor limiting reading speed in patients with age-related macular degeneration (AMD). We have recently shown that a temporal property of letter recognition - the exposure time required for a high level of accuracy – is also a factor limiting reading speed in AMD (Cheong, Legge, Lawrence, Cheung & Ruff, 2007). We measured the visual-span profiles of AMD subjects and assessed the relationship of the spatial and temporal properties of these profiles to reading speed.
Thirteen AMD subjects and 11 age-matched normals were tested. Visual-span profiles were measured by using the trigram letter-recognition method described by Legge et al. (2001). Each individual’s temporal threshold for letter recognition (80% accuracy criterion) was used as the exposure time for measuring the visual-span profile. Size of the visual span was computed as the area under the profile in bits of information transmitted. The information transfer rate in bits per second was defined as the visual-span size in bits divided by the exposure time in sec.
AMD visual-span sizes were substantially smaller (median of 23.9 bits) than normal visual-span sizes in central vision (median of 40.8 bits, p<0.01). For the nine AMD subjects with eccentric fixation, the visual-span sizes (median of 20.6 bits) were also significantly smaller than visual spans of normal controls at 10° below fixation in peripheral vision (median of 29.0 bits, p=0.01). Information transfer rate for the AMD subjects (median of 29.5 bits/sec) was significantly slower than that for the age-matched normals at both central and peripheral vision (median of 411.7 & 290.5 bits/sec respectively, ps<0.01). Information transfer rates were more strongly correlated with reading speed than the size of the visual span, and explained 36% of the variance in AMD reading speed.
Both visual-span size and information transfer rate were significantly impaired in the AMD subjects compared with age-matched normals. Information transfer rate, representing the combined effects of a reduced visual span and slower temporal processing of letters, was a better predictor of reading speed in AMD subjects than was the size of the visual span.
PMCID: PMC2323914  PMID: 18191983
low vision; age-related macular degeneration; reading speed; visual span; letter recognition; information transfer rate
8.  Reading Speed in the peripheral visual field of older adults: Does it benefit from perceptual learning? 
Vision research  2010;50(9):860-869.
Enhancing reading ability in peripheral vision is important for the rehabilitation of people with central-visual-field loss from age-related macular degeneration (AMD). Previous research has shown that perceptual learning, based on a trigram letter-recognition task, improved peripheral reading speed among normally-sighted young adults (Chung, Legge & Cheung, 2004). Here we ask whether the same happens in older adults in an age range more typical of the onset of AMD. Eighteen normally-sighted subjects, aged 55 to 76 years, were randomly assigned to training or control groups. Visual-span profiles (plots of letter-recognition accuracy as a function of horizontal letter position) and RSVP reading speeds were measured at 10° above and below fixation during pre- and post-tests for all subjects. Training consisted of repeated measurements of visual-span profiles at 10° below fixation, in 4 daily sessions. The control subjects did not receive any training. Perceptual learning enlarged the visual spans in both trained (lower) and untrained (upper) visual fields. Reading speed improved in the trained field by 60% when the trained print size was used. The training benefits for these older subjects were weaker than the training benefits for young adults found by Chung et al. Despite the weaker training benefits, perceptual learning remains a potential option for low-vision reading rehabilitation among older adults.
PMCID: PMC2858588  PMID: 20156473
9.  Reading Speed Does Not Benefit from Increased Line Spacing in AMD Patients 
Crowding, the adverse spatial interaction due to the proximity of adjacent targets, has been suggested as an explanation for slow reading in peripheral vision. Previously, we showed that increased line spacing, which presumably reduces crowding between adjacent lines of text, improved reading speed in the normal periphery (Chung, Optom Vis Sci 2004;81:525–35). The purpose of this study was to examine whether or not individuals with age-related macular degeneration (AMD) would benefit from increased line spacing for reading.
Experiment 1: Eight subjects with AMD read aloud 100-word passages rendered at five line spacings: the standard single spacing, 1.5×, 2×, 3×, and 4× the standard spacing. Print sizes were 1× and 2× of the critical print size. Reading time and number of reading errors for each passage were measured to compute the reading speed. Experiment 2: Four subjects with AMD read aloud sequences of six 4-letter words, presented on a computer monitor using the rapid serial visual presentation (RSVP) paradigm. Target words were presented singly, or flanked above and below by two other words that changed in synchrony with the target word, at various vertical word separations. Print size was 2× the critical print size. Reading speed was calculated based on the RSVP exposure duration that yielded 80% of the words read correctly.
Averaged across subjects, reading speeds for passages were virtually constant for the range of line spacings tested. For sequences of unrelated words, reading speeds were also virtually constant for the range of vertical word separations tested, except at the smallest (standard) separation at which reading speed was lower.
Contrary to the previous finding that reading speed improved in normal peripheral vision, increased line spacing in passages, or increased vertical separation between words in RSVP, did not lead to improved reading speed in people with AMD.
PMCID: PMC2729069  PMID: 18772718
10.  Reading Speed Benefits from Increased Vertical Word Spacing in Normal Peripheral Vision 
Crowding, the adverse spatial interaction due to proximity of adjacent targets, has been suggested as an explanation for slow reading in peripheral vision. The purposes of this study were to (1) demonstrate that crowding exists at the word level and (2) examine whether or not reading speed in central and peripheral vision can be enhanced with increased vertical word spacing.
Five normal observers read aloud sequences of six unrelated four-letter words presented on a computer monitor, one word at a time, using rapid serial visual presentation (RSVP). Reading speeds were calculated based on the RSVP exposure durations yielding 80% correct. Testing was conducted at the fovea and at 5° and 10° in the inferior visual field. Critical print size (CPS) for each observer and at each eccentricity was first determined by measuring reading speeds for four print sizes using unflanked words. We then presented words at 0.8× or 1.4× CPS, with each target word flanked by two other words, one above and one below the target word. Reading speeds were determined for vertical word spacings (baseline-to-baseline separation between two vertically separated words) ranging from 0.8× to 2× the standard single-spacing, as well as the unflanked condition.
At the fovea, reading speed increased with vertical word spacing up to about 1.2× to 1.5× the standard spacing and remained constant and similar to the unflanked reading speed at larger vertical word spacings. In the periphery, reading speed also increased with vertical word spacing, but it remained below the unflanked reading speed for all spacings tested. At 2× the standard spacing, peripheral reading speed was still about 25% lower than the unflanked reading speed for both eccentricities and print sizes. Results from a control experiment showed that the greater reliance of peripheral reading speed on vertical word spacing was also found in the right visual field.
Increased vertical word spacing, which presumably decreases the adverse effect of crowding between adjacent lines of text, benefits reading speed. This benefit is greater in peripheral than central vision.
PMCID: PMC2734885  PMID: 15252352
crowding; reading; peripheral vision; low vision
11.  Sensory factors limiting horizontal and vertical visual span for letter recognition 
Journal of Vision  2014;14(9):23.
Reading speed for English text is slower for text oriented vertically than horizontally. Yu, Park, Gerold, and Legge (2010) showed that slower reading of vertical text is associated with a smaller visual span (the number of letters recognized with high accuracy without moving the eyes). Three possible sensory determinants of the size of the visual span are: resolution (decreasing acuity at letter positions farther from the midline), mislocations (uncertainty about the relative position of letters in strings), and crowding (interference from flanking letters in recognizing the target letter). In the present study, we asked which of these factors is most important in determining the size of the visual span, and likely in turn in determining the horizontal/vertical difference in reading when letter size is above the critical print size for reading. We used a decomposition analysis to represent constraints due to resolution, mislocations, and crowding as losses in information transmitted (in bits) about letter recognition. Across vertical and horizontal conditions, crowding accounted for 75% of the loss in information, mislocations accounted for 19% of the loss, and declining acuity away from fixation accounted for only 6%. We conclude that crowding is the major factor limiting the size of the visual span, and that the horizontal/vertical difference in the size of the visual span is associated with stronger crowding along the vertical midline.
PMCID: PMC4144171
visual span; crowding; reading; vertical text; acuity; mislocation
12.  Training improves reading speed in peripheral vision: Is it due to attention? 
Journal of vision  2010;10(6):18.
Previous research has shown that perceptual training in peripheral vision, using a letter-recognition task, increases reading speed and letter recognition (Chung, Legge, & Cheung, 2004). We tested the hypothesis that enhanced deployment of spatial attention to peripheral vision explains this training effect. Subjects were pre- and post-tested with 3 tasks at 10° above and below fixation—RSVP reading speed, trigram letter recognition (used to construct visual-span profiles), and deployment of spatial attention (measured as the benefit of a pre-cue for target position in a lexical-decision task). Groups of five normally sighted young adults received 4 days of trigram letter-recognition training in upper or lower visual fields, or central vision. A control group received no training. Our measure of deployment of spatial attention revealed visual-field anisotropies; better deployment of attention in the lower field than the upper, and in the lower-right quadrant compared with the other three quadrants. All subject groups exhibited slight improvement in deployment of spatial attention to peripheral vision in the post-test, but this improvement was not correlated with training-related increases in reading speed and the size of visual-span profiles. Our results indicate that improved deployment of spatial attention to peripheral vision does not account for improved reading speed and letter recognition in peripheral vision.
PMCID: PMC2951270  PMID: 20884567
reading; attention; perceptual learning; peripheral vision; visual span
13.  The Effect of Letter-stroke Boldness on Reading Speed in Central and Peripheral Vision 
Vision research  2013;84:33-42.
People with central vision loss often prefer boldface print over normal print for reading. However, little is known about how reading speed is influenced by the letter-stroke boldness of font. In this study, we examined the reliance of reading speed on stroke boldness, and determined whether this reliance differs between the normal central and peripheral vision. Reading speed was measured using the rapid serial visual presentation paradigm, where observers with normal vision read aloud short single sentences presented on a computer monitor, one word at a time. Text was rendered in Courier at six levels of boldness, defined as the stroke-width normalized to that of the standard Courier font: 0.27, 0.72, 1, 1.48, 1.89 and 3.04× the standard. Testings were conducted at the fovea and 10° in the inferior visual field. Print sizes used were 0.8× and 1.4× the critical print size (smallest print size that can be read at the maximum reading speed). At the fovea, reading speed was invariant for the middle four levels of boldness, but dropped by 23.3% for the least and the most bold text. At 10° eccentricity, reading speed was virtually the same for all boldness <1, but showed a poorer tolerance to bolder text, dropping by 21.5% for 1.89x boldness and 51% for the most bold (3.04x) text. These results could not be accounted for by the changes in print size or the RMS contrast of text associated with changes in stroke boldness. Our results suggest that contrary to the popular belief, reading speed does not benefit from bold text in the normal fovea and periphery. Excessive increase in stroke boldness may even impair reading speed, especially in the periphery.
PMCID: PMC3642228  PMID: 23523572
Reading; stroke boldness; peripheral vision
14.  Improving Reading Speed for People with Central Vision Loss through Perceptual Learning 
Patients with central vision loss showed a substantial improvement in reading speed after six sessions of perceptual learning. Perceptual learning might be an effective way of enhancing visual performance for people with central vision loss.
Perceptual learning has been shown to be effective in improving visual functions in the normal adult visual system, as well as in adults with amblyopia. In this study, the feasibility of applying perceptual learning to enhance reading speed in people with long-standing central vision loss was evaluated.
Six observers (mean age, 73.8) with long-standing central vision loss practiced an oral sentence-reading task, with words presented sequentially using rapid serial visual presentation (RSVP). A pre-test consisted of measurements of visual acuities, RSVP reading speeds for six print sizes, the location of the preferred retinal locus for fixation (fPRL), and fixation stability. Training consisted of six weekly sessions of RSVP reading, with 300 sentences presented per session. A post-test, identical with the pre-test, followed the training.
All observers showed improved RSVP reading speed after training. The improvement averaged 53% (range, 34–70%). Comparisons of pre- and post-test measurements revealed little changes in visual acuity, critical print size, location of the fPRL, and fixation stability.
The specificity of the learning effect, and the lack of changes to the fPRL location and fixation stability suggest that the improvements are not due to observers adopting a retinal location with better visual capability, or an improvement in fixation. Rather, the improvements are likely to represent genuine plasticity of the visual system despite the older ages of the observers, coupled with long-standing sensory deficits. Perceptual learning might be an effective way of enhancing visual performance for people with central vision loss.
PMCID: PMC3053100  PMID: 21087972
15.  Sensory and cognitive influences on the training-related improvement of reading speed in peripheral vision 
Journal of Vision  2013;13(7):14.
Reading speed in normal peripheral vision is slow but can be increased through training on a letter-recognition task. The aim of the present study is to investigate the sensory and cognitive factors responsible for this improvement. The visual span is hypothesized to be a sensory bottleneck limiting reading speed. Three sensory factors—letter acuity, crowding, and mislocations (errors in the spatial order of letters)—may limit the size of the visual span. Reading speed is also influenced by cognitive factors including the utilization of information from sentence context. We conducted a perceptual training experiment to investigate the roles of these factors. Training consisted of four daily sessions of trigram letter-recognition trials at 10° in the lower visual field. Subjects' visual-span profiles and reading speeds were measured in pre- and posttests. Effects of the three sensory factors were isolated through a decomposition analysis of the visual span profiles. The impact of sentence context was indexed by context gain, the ratio of reading speeds for ordered and unordered text. Following training, visual spans increased in size by 5.4 bits of information transmitted, and reading speeds increased by 45%. Training induced a substantial reduction in the magnitude of crowding (4.8 bits) and a smaller reduction for mislocations (0.7 bits), but no change in letter acuity or context gain. These results indicate that the basis of the training-related improvement in reading speed is a large reduction in the interfering effect of crowding and a small reduction of mislocation errors.
PMCID: PMC3692378  PMID: 23798030
reading; peripheral vision; visual span; crowding; context gain
16.  Relationship between slow visual processing and reading speed in people with macular degeneration 
Vision research  2007;47(23):2943-2955.
People with macular degeneration (MD) often read slowly even with adequate magnification to compensate for acuity loss. Oculomotor deficits may affect reading in MD, but cannot fully explain the substantial reduction in reading speed. Central-field loss (CFL) is often a consequence of macular degeneration, necessitating the use of peripheral vision for reading. We hypothesized that slower temporal processing of visual patterns in peripheral vision is a factor contributing to slow reading performance in MD patients.
Fifteen subjects with MD, including 12 with CFL, and five age-matched control subjects were recruited. Maximum reading speed and critical print size were measured with RSVP (Rapid Serial Visual Presentation). Temporal processing speed was studied by measuring letter-recognition accuracy for strings of three randomly selected letters centered at fixation for a range of exposure times. Temporal threshold was defined as the exposure time yielding 80% recognition accuracy for the central letter.
Temporal thresholds for the MD subjects ranged from 159 to 5881 ms, much longer than values for age-matched controls in central vision (13 ms, p<0.01). The mean temporal threshold for the 11 MD subjects who used eccentric fixation (1555.8 ± 1708.4 ms) was much longer than the mean temporal threshold (97.0 ms ± 34.2 ms, p<0.01) for the age-matched controls at 10° in the lower visual field. Individual temporal thresholds accounted for 30% of the variance in reading speed (p<0.05).
The significant association between increased temporal threshold for letter recognition and reduced reading speed is consistent with the hypothesis that slower visual processing of letter recognition is one of the factors limiting reading speed in MD subjects.
PMCID: PMC2094698  PMID: 17881032
macular degeneration; central-field loss; peripheral vision; reading speed; letter recognition; temporal processing
17.  Can reading-specific training stimuli improve the effect of perceptual learning on peripheral reading speed? 
Vision research  2012;66:17-25.
In a previous study, Chung, Legge & Cheung (2004) showed that training using repeated presentation of trigrams (sequences of three random letters) resulted in an increase in the size of the visual span (number of letters recognized in a glance) and reading speed in the normal periphery. In this study, we asked whether we could optimize the benefit of trigram training on reading speed by using trigrams more specific to the reading task (i.e. trigrams frequently used in the English language) and presenting them according to their frequencies of occurrence in normal English usage and observers’ performance. Averaged across seven observers, our training paradigm (four days of training) increased the size of the visual span by 6.44 bits, with an accompanied 63.6% increase in the maximum reading speed, compared with the values before training. However, these benefits were not statistically different from those of Chung et al (2004) using a random-trigram training paradigm. Our findings confirm the possibility of increasing the size of the visual span and reading speed in the normal periphery with perceptual learning, and suggest that the benefits of training on letter recognition and maximum reading speed may not be linked to the types of letter strings presented during training.
PMCID: PMC3412893  PMID: 22750053
18.  Eye Exercises Enhance Accuracy and Letter Recognition, but Not Reaction Time, in a Modified Rapid Serial Visual Presentation Task 
PLoS ONE  2013;8(3):e59244.
Eye exercises have been prescribed to resolve a multitude of eye-related problems. However, studies on the efficacy of eye exercises are lacking, mainly due to the absence of simple assessment tools in the clinic. Because similar regions of the brain are responsible for eye movements and visual attention, we used a modified rapid serial visual presentation (RSVP) to assess any measurable effect of short-term eye exercise in improvements within these domains. In the present study, twenty subjects were equally divided into control and experimental groups, each of which performed a pre-training RSVP assessment where target letters, to which subjects were asked to respond to by pressing a spacebar, were serially and rapidly presented. Response time to target letters, accuracy of correctly responding to target letters, and correct identification of target letters in each of 12 sessions was measured. The experimental group then performed active eye exercises, while the control group performed a task that minimized eye movements for 18.5 minutes. A final post-training RSVP assessment was performed by both groups and response time, accuracy, and letter identification were compared between and within subject groups both pre- and post-training. Subjects who performed eye exercises were more accurate in responding to target letters separated by one distractor and in letter identification in the post-training RSVP assessment, while latency of responses were unchanged between and within groups. This suggests that eye exercises may prove useful in enhancing cognitive performance on tasks related to attention and memory over a very brief course of training, and RSVP may be a useful measure of this efficacy. Further research is needed on eye exercises to determine whether they are an effective treatment for patients with cognitive and eye-related disorders.
PMCID: PMC3602039  PMID: 23527146
19.  Learning to Identify Near-Acuity Letters, either with or without Flankers, Results in Improved Letter Size and Spacing Limits in Adults with Amblyopia 
PLoS ONE  2012;7(4):e35829.
Amblyopia is a developmental abnormality that results in deficits for a wide range of visual tasks, most notably, the reduced ability to see fine details, the loss in contrast sensitivity especially for small objects and the difficulty in seeing objects in clutter (crowding). The primary goal of this study was to evaluate whether crowding can be ameliorated in adults with amblyopia through perceptual learning using a flanked letter identification task that was designed to reduce crowding, and if so, whether the improvements transfer to untrained visual functions: visual acuity, contrast sensitivity and the size of visual span (the amount of information obtained in one fixation). To evaluate whether the improvements following this training task were specific to training with flankers, we also trained another group of adult observers with amblyopia using a single letter identification task that was designed to improve letter contrast sensitivity, not crowding. Following 10,000 trials of training, both groups of observers showed improvements in the respective training task. The improvements generalized to improved visual acuity, letter contrast sensitivity, size of the visual span, and reduced crowding. The magnitude of the improvement for each of these measurements was similar in the two training groups. Perceptual learning regimens aimed at reducing crowding or improving letter contrast sensitivity are both effective in improving visual acuity, contrast sensitivity for near-acuity objects and reducing the crowding effect, and could be useful as a clinical treatment for amblyopia.
PMCID: PMC3340394  PMID: 22558234
20.  Letters in the forest: global precedence effect disappears for letters but not for non-letters under reading-like conditions 
Normally skilled reading involves special processing strategies for letters, which are habitually funneled into an abstract letter code. On the basis of previous studies we argue that this habit leads to the preferred usage of an analytic strategy for the processing of letters, while non-letters are preferably processed via a holistic strategy. The well-known global precedence effect (GPE) seems to contradict to this assumption, since, with compound, hierarchical figures, including letter items, faster responses are observed to the global than to the local level of the figure, as well as an asymmetric interference effect from global to local level. We argue that with letters these effects depend on presentation conditions; only when they elicit the processing strategies automatized for reading, an analytic strategy for letters in contrast to non-letters is to be expected. We compared the GPE for letters and non-letters in central viewing, with the global stimulus size close to the functional visual field in whole word reading (6.5° of visual angle) and local stimuli close to the critical size for fluent reading of individual letters (0.5° of visual angle). Under these conditions, the GPE remained robust for non-letters. For letters, however, it disappeared: letters showed no overall response time advantage for the global level and symmetric congruence effects (local-to-global as well as global-to-local interference). We interpret these results as according to the view that reading is based on resident analytic visual processing strategies for letters.
PMCID: PMC4102249  PMID: 25101012
reading acquisition; global advantage effect; analytic processing; holistic processing; literacy; developmental dyslexia; congruence effect
21.  Overt use of a tactile-kinesthetic strategy shifts to covert processing in rehabilitation of letter-by-letter reading 
Aphasiology  2010;24(11):1424-1442.
Letter-by-letter readers identify each letter of the word they are reading serially in left to right order before recognizing the word. When their letter naming is also impaired, letter-by-letter reading is inaccurate and can render even single word reading very poor. Tactile and/or kinesthetic strategies have been reported to improve reading in these patients, but only under certain conditions or for a limited set of stimuli.
The primary aim of the current study was to determine whether a tactile/kinesthetic treatment could significantly improve reading specifically under normal reading conditions, i.e. reading untrained words presented in free vision and read without overt use of the strategy.
Methods & Procedures
Three chronic letter-by-letter readers participated in a tactile/kinesthetic treatment aimed at first improving letter naming accuracy (phase 1) and then letter-by-letter reading speed (phase 2). In a multiple case series design, accuracy and speed of reading untrained words without overt use of the trained tactile/kinesthetic strategy was assessed before phase 1, after phase 1 and again after phase 2.
Outcomes & Results
All three patients significantly improved both their speed and accuracy reading untrained words without overt use of the trained tactile/kinesthetic strategy. All three patients required the additional practice in phase 2 to achieve significant improvement. Treatment did not target sentence level reading, yet two of the three patients became so adept that they could read entire sentences.
This study replicates previous findings on the efficacy of tactile/kinesthetic treatment for letter-by-letter readers with poor letter naming. It further demonstrates that this treatment can alter cognitive processing such that words never specifically trained can be read in free vision without overtly using the trained strategy. The data suggest that an important element in achieving this level of generalization is continuing training beyond the point of initial mastery (i.e. accurate letter naming).
PMCID: PMC3002229  PMID: 21170161
aphasia; cognitive rehabilitation; Speech-Language Pathology; pure alexia; letter-by-letter reading; generalization
22.  Letter case and text legibility in normal and low vision 
Vision research  2007;47(19):2499-2505.
It is thought by cognitive scientists and typographers alike, that lower-case text is more legible than upper-case. Yet lower-case letters are, on average, smaller in height and width than upper-case characters, which suggests an upper-case advantage. Using a single unaltered font and all upper-, all lower-, and mixed-case text, we assessed size thresholds for words and random strings, and reading speeds for text with normal and visually impaired participants. Lower-case thresholds were roughly 0.1 log unit higher than upper-. Reading speeds were higher for upper- than for mixed-case text at sizes twice acuity size; at larger sizes, the upper-case advantage disappeared. Results suggest that upper-case is more legible than the other case styles, especially for visually-impaired readers, because smaller letter sizes can be used than with the other case styles, with no diminution of legibility.
PMCID: PMC2016788  PMID: 17675131
23.  Development of a training protocol to improve reading performance in peripheral vision 
Vision research  2010;50(1):36-45.
People with central-field loss must use peripheral vision for reading. Previous studies have shown that reading performance in peripheral vision can improve with extensive practice on a trigram letter-recognition task. The present study compared training on this task with training on two other character-based tasks (lexical decision and RSVP (Rapid Serial Visual Presentation) reading) which might plausibly produce more improvement in peripheral reading speed. Twenty-eight normally sighted young adults were trained at 10° in the lower visual field in a pre/post design. All three training methods produced significant improvements in reading speed, with average gains of 39% for lexical-decision, 54% for trigram letter-recognition, and 72% for RSVP training. Although the RSVP training was most effective, the lexical-decision task has the advantage of easy self administration making it more practical for home-based training.
PMCID: PMC2794940  PMID: 19819251
visual span; reading speed; perceptual learning; peripheral vision; visual training
24.  The cost of space independence in P300-BCI spellers 
Though non-invasive EEG-based Brain Computer Interfaces (BCI) have been researched extensively over the last two decades, most designs require control of spatial attention and/or gaze on the part of the user.
In healthy adults, we compared the offline performance of a space-independent P300-based BCI for spelling words using Rapid Serial Visual Presentation (RSVP), to the well-known space-dependent Matrix P300 speller.
EEG classifiability with the RSVP speller was as good as with the Matrix speller. While the Matrix speller’s performance was significantly reliant on early, gaze-dependent Visual Evoked Potentials (VEPs), the RSVP speller depended only on the space-independent P300b. However, there was a cost to true spatial independence: the RSVP speller was less efficient in terms of spelling speed.
The advantage of space independence in the RSVP speller was concomitant with a marked reduction in spelling efficiency. Nevertheless, with key improvements to the RSVP design, truly space-independent BCIs could approach efficiencies on par with the Matrix speller. With sufficiently high letter spelling rates fused with predictive language modelling, they would be viable for potential applications with patients unable to direct overt visual gaze or covert attentional focus.
PMCID: PMC3733823  PMID: 23895406
RSVP Speller BCI; Matrix P300 Speller BCI; Space-independence; Gaze-independence; Rapid serial visual presentation
25.  Difficulty with Out-Loud and Silent Reading in Glaucoma 
We evaluated the impact of glaucoma on out-loud and silent reading.
Glaucoma patients with bilateral visual field (VF) loss and normally-sighted controls had the following parameters measured: speed reading an International Reading Speed Text (IReST) passage out loud, maximum out-loud MNRead chart reading speed, sustained (30 minutes) silent reading speed, and change in reading speed during sustained silent reading.
Glaucoma subjects read slower than controls on the IReST (147 vs. 163 words per minute [wpm], P < 0.001), MNRead (172 vs. 186 wpm, P < 0.001), and sustained silent (179 vs. 218 wpm, P < 0.001) tests. In multivariable analyses adjusting for age, race, sex, education, employment, and cognition, IReST and MNRead reading speeds were 12 wpm (6%–7%) slower among glaucoma subjects compared to controls (P < 0.01 for both), while sustained silent reading speed was 16% slower (95% confidence interval [CI] = −24 to −6%, P = 0.002). Each 5 decibel (dB) decrement in better-eye VF mean deviation was associated with 6 wpm slower IReST reading (95% CI = −9 to −3%, P < 0.001), 5 wpm slower MNRead reading (95% CI = −7 to −2%, P < 0.001), and 9% slower sustained silent reading (95% CI = −13 to −6%, P < 0.001). A reading speed decline of 0.5 wpm/min or more over the sustained silent reading period was more common among glaucoma subjects than controls (odds ratio [OR] = 2.2, 95% CI = 1.0–4.9, P < 0.05).
Reading speed is slower among glaucoma patients with bilateral VF loss, with the greatest impact present during sustained silent reading. Persons with glaucoma fatigue during silent reading, resulting in slower reading over time.
Bilateral visual field loss from glaucoma is associated with slower reading speed and decline of reading speed during prolonged silent reading. Silent reading speed over prolonged durations is more affected by glaucomatous visual field loss than reading out loud for short durations.
PMCID: PMC3559070  PMID: 23074207

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