Scientific Studies of Reading

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A Meta-Analytic Review of Naming-Speed Deficits

in Developmental Dyslexia

Susana Araújo & Luís Faísca

To cite this article: Susana Araújo & Luís Faísca (2019) A Meta-Analytic Review of Naming-
Speed Deficits in Developmental Dyslexia, Scientific Studies of Reading, 23:5, 349-368, DOI:
10.1080/10888438.2019.1572758

To link to this article: https://doi.org/10.1080/10888438.2019.1572758

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SCIENTIFIC STUDIES OF READING
2019, VOL. 23, NO. 5, 349–368
https://doi.org/10.1080/10888438.2019.1572758

A Meta-Analytic Review of Naming-Speed Deficits in

Developmental Dyslexia
Susana Araújoa and Luís Faíscab
a
Universidade de Lisboa; bUniversity of Algarve

ABSTRACT
This study presents a meta-analytic review of serial rapid automatized naming
(RAN) deficits in individuals with dyslexia relative to typical readers (based on
216 effect sizes comprising 8335 dyslexic readers, 14,083 age-matched con-
trols, and 921 reading-matched controls). A random-effects model analysis
indicated a large impairment in speeded RAN in individuals with dyslexia
compared with age-matched controls (d = 1.19) but a similar performance
when compared with reading-matched controls (d = 0.13). In addition, dyslexic
readers presented a deficit in discrete-naming formats (d = 0.74), although the
deficit in serial RAN was notably larger; hence, adding seriality is particularly
detrimental for these readers. The deficit appears to span all stimulus types
(alphanumeric and nonalphanumeric), indicating that processes beyond letter
processing are responsible for the delays and are independent of set size. Poor
RAN is a long-term and universal symptom of dyslexia, and the transparency of
the writing system does not influence its severity.

Introduction
Individuals with developmental dyslexia experience well-documented rapid automatized naming
(RAN; henceforth, rapid naming) difficulties that are expressed by slower naming times in response
to familiar items (Denckla & Rudel, 1976; Wolf, Bowers, & Biddle, 2000). These difficulties are
pervasive and might become even more prominent with age than other hallmark effects of dyslexia
(e.g., de Jong & van der Leij, 2003; Fernandes, Araújo, Sucena, Reis, & Castro, 2017; Swanson &
Hsieh, 2009). However, the empirical evidence on how exactly RAN is affected by this disorder is
surprisingly sparse. Thus, we have investigated this relationship in the current meta-analytic study.
RAN has become one of the most influential constructs in learning to read. This ability is assessed by
simple tasks in which participants name an array of letters, digits, objects, or colors as quickly as
possible (Denckla & Rudel, 1976). The total time necessary to name the whole array is typically
interpreted as a proxy for the automaticity by which familiar stimuli and their phonological codes
are retrieved and named. RAN is a strong concurrent and longitudinal predictor of reading ability and
reading disorder across development and languages (Caravolas, Lervåg, Defior, Málková, & Hulme,
2013; Georgiou, Aro, Liao, & Parrila, 2016; Georgiou, Parrila, & Liao, 2008; Kirby, Desrochers, Roth, &
Lai, 2008; Kirby, Parrila, & Pfeiffer, 2003; Landerl et al., 2018; Peterson et al., 2017; Vaessen et al., 2010).
It is important to note that this association is found even after controlling for phonological awareness
and phonological short-term memory, letter knowledge, and IQ (e.g., Georgiou, Parrila, & Kirby, 2009;
Kirby et al., 2003; Landerl & Wimmer, 2008; Manis, Doi, & Bhadha, 2000; Powell, Stainthorp, Stuart,
Garwood, & Quinlan, 2007).

CONTACT Susana Araújo smaraujo@psicologia.ulisboa.pt Faculdade de Psicologia & Center for Psychological Research,
Universidade de Lisboa, Alameda da Universidade, Lisboa 1649-013, Portugal.
Color versions of one or more of the figures in the article can be found online at www.tandfonline.com/hssr.
Supplemental data for this article can be accessed here.
© 2019 Society for the Scientific Study of Reading
350 S. ARAÚJO AND L. FAÍSCA

A recent meta-analysis confirmed the moderate-to-strong positive correlation between RAN and
reading (r = .43; Araújo, Reis, Petersson, & Faísca, 2015). This is (partly) expected as both share perceptual
and cognitive processes, including visual object recognition (from initial feature detection to access to
abstract object representations) and speech production processes (Norton & Wolf, 2012). However, the
exact reason for the predictive success and discriminative power of the RAN tasks has been elusive.
RAN capacity is often subsumed under phonological processes, and slowed performance is
hypothesized to reflect failure to access and retrieve phonological codes from long-term memory
(e.g., Clarke, Hulme, & Snowling, 2005; Pennington, Cardoso-Martins, Green, & Lefly, 2001;
Torgesen, Wagner, & Rashotte, 1994; Wagner, Torgesen, Laughon, Simmons, & Rashotte, 1993).
Other accounts, however, claim that RAN and phonological processing are partially distinct con-
structs that are independently related to reading. The proposed mechanisms underlying the RAN–
reading relationship are diverse: RAN is associated with reading via orthographic processing (Bowers
& Newby-Clark, 2002; Bowers & Wolf, 1993; Wolf et al., 2000); both draw upon a domain-general
speed-of-processing factor (Kail & Hall, 1994; Kail, Hall, & Caskey, 1999) and/or rely on the
automation or efficiency of translating print to sound (e.g., Pan, Yan, Laubrock, Shu, & Kliegl,
2013), among other interpretations and factors (for an overview, see Kirby, Georgiou, Martinussen,
& Parrila, 2010). Nevertheless, this relationship may depend on developmental stage and the
strategies evolved for reading (de Jong, 2011; Protopapas, Altani, & Georgiou, 2013). Moreover,
there may be reciprocal relationships between reading skills and RAN. If reading experience is not
only influenced by but also enhances RAN efficiency (Araújo, Fernandes, & Huettig, 2018), then
dyslexics’ difficulties may at least partially be a consequence of their poor reading level (cf. Huettig,
Lachmann, Reis, & Petersson, 2018). However, this hypothesis awaits experimental testing.

Serial and discrete-naming

An ongoing debate in the research literature is whether the naming deficit in dyslexia is task specific,
that is, differentially affects the ability to name items in an array (i.e., in standard, serial RAN) and
individually presented items (i.e., one item displayed at a time, as in discrete or confrontation
naming tasks; henceforth, discrete-naming1). Naming speed has often been assessed through serial
RAN tasks (Denckla & Rudel, 1976) involving multiple, matrix presentations of highly familiar
items. Performance on these tasks distinguishes between dyslexic and nondyslexic reading groups
because individuals with dyslexia are consistently slower even when compared with otherwise
learning disabled individuals (e.g., Araújo et al., 2011; Denckla & Rudel, 1976; Pan et al., 2013;
Wolf & Bowers, 1999). However, if stimuli are presented one by one, similar to discrete-naming
tasks, performance on the task does not consistently predict reading skill (Georgiou, Parrila, Cui, &
Papadopoulos, 2013; Logan, Schatschneider, & Wagner, 2011; but see also Protopapas et al., 2013).
Moreover, discrete-naming tasks discriminate dyslexic from nondyslexic readers less robustly than
serial RAN tasks (Bowers & Swanson, 1991; Jones, Branigan, & Kelly, 2009; Zoccolotti et al., 2013).
Jones et al. (2009) experimentally manipulated the task formats (continuous-matrix vs. discrete-
matrix vs. discrete-static) and found that having to repeatedly name consecutive items in an array
affects adult dyslexic readers adversely (when compared with nondyslexic readers’ and their own
performance in the discrete-static condition) but not average readers who actually benefit from the
serial presentation format. Converging evidence comes also from children (Zoccolotti et al., 2013).
Nonetheless, a number of studies have demonstrated that discrete-naming tasks also incur
a significant cost for individuals with dyslexia (Araújo et al., 2011; Castel, Pech-Georgel, George,
1
We avoid the term discrete RAN because it usually refers to variants of the standard RAN test (Denckla & Rudel, 1976), which has
been occasionally used in recent studies (e.g., Jones et al., 2009, in which individual items were presented discretely but in
positions analogous to the continuous-matrix version). More often, discrete/confrontation naming studies have used isolated
naming tests that do not have the same nature as RAN (using, e.g., a larger set of unrepeated items presented in a single
location, e.g., as in Araújo et al., 2011).
 SCIENTIFIC STUDIES OF READING 351

& Ziegler, 2008; Faust & Sharfstein-Friedman, 2003; Gasperini, Brizzolara, Cristofani, Casalini, &
Maria, 2014; Nation, Marshall, & Snowling, 2001; Truman & Hennessey, 2006).
In serial RAN tasks, stimuli are presented in a simultaneous, left-to-right serial fashion (mimicking
words in a text). This aspect has led to suggestions that serial RAN, relative to discrete-naming, is
strongly related to reading because it measures how well the eyes move and attention is allocated to
process upcoming items in the array and suppress those already named (e.g., Jones, Ashby, &
Branigan, 2013; Jones et al., 2009; Logan et al., 2011). Gordon and Hoedemaker’s (2016) novel proposal
is that fast RAN times, such as reading, require effective scheduling (coordination in time) of eye
movements with vocalization; having the eyes far enough ahead of the voice (expressed by the eye–
voice span2) is helpful, because upcoming items can be encoded for articulation without delays (but
close enough to strain memory for the correct order of the items; see also Protopapas et al., 2013,;
Protopapas, Katopodi, Altani, & Georgiou, 2018).
With regard to these interpretations, an open question is whether slowed RAN in individuals with
dyslexia stems from the cognitive processes underlying naming or just from the demands of these
tasks (including sequencing of multiple items and parafoveal previewing, oculomotor programming,
and/or executive control). This is relevant because dyslexic readers are less efficient in parafoveal
processing during RAN and are especially slower to name multiple items in a continuous format
when compared with nondyslexic readers (Jones, Obregón, Kelly, & Branigan, 2008; Pan et al., 2013;
Silva et al., 2016; Yan, Pan, Laubrock, Kliegl, & Shu, 2013).

RAN task-specific variables

Studies differ on various aspects of RAN testing that could potentially influence performance on
these tasks. These aspects include stimulus factors related to the choice of items, for example, the
type of stimuli or the set size, and the outcome used to assess naming performance.
Two recent meta-analyses revealed that RAN stimulus type strongly moderates the magnitude of
the association with reading in alphabetic (Araújo et al., 2015) and nonalphabetic (Song, Georgiou,
Su, & Hua, 2016) orthographies. Specifically, serial letter-naming and digit-naming correlated better
with reading outcomes than color-naming and object-naming. Although, in at least some studies,
serial object-naming correlated equally well with character recognition as it did with digit- or
character-naming (e.g., McBride-Chang, Shu, Zhou, Wat, & Wagner, 2003).
Gordon and Hoedemaker (2016) used the eye-tracking method and observed that the processing
stream from encoding to articulation evolves more smoothly and is less susceptible to interitem
interference for the letter and digit RANs than for the object and color RANs. This finding is
probably because letters and digits come from small and closed sets and thus may benefit from
a stronger association (automaticity) between items and their names. However, children with
dyslexia are apparently slower in RAN than are typically developing readers regardless of stimulus
type being either letters or objects (e.g., Araújo et al., 2011).
Another source of between-studies variability is that researchers have assessed RAN performance
using different adaptations of the classical task by varying the number of items to be accessed and
retrieved (i.e., the set size). The original RAN paradigm uses many repetitions of a small set of items
(five stimulus items repeated 10 times each; Denckla & Rudel, 1976), as the main interest is on the
issue of skill automatization. Most studies on RAN still use a small set size but vary in the number of
repetitions used (e.g., five different items repeated three times each: Araújo, Pacheco, Faísca,
Petersson, & Reis, 2010), whereas large sets of unrepeated items have been used in discrete-
naming. Increasing the total set size is assumed to increase the phonological encoding demands
because participants would need to access and retrieve the names of different symbols.
Consequently, more token items should exacerbate the differences between dyslexic and nondyslexic
groups. One possibility is also that readers with dyslexia fail to benefit from repetitions to form
2
Defined as the number of items that the eyes are ahead of the voice at the onset of vocal response.
352 S. ARAÚJO AND L. FAÍSCA

a “perceptual anchor” (Ahissar, 2007; Ahissar, Lubin, Putter-Katz, & Banai, 2006). In this case, their
performance is expected to lag behind that of controls, especially when RAN involves a small set of
repeated stimuli (vs. large open set). Yet only a few studies have experimentally manipulated the set
size, and the results have been mixed. Georgiou et al. (2013) demonstrated that set size does not
matter for the RAN–reading correlations among readers with no history of reading impairments. Di
Filippo and colleagues (Di Filippo, Zoccolotti, & Ziegler, 2008) reported deficits in samples with
dyslexia compared to controls for both small (five items repeated 10 times) and large sets (50
unrepeated items) of digit and object naming, yet the deficit was bigger for large sets. However, this
modulation by reading group was not confirmed in a recent study (Georgiou, Ghazyani, & Parrila,
2018). Thus, a meta-analytic study on the role of set size is justified.
Another issue that is of relevance is whether individuals with dyslexia have significant difficulties with
both speed and accuracy of RAN. Speed is a measure of automatization and efficiency of the cognitive
system, and accuracy indicates the level of success of the recognition and naming process. Denckla and
Rudel’s (1976) seminal paper showed that RAN errors are extremely rare, and thus, speed measures seem
to provide a finer assay of dyslexics’ impairments. Nevertheless, a small, highly familiar set of items was
used in this study, and participants performed at or near ceiling for accuracy. Thus, it remains to be
clarified whether accuracy measures discriminate as well between reading groups.

Developmental stability and causality

Even high-functioning individuals (“compensated” university students) with dyslexia show severe
delays in RAN (Jones et al., 2009; Silva et al., 2016). However, what is the developmental trajectory of
their RAN skills? Very few studies have addressed the long-term stability of the cognitive predictors
of reading and dyslexia from childhood to adulthood. Araújo and colleagues’ (2015) meta-analytic
study demonstrated that, in typical readers, RAN is related to reading gains from the very start of
reading acquisition. Landerl and Wimmer (2008) confirmed the long-term stability and predictive
strength of RAN to reading fluency over the full 8-year testing period. Others reported that the
contribution of RAN increases as a function of reading experience (Kirby et al., 2003; Vaessen et al.,
2010; Vaessen & Blomert, 2010). Nonetheless, readers with dyslexia do not acquire appropriate levels
of RAN regardless of their age. Notably, in adults with dyslexia, the RAN deficit might become even
more prominent than residual deficits in other core cognitive skills, including phonological aware-
ness and phonological memory (Fernandes et al., 2017; Swanson & Hsieh, 2009). In a preliminary
study, Reis, Faísca, Araújo, and Castro (2017) tested children and adult readers with dyslexia on
similar literacy measures. For adults, the RAN deficit was less marked than that for children with
dyslexia compared with controls, suggesting that readers with dyslexia eventually become less
affected over time. This finding, however, remains to be replicated.
The direction and locus of the association between RAN and reading is also still largely unclear.
A common view is that RAN taps underlying cognitive processes that contribute causally to reading
development or its failure. Accordingly, some studies have reported a unidirectional effect of (early)
RAN on later reading skills (Lervåg & Hulme, 2009; Verhagen, Aarnoutse, & van Leeuwe, 2008;
Wagner & Torgesen, 1987; Wei, Georgiou, & Deng, 2015). However, slowed RAN speed may also be
partially a consequence of less reading experience (cf. Huettig et al., 2018). Wolff (2014) reported that
phonics training (i.e., training in phonemic awareness and decoding, reading fluency and comprehen-
sion) significantly enhanced RAN in third graders with reading difficulties, and Peterson et al. (2017)
found longitudinal evidence for a causal effect of early reading skills on children’s RAN (whereas this
relation was reversed in older children; see also Compton, 2003). Thus, the results might better be
summarized as evidence for a bidirectional effect between learning to read and RAN.
In this meta-analysis, we also analyzed effect sizes based on reading-level matched designs (i.e.,
matching dyslexic individuals with younger controls who have the same absolute reading level). The
usual logic is that if deficits are found in a particular cognitive task compared with reading-level
matched controls, then the performance of dyslexic participants is significantly slower than it should
 SCIENTIFIC STUDIES OF READING 353

be given the level of reading attained (and difficulties are therefore more likely to represent causal
effects; Bryant & Goswami, 1986; Goswami, 2003; Goswami & Bryant, 1989). A reading-matched
design has been occasionally used in previous RAN studies, and the results are mixed at best. Either
readers with dyslexia were found to lag behind younger children of the same reading level (e.g.,
Moura, Moreno, Pereira, & Simões, 2015), which may suggest that the underlying mechanism in
RAN plays a causal role in the failure to read (but see, e.g., Van den Broeck & Geudens, 2012, for
a discussion about the limits of the reading-matched design) or no group differences were found
(e.g., Georgiou, Papadopoulos, Zarouna, & Parrila, 2012; Griffiths & Snowling, 2001).

Orthography
The orthographic consistency of a writing system (i.e., the transparency of its letter-sound mappings)
has been recognized as influencing the rate of reading acquisition and the grain size of basic reading
units (Seymour, Aro, & Erskine, 2003; Ziegler, Perry, Jacobs, & Braun, 2001). Likewise, transparent
versus opaque mapping systems cause particular problems for dyslexic individuals. For example, in
languages with a more transparent orthography (such as Italian and German), reading accuracy is
preserved and near ceiling, whereas impaired readers exhibit severe fluency problems. That is,
reading disturbance is primarily attributable to deficient automatization of word identification
processes. This outcome contrasts with the English-speaking pattern of both low accuracy and
speed for reading (Landerl, Wimmer, & Frith, 1997; Wimmer, 1993; Ziegler, Perry, Ma-Wyatt,
Ladner, & Schulte-Körne, 2003).
Empirical investigations of the impact of orthographic consistency on the cognitive predictors of
reading and dyslexia show unequivocally that serial RAN is one of the best and most universal correlates
of reading ability (Araújo et al., 2015; Song et al., 2016). The relative weight of RAN performance in
predicting reading fluency also varies minimally as a function of script transparency, unlike, for example,
phonological awareness (Georgiou et al., 2016; Landerl et al., 2018; Moll et al., 2014; Vaessen et al., 2010;
Ziegler et al., 2010). Important to note, in Landerl et al.’s (2013) cross-linguistic study (Finish,
Hungarian, German, Dutch, French, and English-speaking samples), it was found that RAN is
a strong concurrent predictor of dyslexia status, especially in more complex orthographies. This meta-
analysis follows up on this finding and extends it by including results on alphabetic as well as
nonalphabetic writing systems. A subsidiary issue is that studies differ as to whether they use word-
level or nonword-level reading skills (or a composite of the two) and fluency or accuracy in reading to
diagnose dyslexia. They may also differ in the severity of the reading problem. This aspect is relevant
because orthographic transparency influences the prevalence of dyslexia subtypes depending on the tasks
used to classify the subjects (e.g., Sprenger-Charolles, Siegel, Jimenez, & Ziegler, 2011). We therefore
examined these factors as possible moderators of the effect sizes obtained.

The current study

In this meta-analytic study, we sought to establish the size of the RAN deficit in individuals with
dyslexia and to tackle the following six fundamental questions:

(1) Is there truly something special about the naming aspect of serial RAN tasks? It is possible that
a deficit in rapid access to, or production of, multiple items during RAN is just a consequence of
the task-specific demands (e.g., multi-item sequencing, visual scanning, eye–voice coordina-
tion), which are harder for dyslexic readers. To test this hypothesis, we considered task-format
(multiple vs. individual stimulus presentation) as a potential moderator.
(2) How precisely can both speed and accuracy measures capture an estimate of the deficit?
Moreover, does the relative size of the deficit depend on the type of stimulus (e.g., is the
impairment specifically tied to alphanumeric stimuli?) or the set size?
354 S. ARAÚJO AND L. FAÍSCA

(3) Is this deficit likely to remain the same in the long run, from childhood to adulthood? The
literature is sparse as to whether individuals with dyslexia exhibit the same set of cognitive
deficits across age (but see Swanson & Hsieh, 2009).
(4) To what extent do incidences of RAN problems depend on the properties of the ortho-
graphy acquired?
(5) Might the observed group differences simply reflect differential reading experience? A useful
way to test this prediction is to compare individuals with dyslexia and age-matched as well
as reading-level-matched controls on measures of RAN (see Goswami, 2003).
(6) A further issue is to establish the role of the reading measure used for the diagnosis of
dyslexia and the severity of the reading problem as a possible moderator of the effect sizes
obtained.

It is worth noting that the choice was made to focus on RAN ability as assessed by the standard
RAN test (Denckla & Rudel, 1976) in the present meta-analysis because (a) much of the evidence
supporting naming speed as a core deficit in dyslexia comes from serial RAN tasks and (b) compared
to discrete-naming, serial RAN studies are significantly heterogeneous and considerably larger in
number, and therefore more variability exists among the individual effect sizes linked to the
moderators of interest. Effect sizes associated with discrete-naming were included only in the specific
moderator analysis because of theoretical relevance (Question 1).

Method
Study selection and inclusion criteria
The studies included in this meta-analysis were identified by searching the PsycINFO, PubMed, and Web
of Knowledge databases, using a combination of search terms related to visual naming (rapid naming OR
naming speed OR serial naming OR RAN OR confrontation naming OR discrete naming OR naming
deficit(s) OR naming difficulties) and phonological processing (phonological processing OR phonological
skills OR phonological deficit), crossed with terms related to dyslexia disorder (dyslexia OR dyslexic(s) OR
reading disabilities OR learning disabilities). Only studies published in English were included in the meta-
analysis, plus one that was written in French. Our search covered the title, abstract, and keywords of all of
the published articles, dissertations, and book chapters that were available in the databases up until
June 2018; there were 1,462 citations identified. Specialized journals were also hand-searched (Scientific
Studies in Reading, Reading and Writing, Journal of Research in Reading, Reading Research Quarterly,
Dyslexia, and Annals of Dyslexia), as well as the reference lists of prior meta-analyses and narrative
reviews, thereby yielding 62 additional relevant studies. Authors were contacted if effect sizes could not
be extracted from the data. For inclusion, a study had to meet the following criteria: (a) reported original
empirical data for the RAN or/and discrete-naming tasks, (b) used a design in which naming skills of
individuals with dyslexia were compared with those of typical readers matched for chronological-age or/
and reading-level, and (c) contained enough information to compute effect sizes.
Preestablished criteria were used to specify acceptable measures that were to represent multiple- and
discrete-naming, as well as the subjects’ reading status. We focused on studies that assessed accuracy or/
and speed of visual naming of familiar items, presented in a serial list format (like in Denckla & Rudel,
1976) for (serial) RAN assessments and in an individual format (one item at a time) for discrete-naming
assessments. Whenever we did not have information about the design of the naming task that was used or
were not sure of it, the study was excluded. Samples with dyslexia were required to have either (a) an
explicit classification as “dyslexic readers” or with a “specific reading disability,” typically based on
a previous diagnosis by a therapist, and scores in the normal range for IQ measures, or (b)
a classification as poor readers and fulfillment of the ICD-10 (2008) criteria for specific reading disability,
that is, a serious deficit in word recognition but general cognitive skills within the normal range. These
criteria were defined to rule out possible extrinsic reasons that might account for or be associated with
 SCIENTIFIC STUDIES OF READING 355

impaired reading. Regarding (b), we included those participants whose reading was significantly below
expectations on the basis of their age and corresponding reading level, applying a relatively stringent
criterion of −1.25 SD3 (cf. Landerl et al., 2013).
To avoid violation of the independence of observations (by including data from the same sample more
than once), studies with identical authors were examined for duplicate samples. Whenever sample
overlap occurred, we included the article that reported a more complete data set and excluded the
overlapping studies. In longitudinal studies, data were coded from the first time point after formal
reading instruction had started. For intervention studies, only pretest data were coded.
Of the initial 1,524 articles, only 214 articles met all of our inclusion criteria (Figure 1). A random
sample of 30% of the studies was coded independently by each author. Intercoder agreement was
estimated using Pearson correlation for continuous information (such as effect sizes) and Cohen’s
kappa for categorical information (such as stimulus type). Intercoder correlation coefficients ranged
from .96 to 1.0, and the kappa coefficients ranged from .85 to 1.0. Disagreements were solved by
consulting the original article or by discussion.

Recorded variables and coding

For each study, sample size, means, and standard deviations for each group were extracted for measures
of RAN and discrete-naming. Each study was coded for (a) type of task, (b) the characteristic of the RAN
task, and (c) the sample characteristics. See Table S1a-c for a complete description.

Type of task
Naming task. The type of task was separated into two categories: “RAN,” which includes tasks featuring
continuous, matrix presentation of items, as in the standard serial RAN test (Denckla & Rudel, 1976), and
“discrete-naming,” which includes tasks involving individual stimulus presentation, either in the context
of a confrontation naming task (typically with a large set of unrepeated items presented in a single
location) or a variant of the standard RAN format (as, e.g., in Jones et al., 2009). The potential moderator
effect of the type of task was evaluated by comparing the mean effect size estimated from studies in each
of these categories. In the remainder of the meta-analysis, however, only the effect sizes associated with
“RAN” were considered.

RAN task characteristics

Type of score. The outcome used to assess naming performance was coded into “accuracy-based”
measures and “fluency-based” measures.

Stimulus type. Stimulus type was coded to distinguish between “object,” “color,” “letter,” and “digit
naming.” Whenever only a composite measure was provided, stimulus type was not coded, and these
effect sizes were excluded from the moderator analysis.

Stimulus Set. The total number of items to be named and the number of different token items
included in the naming task were coded as measures of task format.
3
As can be determined from the supplementary material, in some of the studies that were included based on the first criteria and
that explicitly described their samples as dyslexic/with a specific reading disability, either this criterion could not be verified or
the cutoff point was lower than −1.25 SD. These studies were left in the analysis to avoid a massive loss of data (it may well be
that for those considering a less stringent criterion than −1.25 SD, the dyslexic participants were somehow already compen-
sated). Regarding those studies that were included based on the second criteria, we determined whether the pattern of results
held constant when those using a less stringent criterion of −1 SD were also included. The overall mean effect size was likewise
large and significant (k = 194, d = 1.19), 95% CI [1.11, 1.30].
356 S. ARAÚJO AND L. FAÍSCA

Figure 1. Flow diagram for the search and inclusion of studies.

Sample characteristics
Age. Mean age of the samples in months was coded. The age range for the studies was 7 years
2 months to 36 years 8 months.

Reading level. We coded for differences in the classification of subjects as reading disabled (i.e., the
diagnostic criteria) depending on which test was used to determine reading level: “accuracy” or/and
“fluency” scores from “real word reading” tests or “pseudoword reading” tests, or “both.” Means and
standard deviations regarding the subjects’ reading performance were further coded for fluency and
 SCIENTIFIC STUDIES OF READING 357

accuracy to estimate the size of the reading deficit in dyslexia. If a study reported data from more than
one reading test, measures based on real word reading (e.g., single-word reading tasks) were preferred.

Orthography. The orthographies were classified into three categories of orthographic complexity
expressing feedforward and feedback consistency of grapheme-phoneme and phoneme-grapheme
correspondences (similar to a recent large-scale cross-linguistic study; cf. Landerl et al., 2013), based
on Seymour et al. (2003), namely, “opaque” (e.g., English, French) and “transparent” (e.g., Italian,
Finnish, Spanish), with the highest and the lowest level of inconsistencies in both directions,
respectively, and “medium” complexity level (Dutch, German, European-Portuguese4), with either
high feedforward consistency but low feedback consistency, or the reverse. The writing system was
also coded as “alphabetic” and “nonalphabetic” (e.g., Chinese) writing systems. Based on Verhoeven
and Perfetti (2017), consonantal root-based writing systems, such as Arabic and Hebrew, were
included in the former category. Given participants’ age, all the studies except for one (Grades 3
and 4) were included in the opaque category.5

Meta-analytic procedures
Effect size estimates
Data were analyzed using Comprehensive Meta-Analysis software (Borenstein, Hedges, Higgins, &
Rothstein, 2005). For each study, we calculated Cohen’s d to estimate the magnitude of the naming
deficit in dyslexic readers compared with control-matched readers. Effect size estimates were in some
cases aggregated using the arithmetic mean (e.g., a study reporting two measures of letter RAN) to avoid
overrepresentation of multiexperiment studies in the overall analyses (Rosenthal, 1991). When means
and standard deviations were not provided, d values were estimated from the reported t or F statistics.
A positive d value indicates that the control subjects had the highest group mean. Effect sizes were
interpreted as small (d = 0.2), moderate (d = 0.5), and large (d = 0.8), based on Cohen’s (1988)
recommended guidelines.
When individual studies reported more than one effect size of interest for the same population, we
used the shifting unit of analysis approach (Cooper, 2010), as this procedure provides a good compro-
mise between preserving the independence of the effect sizes and retaining the maximum amount of
information from each study. In this approach, each effect size associated with a sample is first coded as
if it was an independent estimate of the relationship; the unit of analysis is then shifted according to the
hypothesis being tested. For the overall mean effect analysis and whenever the moderator corresponded
to a between-subjects factor defining separate groups of participants (e.g., orthography), we used the
sample as the unit of analysis. Multiple effects from a given sample were aggregated so that each sample
contributed only one effect and all sample-averaged effects were (almost) independent. When testing
the moderator effect of an outcome domain (e.g., task, stimulus type) and multiple effect sizes were
available within the same sample, we shifted the unit of analysis from the sample to the effect sizes,
allowing each sample to contribute one effect size for each category of the moderator.

Analysis of effect sizes

Overall effect sizes were estimated by calculating a weighted average of individual effect sizes
(Rosenthal, 1991). For each meta-analysis, we calculated a 95% confidence interval (CI) based on
a random effects model; effect sizes are considered significant when the CI does not include zero. In
4
Typically developing European-Portuguese children show a reading accuracy quite similar to that of children from deeper
orthographies (i.e. orthographies with less grapheme–phoneme consistency), but reading is typically faster in Portuguese
(Seymour et al., 2003) because it is an orthography of intermediate depth (for details, see, e.g., Lima & Castro, 2010; Sucena,
Castro, & Seymour, 2009), that is, more transparent than French or English but deeper than Italian, Spanish, or Dutch.
5
Hebrew and Arabic have two forms of script, a transparent—the pointed script (with diacritics)—and an opaque, or the
unpointed script (without diacritics). Reading skills are initially trained with the pointed script, but by the fourth grade, children
are expected to have mastered reading of the unpointed script, and this script is used almost exclusively thereafter.
358 S. ARAÚJO AND L. FAÍSCA

addition, we calculated statistical significance (p), within-group heterogeneity (Qwithin), and the
percentage of variation across studies due to heterogeneity rather than sampling error (I2;
Borenstein, Hedges, Higgins, & Rothstein, 2009).
For additional clarification of differences between effect size estimates, for categorical moderator
variables, we proceeded with a subgroup analysis to test the moderator variable effects with mixed-
effects between-group heterogeneity (Qbetween, which has a chi-square distribution and is analogous
to an analysis of variance F test). For the continuous variables, a meta-regression based on the
method of moments for random-effects models was used to predict variations in effect size across
studies attributable to the moderator variables. We reported the percentage of between-study
variance explained (R2) as a measure of the effect size of the moderator.
Forest plots were used to examine the distributions of effect sizes and to detect potential outliers,
and sensitivity analyses were used to determine their impact on the overall range of means.
Sensitivity analyses allow for an adjusted overall effect size to be estimated after removing studies
one by one. Finally, we examined funnel plots for random-effects models to determine the presence
of publication bias. If there is no bias, the scatterplot will be symmetric. The “trim and fill” method
for random-effects models (Duval & Tweedie, 2000) was used to examine the impact of possible
missing studies. This method imputes values in the funnel plot to render it symmetrical and
calculates an estimated overall effect size on this basis.

Results
Comparisons of individuals with dyslexia and age-matched controls
Global mean effect size
An overall effect size was calculated that incorporated all 216 independent effect sizes comparing
dyslexia and age-matched control groups on speed measures of serial RAN (N dyslexia
group = 8,335, M sample size = 39, range = 6–1,235; N controls = 14,083, M sample size = 65,
range = 6–1,108). The overall mean effect size was large and significant (d = 1.19), 95% CI [1.12, 1.27],
p < .001, confirming that individuals with dyslexia perform much poorer on speeded RAN than do
age-matched controls without reading difficulties. A sensitivity analysis showed that after removing
potential outliers, the overall effect size was in the range of 1.17, 95% CI [1.10, 1.25], to 1.20, 95% CI
[1.12, 1.27]. The funnel plot did not indicate any publication bias. The heterogeneity test was
significant, Qwithin(215) = 1000.81, p < .001, I2 = 78.53, suggesting that more than two-thirds of the
observed variance was not accounted for by sampling error alone. This implies that further meta-
analytic subdivision of the overall sample is warranted. A systematic analysis of theoretically mean-
ingful, a priori selected moderator variables was therefore conducted (Table 1). As mentioned before,
except for the type of naming task (serial vs. discrete), these moderator analyses were all performed on
the effect sizes associated with speeded serial RAN.

Type of naming task

To test whether the deficit in serial RAN transfers to discrete-type measures of naming, we first
calculated the weighted mean effect size for the difference between readers with dyslexia and
age-matched controls in discrete-naming tasks. A significant and moderate-to-large overall
mean effect size for speed measures of discrete-naming (d = 0.74), 95% CI [0.57, 0.92],
p < .001, indicated that individual stimulus presentation also incurs a significant cost for readers
with dyslexia. We further examined those studies that scored accuracy performance, as, for
discrete-naming tasks, accuracy is as often the dependent measure (k = 32). The mean effect size
was again large and significant (d = 0.76), 95% CI [0.52, 1.00], p < .001. We then compared
studies that used discrete-type with those that used serial-type tasks. The analysis of variance
analog analysis showed significant heterogeneity across tasks, Qbetween(1) = 14.40 and p < .001,
with larger group differences being shown in studies of multiple stimulus presentation (RAN)
 SCIENTIFIC STUDIES OF READING 359

Table 1. Effect sizes with 95% confidence interval, and heterogeneity statistics across the subgroups, in studies comparing subjects
with dyslexia (DYS) with chronological age (CA) controls.
Effect Size Heterogeneity
k nDYS nCA d 95% CI QWithin p I2 QBetween p
Categorical moderators
Task
Serial RAN 216 8,335 14,083 1.19 [1.12, 1.27] 1000.21 < .001 78.53
Discrete naming 26 646 687 0.74 [0.57, 0.92] 52.13 < .001 52.04
14.40 < .001
RAN score
Accuracy 21 405 551 0.47 [0.32, 0.61] 22.20 .330 9.91
Fluency 216 8,335 14,083 1.19 [1.12, 1.27] 1000.21 < .001 78.53
29.76 < .001
Stimulus type
Letters 67 2,358 7,068 1.35a [1.18, 1.51] 500.41 < .001 86.81
Numbers 127 5,935 10,641 1.26a [1.16, 1.37] 751.82 < .001 83.24
Objects 93 3,570 7,201 1.03b [0.93, 1.13] 369.74 < .001 75.12
Colors 56 1,420 1,974 1.00b [0.87, 1.13] 154.47 < .001 64.39
16.01 .001
Orthographic complexity
Opaque 121 4,557 4,597 1.26 [1.15, 1.37] 568.09 < .001 78.88
Medium 54 2,557 7,325 1.08 [0.96, 1.21] 246.48 < .001 78.50
Transparent 41 1,221 2,161 1.16 [1.01, 1.32] 131.37 < .001 69.55
2.83 .243
Writing system 4
Alphabetic 191 6,406 12,751 1.17 [1.09, 1.25] 768.63 < .001 75.28
Nonalphabetic 25 1,929 1,332 1.32 [1.10, 1.54] 117.64 < .001 79.60
1.71 .192
Dyslexia criteria
Word reading 76 3,144 5,948 1.19 [1.08, 1.30] 290.47 < .001 74.18
Pseudoword reading 5 126 119 0.95 [0.62, 1.27] 5.71 .222 29.94
Both 32 1,125 3,808 1.13 [0.95, 1.31] 143.14 < .001 78.34
1.36 .507
Reading accuracy 29 1,120 1,197 1.00 [0.84, 1.16] 74.82 < .001 62.58
Reading fluency 66 2,957 8,004 1.12 [1.01, 1.23] 258.52 < .001 74.86
Both 37 1,001 1,709 1.24 [1.03, 1.45] 185.82 < .001 80.63
2.95 .229
Continuous moderators
k nDYS nCA β p R 2

Task format
No. of tokens 171 6,445 11,744 — — −.004 .629 .00 — —
Total items 188 6,680 11,997 — — −.008 .002a .15 — —
Age 201 7,907 13,075 — — .006 .315 .00 — —
Reading level — —
Fluency 107 2,970 7,990 — — .285 < .001 .26 — —
Accuracy 120 4,800 7,562 — — .050 .220 .06 — —
Note. Mean effect sizes without the same subscript letters differ at p < .05. k = number of independent effect sizes that
contributed to each meta-analysis; n = total number of subjects on which these effect sizes were based; d = effect size of group
differences; CI = confidence interval (effect sizes are considered statistically significant when the CI does not include zero); QWithin
= within-group homogeneity of variance and significance level; I2 = the proportion of total variation between the effect sizes
that are caused by real heterogeneity rather than chance; QBetween = between-group homogeneity of variance and significance
level; RAN = rapid automated naming.
a
This result is highly dependent upon the inclusion of one study with a very large set size (see the main text).

than in studies of discrete stimulus presentation (discrete-naming). In sum, our results indicated
inefficiencies in visual naming in individuals with dyslexia when tested either with serial RAN
or discrete-naming tasks, but with somewhat greater impairment for the former. The next
sections focus on serial RAN tasks only, as, unfortunately, for discrete-naming studies the
number of samples within moderator categories was not large enough to allow for analytical
comparisons.
360 S. ARAÚJO AND L. FAÍSCA

Type of score
Results indicated that readers with dyslexia are both significantly slower and less accurate than
control readers in the RAN task. The comparison between studies that used fluency-based versus
accuracy-based assessments yielded significant results, Qbetween(1) = 29.76, p < .001, indicating that
dyslexic readers’ performance was particularly impaired (i.e., had a higher effect size) in terms of
naming times and less so in terms of response accuracy.

Stimulus type
The analyses indicated significant effect sizes across stimulus types, suggesting that dyslexic readers
are impaired overall (i.e., in naming letters, digits, colors and objects), including when the task does
not require letter processing. Nevertheless, we found statistically significant differences in the
magnitude of group differences yielded by the different stimulus type, Qbetween(3) = 16.01,
p = .001. Pairwise comparisons revealed that digit- and letter-naming studies demonstrated higher
effect sizes than did the object-naming and the color-naming studies: for contrasts with digit-
naming, Qbetween(1) = 8.14, p = .004, and Qbetween(1) = 7.13, p = .008, respectively; for contrasts
with letter-naming, Qbetween(1) = 8.63, p = .003, and Qbetween(1) = 7.66, p = .006, respectively. All
remaining pairwise comparisons were nonsignificant.

Stimulus set
Metaregression analyses showed that the number of different tokens to be retrieved from memory
was not a significant predictor of the effect size obtained (β = −0.00, p = .629, k = 171, R2 = .00) but
the total number of items to be named was (β = −0.01, p < .005, k = 188, R2 = .15). However, we note
here that the latter was dependent upon the inclusion of one study with a very large set size
(Verhoeven & Keuning, 2018; 120 items); after removing that particular study, the total number
of items no longer predicted the size of the RAN deficit (p = .103).

Age
Age had no significant impact on effect size (β = 0.06, p = .315, k = 201, R2 = .00); hence, the RAN
deficit in individuals with dyslexia was stable through the age ranges studied.

Reading level
We found no reliable differences between studies that used either a word or a pseudoword reading
test or a composite of both to select samples with dyslexia, Qbetween(2) = 1.36, p = .507, or that
measured fluency or/and accuracy in reading, Qbetween(2) = 2.95, p = .229. We next examined how
differences between studies in the severity of the reading deficit in samples with dyslexia predicted
the size of the RAN deficit. For each study, we calculated an effect size (d) expressing the difference
in reading level between groups, which was then used as a predictor in the meta-regression. We
observed that the severity of the reading deficit in samples with dyslexia, as expressed by their
reading fluency scores, was a significant moderator of the effect size obtained across studies, β = 0.28,
p < .001, k = 107, R2 = .35 (for reading accuracy as a predictor, and after removing an outlier:
β = 0.05, p = .103, k = 79, R2 = .02).

Orthography
The analysis of variance analog analysis indicated that neither orthographic complexity, Qbetween
(2) = 2.69, p = .261, nor the writing system, Qbetween(1) = 1.71, p = .192, were significant moderator
variables. All types of studies displayed a significant and large effect size.
 SCIENTIFIC STUDIES OF READING 361

Comparisons of individuals with dyslexia and reading-level controls

Global mean effect size
Thirty-nine independent studies compared RAN speed in readers with dyslexia and reading-level
matched controls (N dyslexia group = 981, M sample size = 25, range = 15–44; N reading-level
controls = 921, M sample size = 24, range = 10–64). The overall mean effect size was small and
nonsignificant (d = 0.13), 95% CI [−0.05, 0.31], p = .149, indicating that subjects with dyslexia
performed as well on RAN as younger typical readers with the same absolute reading level.
A sensitivity analysis showed that after removing potential outliers, the overall effect size was in
the range of 0.09, 95% CI [−0.08, 0.25], to 0.16, 95% CI [−0.01, 0.34]. The funnel plot indicated no
publication bias.

Discussion
The current meta-analysis provides strong support for substantial impairment in serial RAN among
individuals with dyslexia compared with typically developing controls of the same chronological age
(d = 1.19). We also found that the size of this deficit is associated with the severity of the reading
impairment (dyslexia severity), that is, the lower participant’s reading fluency level, the more severe
his or her naming speed deficit. Notably, the reading measures used to select dyslexic participants
(accuracy or fluency of word and pseudoword reading) were not significantly related to variation in
the effect size between studies. Thus, our results emphasize the potential utility of the RAN tasks for
neuropsychological/psychoeducational assessment of dyslexia (as in some recent batteries; Blomert &
Vaessen, 2009; Moura et al., 2017) and attest to the contribution of these tasks in predicting group
membership (dyslexic or normal; e.g., Moura et al., 2015).
In addition, individual stimulus presentation also incurred a moderate-to-large and significant
naming speed cost for readers with dyslexia compared to age-matched controls (discrete-naming,
d = 0.74). This finding refutes some researchers who have questioned the consistency with which
discrete-naming tasks discriminate between reading groups (Walsh, Price, & Gillingham, 1988). Our
meta-analysis clearly shows that the underlying deficit in dyslexia significantly affects the naming of
items in both the serial- and discrete-task formats, albeit with somewhat greater impairment for the
former.
Together, these findings allow two major conclusions. First, because dyslexic readers were
inefficient at naming in both task formats, we can conclude that the impairment is at least partly
related to the underlying cognitive processes required for naming and is not simply related to
difficulties in serial performance. Hence, slow naming speed is not just a matter of the complexity of
the task (and of the continuous lists) but represents a core feature of the disorder. Second, the data
indicate that multiple (vs. individual) presentation of items is particularly difficult for dyslexic
readers, which is in agreement with the few studies that have experimentally manipulated task
format (Gasperini et al., 2014; Jones et al., 2009; Zoccolotti et al., 2013).
That said, why is the addition of seriality particularly disruptive to dyslexic participants? During
RAN, the eyes are ahead of the voice, and the articulatory preparation for an item’s name overlaps
with the inspection and lexical retrieval of the next item. Therefore, processes such as saccadic
programming, multiple-items sequencing, eye–voice coordination, and executive attentional
mechanisms are essential for RAN (Gordon & Hoedemaker, 2016; Jones, Branigan, Hatzidaki, &
Obregón, 2010; Kuperman, Van Dyke, & Henry, 2016). All might be relevant to disparities in group
performance given that, for example, parafoveal processing is suboptimal in individuals with dyslexia
(Jones et al., 2008; Pan et al., 2013; Silva et al., 2016; Yan et al., 2013) and multielement sequence
processing is a critical factor underlying fluent reading, beyond automatization of individual words
(Protopapas et al., 2018).
Beyond seriality, RAN versus discrete-naming also differ in articulation. The former is scored as
the total time needed to name a matrix of stimuli, whereas discrete-naming is scored as the naming
362 S. ARAÚJO AND L. FAÍSCA

latency (i.e., the time between stimulus onset and when the participant begins to respond). Because
the outcome measure in serial RAN includes not only decoding but also the articulatory implemen-
tation of the stimulus’ name, one possibility is that articulatory-motor factors account for the
observed group differences. This is, however, unlikely. Individual differences in articulation times
are only weakly correlated with the variance in reading fluency (Georgiou, Parrila, & Kirby, 2006;
Georgiou, Parrila, Kirby, & Stephenson, 2008) and do not distinguish between dyslexic and typical
readers (Araújo et al., 2011; Wimmer, Mayringer, & Landerl, 1998).
For RAN, we further found that naming times differentiated dyslexic and typical readers far
better than naming accuracy, which is consistent with previous reports (Denckla & Rudel, 1976)
and is not surprising. Accordingly, far fewer studies have used accuracy in RAN as the dependent
variable. However, we note that RAN tasks typically use a small, highly familiar stimulus set,
which probably provides participants with sufficient practice to complete the task accurately,
including those with dyslexia. With large, unrepeated sets of items in discrete-naming, dyslexic
readers produced significantly more errors (Araújo, Faísca, Reis, Marques, & Petersson, 2016;
Swan & Goswami, 1997) and “tip-of-the-tongue” responses (Faust & Sharfstein-Friedman, 2003)
than unimpaired readers.
In this meta-analysis, we also tested whether RAN delays in dyslexia are domain-general or
specifically tied to letter processing. The anomalous letter processing in dyslexia (e.g., De Luca,
Burani, Paizi, Spinelli, & Zoccolotti, 2010; Fernandes, Vale, Martins, Morais, & Kolinsky, 2014) and
the closer association of alphanumeric RAN (vs. nonalphanumeric RAN) with reading ability
(Araújo et al., 2015; Song et al., 2016) would lead one to expect that dyslexic readers will eventually
perform poorer in the naming of letters. Our meta-analytic results were consistent with that, as effect
sizes were the highest for letter naming. However, we also found that readers with dyslexia were
significantly impaired in RAN of nonalphanumeric shapes, although the size of the deficit was
smaller. This finding is interesting, because it eliminates the possibility that some aspects peculiar to
letters are only responsible for the delays in RAN.
In addition, we examined the effects of set size (i.e., the number of items to be accessed and
produced in a RAN task) on the size of the RAN deficit. Georgiou et al. (2013) and Araújo et al.
(2015) concluded that increasing the set size has no influence on the RAN–reading association. We
are aware of only two published studies in which this variable was experimentally manipulated and
that tested individuals with dyslexia. In Di Filippo et al. (2008), dyslexic readers performed poorly in
both large- and small-set conditions but more so in the former, whereas in Georgiou et al. (2018),
the effect of set size was similar in both groups. Our metaregression supported the later; the number
of items did not matter for the size of the deficit in dyslexia. It is, therefore, unlikely that the
phonological component of RAN performance (Clarke et al., 2005; Pennington et al., 2001; Wagner
& Torgesen, 1987; Wagner et al., 1993; Wolf & Bowers, 1999) and, in particular, the phonological
problems that feature dyslexia are associated with the encoding and retrieval “stages” of RAN. Our
meta-analytic results showed that having more and different items to be named (and, thus, increas-
ing the phonological encoding demands) did not predict group differences. Neither did we support
the proposal that deficits in RAN are due to inefficiencies in forming an anchor from repetitive items
(Ahissar, 2007). Likewise, in a reanalysis of the data, Ziegler (2008) showed that RAN deficits already
were present in the very first encounters of the objects (i.e., first trial) and that the size of the deficit
in dyslexia remained unchanged after several repetitions.
Do these differences between reading groups change in the long run from childhood to adult-
hood? Difficulties in speeded RAN have been found to persist into adulthood, including in “high-
functioning” or “compensated” (university students) participants (Jones et al., 2009; Nergård-Nilssen
& Hulme, 2014; Silva et al., 2016). Less is known, however, about the longitudinal stability of this
impairment. In a longitudinal study, de Jong and van der Leij (2003) found that impairments in
RAN were manifested from kindergarten to sixth grade by children with dyslexia. Preliminary cross-
sectional results in adults and school-age children showed that, even though RAN skills continue to
lag behind, the deficit is less severe for adults than for children with dyslexia compared with controls
 SCIENTIFIC STUDIES OF READING 363

(Reis et al., 2017). This result suggests that the deficit in RAN eventually attenuates over a longer
time frame. However, the current meta-analysis did not confirm this hypothesis, as the differences
between dyslexic and typical readers were persistent and stable in the long run. We thus propose that
serial naming speed problems are a permanent trait of reading disorders and are apparently hard to
remediate. Nonetheless, we note here that most of the studies in this meta-analysis sampled children.
We now turn to suggestions that orthographic complexity shapes symptoms of dyslexia (e.g.,
Landerl et al., 2013; Wimmer & Schurz, 2010). In particular, we were interested in the expression of
RAN problems in more or less transparent orthographies. Our results were clear: Relative to age-
matched controls, readers with dyslexia performed poorer in speeded RAN across languages, that is,
irrespective of the transparency of the orthography in which they learned to read. This result adds to
the growing evidence showing a reliable association between RAN and reading ability in a wide array
of orthographies (Georgiou, Parrila, & Papadopoulos, 2008; Landerl et al., 2018; Vaessen et al., 2010;
Ziegler et al., 2010). In addition, we found that the transparency of the writing system does not
influence the size of the deficit; neither does the type of writing system (alphabetic or nonalphabetic).
This finding was surprising given a recent cross-language study (Landerl et al., 2013) demonstrating
that RAN was a stronger predictor of dyslexia status for high-complexity orthographies than for less
complex ones.
Last, an open issue is whether the RAN deficit that features dyslexia has a causal influence on the
disorder (e.g., Lervåg & Hulme, 2009; Wagner & Torgesen, 1987; Wimmer, Mayringer, & Landerl,
2000) or is also influenced by a lack of reading experience (Compton, 2003; Peterson et al., 2017;
Huettig et al., 2018; Wolf, 2014), given that reading experience fosters faster access to phonological
lexical representations in rapid automatized naming (Araújo et al., 2018). Here, we have provided
meta-analytic evidence for similar d scores among individuals with dyslexia and typically developing
readers who have the same absolute level of reading skill in measures of RAN. However, the
interpretation of this null result is inherently ambiguous (see Bryant & Goswami, 1986; Goswami
& Bryant, 1989), as it could mean either that no underlying difference in RAN exists between the two
groups (suggesting, then, that the RAN deficit may be dependent of reading experience) or that there
is a difference but it is concealed by the fact that the older dyslexic participants have better
metacognitive strategies or simply higher overall processing speed. Hence, although reading-
matched designs are usually powerful (Bryant & Goswami, 1986; Goswami, 2003, 2015), they do
not allow per se causal direction to be established. In the future, the most convincing evidence for
the causal-consequence direction from learning to read to RAN will have to come from studies with
complementary designs (e.g., the use of longitudinal designs, reading-matched designs, intervention
studies). This is challenging, even more so because of the dynamic nature of the cognitive mechan-
isms underlying the RAN–reading relationship that potentially changes as reading accrues and may
depend on the dominant strategies evolved for reading (de Jong, 2011).

Conclusion
This meta-analysis reveals a pervasive and large impairment in serial RAN among individuals with
dyslexia compared with age-matched controls but a similar performance when they are compared
with reading-level-matched controls. This deficit significantly extends to discrete-naming formats,
although less markedly so. The RAN deficit is mainly expressed in abnormally long response times
and generalizes across stimulus types (alphanumeric and nonalphanumeric). Thus, processes not
limited to letter processing are responsible for the delays. We also demonstrated that slowed RAN is
an important symptom of dyslexia in all languages and writing systems. Hence, the inclusion of RAN
tasks in neuropsychological/educational assessments of reading disorders is strongly encouraged.
Performance in RAN measures is a strong correlate of reading ability and reliably discriminates
between dyslexic and normal readers, independent of age. Last, we should note that we are aware
that, as in serial RAN, not all discrete-naming tasks are the same (e.g., include repeated vs.
unrepeated items) and that their relationship with reading is a complex one, as it potentially varies
364 S. ARAÚJO AND L. FAÍSCA

across development (e.g., de Jong, 2011; Protopapas et al., 2013). Future research could usefully
explore this further by separating the moderator analyses and looking more carefully into the types
of discrete-naming studies, as we did here for serial RAN.

Acknowledgments
The first author and this work were supported by IF 2015 Program of the Portuguese Foundation for Science and
Technology, FCT (ref. IF/00533/2015) and by the Research Center for Psychological Science at Universidade de Lisboa
(CICPSI). This work was also supported by a scientific project supported by FCT, ref. EXPL/MHC-PCN/0299/2013,
UID/BIM/04773/2013 CBMR, PTDC/PSI-GER/32602/2017.

Conflict of Interest
The authors declare no conflict of interest.

Funding
This work was supported by the Fundação para a Ciência e a Tecnologia [IF/00533/2015, UID/BIM/04773/2013
CBMR and PTDC/MH].

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