Annals of Dyslexia (2019) 69:318–334

https://doi.org/10.1007/s11881-019-00185-7

Music-related abilities among readers with dyslexia

Adi Lifshitz-Ben-Basat 1 & Leah Fostick

1

Received: 16 March 2019 / Accepted: 14 August 2019/ Published online: 24 August 2019
# The International Dyslexia Association 2019

Abstract
Research suggests that a central difficulty in dyslexia may be impaired rapid temporal processing.
Good temporal processing is also needed for musical perception, which relies on the ability to
detect rapid changes. Our study is the first to measure the perception of adults with and without
dyslexia on all three dimensions of music (rhythm, pitch, and spectrum), as well as their capacity
for auditory imagery and detection of slow changes, while controlling for working memory.
Participants were undergraduate students, aged 20–35 years: 26 readers with dyslexia and 30
typical readers. Participants completed a battery of tests measuring aptitude for recognizing the
similarity/difference in tone pitch or rhythm, spectral resolution, vividness/control of auditory
imagination, the ability to detect slow changes in auditory stimuli, and working memory. As
expected, readers with dyslexia showed poorer performance in pitch and rhythm than controls, but
outperformed them in spectral perception. The data for each test was analyzed separately while
controlling for the letter-number sequencing score. No differences between groups were found in
slow-change detection or auditory imagery. Our results demonstrated that rapid temporal pro-
cessing appears to be the main difficulty of readers with dyslexia, who demonstrated poorer
performance when stimuli were presented quickly rather than slowly and better performance on a
task when no temporal component was involved. These findings underscore the need for further
study of temporal processing in readers with dyslexia. Remediation of temporal processing
deficits may unmask the preserved or even superior abilities of people with dyslexia, leading to
enhanced ability in all areas that utilize the temporal component.

Keywords Dyslexia . Dyslexia and music . Pitch perception . Speech perception

Public significance statement

In the present study, we tested the three dimensions of music: rhythm, pitch, and spectrum, among readers with
dyslexia, as compared with typical readers. We also tested their auditory imagery and the ability to detect slow
changes. The results showed that readers with dyslexia were poorer than typical readers in tests where the stimuli
were presented rapidly, namely in rhythm and pitch perception. However, in spectrum perception, when stimuli
were presented with no temporal changes, readers with dyslexia outperformed typical readers. These findings
show that a dyslexia-related difficulty in temporal processing not only interferes with achieving typical-reading
performance but also masks the superior abilities of people with dyslexia.

* Adi Lifshitz-Ben-Basat
adilb@ariel.ac.il

Extended author information available on the last page of the article

Music-related abilities among readers with dyslexia 319

Developmental dyslexia is a congenital neurobiological disorder characterized by poor reading

skills despite preserved intelligence, motivation, and schooling. This disorder is estimated to
occur in approximately 10% to 15% of school age children (Benton & Pearl, 1978; Harris &
Sipay, 1990; Shaywitz, Escobar, Shaywitz, Fletcher, & Makuch, 1992; Sprenger-Charolles,
Siegel, Jimenez, & Ziegler, 2011; Wybrow & Hanley, 2015). There are several theories
regarding the core of this deficit. Some theories suggest that dyslexia is a specific language
disorder caused by impaired phonological processing (Berent, Vaknin-Nusbaum, Balaban, &
Galaburda, 2013; Mayringer & Wimmer, 2000; Mody, Studdert-Kennedy, & Brady, 1997;
Vellutino, Fletcher, Snowling, & Scanlon, 2004), while other theories point to a deficit in more
general mechanisms such as insufficient auditory and/or visual temporal processing that, in
turn, affects the ability to learn to use phonics skills adequately (Ben-Artzi, Fostick, &
Babkoff, 2005; Farmer & Klein, 1995; Fostick, Bar-El, & Ram-Tsur, 2012a, b; Heim,
Freeman, Eulitz, & Elbert, 2001; Keen & Lovegrove, 2000; Lovegrove, Bowling, Badcock,
& Blackwood, 1980; Meyler & Breznitz, 2005; Reed, 1989; Schaadt, Männel, van der Meer,
Pannekamp, & Friederici, 2016; Stein & Walsh, 1997; Tallal, 1980; Wang et al., 2014). Other
theories of dyslexia suggest additional neurological differences and underlying factors that
might impact reading (Ahissar, 2007; Banai & Ahissar, 2004, 2010; Fisher, Chekaluk, &
Irwin, 2015; Garcia, Mammarella, Tripodi, & Cornoldi, 2014; Gathercole & Pickering, 2000;
Gathercole, Tiffany, Briscoe, & Thorn, 2005; Gori et al., 2015; Nicolson & Fawcett, 1990;
Nicolson, Fawcett, & Dean, 2001; Oganian & Ahissar, 2012; Shaywitz, 1998; Stein, Talcott, &
Witton, 2001; Stein & Walsh, 1997; Stoodley & Stein, 2013; Wijnen, Kappers, Vlutters, &
Winkel, 2012; Zhao, Yang, Song, & Bi, 2015).
Indeed, imaging studies have found differences between dyslexic and typical readers in
gray and white matter brain structures. These differences were found in children at age 7–
14.4 years (Beaulieu et al., 2005; Deutsch et al., 2005; Hoeft et al., 2007). Various functional
neuroimaging studies using different tasks that require phonological processing have found
reduced activation in temporo-parietal regions in groups of adults and children with develop-
mental dyslexia compared to typical-reading groups (Temple, 2002). Other studies have
unearthed more left prefrontal cortex activation in typical readers while processing rapid
auditory changes than slow ones; this was not observed, however, among readers with dyslexia
(Mage = 28 years) (Gaab, Gabrieli, Deutsch, Tallal, & Temple, 2007; Temple et al., 2000). This
finding was found both among adults (Mage = 30 years) and children (Mage = 10.5 years) and is
supported by a study that found the same pattern of increased left prefrontal activation among
typical reader children (Mage = 10.5 years) listening to rapidly changing stimuli, while children
with developmental dyslexia did not show such activation differences between rapidly and
slowly changing stimuli. Nonetheless, after remediation focused on phonological and language
training, the children with dyslexia showed significant improvement in reading skills, parallel
to the reading skills of typical-reading children, resulting in increased activation in the left
prefrontal cortex to rapid transitions (relative to slow ones) (Gaab et al., 2007).

Temporal processing

Training studies that show improvement in temporal processing as a result of phonological

training, as well as studies showing the converse, demonstrate one of the main difficulties
underlying reading among dyslexics: impaired rapid temporal auditory processing (Fostick,
Eshcoli, Shtibelman, Nechemya, & Levi, 2014; Gaab et al., 2007). According to the auditory-
320 Lifshitz-Ben-Basat A., Fostick L.

temporal processing theory (Ben-Artzi et al., 2005; Fostick et al., 2014, 2012a; Reed, 1989;
Tallal, 1980), the core difficulty in dyslexia is a fundamental perceptual deficit in processing
rapid auditory or visual stimuli. As speech is composed of brief stimuli presented rapidly, it is
especially vulnerable to deficits in temporal processing, since this impairment reduces the
ability of the individual to perceive critical elements in the speech stream accurately. Indeed, a
number of studies suggested that dyslexic readers have difficulty with speech perception, as
demonstrated by poorer performance than typical readers in speech perception tasks (Dole,
Meunier, & Hoen, 2014; Fraga González et al., 2015; Lohvansuu et al., 2014; Messaoud-
Galusi, Hazan, & Rosen, 2011; Noordenbos, Segers, Serniclaes, Mitterer, & Verhoeven, 2012;
Noordenbos, Segers, Serniclaes, & Verhoeven, 2013; Ortiz, Estévez, Muñetón, & Domínguez,
2014; Ronen, Lifshitz-Ben-Basat, Taitelbaum-Swead, & Fostick, 2018), although other studies
failed to show this difference (Hazan, Messaoud-Galusi, Rosen, Nouwens, & Shakespeare,
2009; Messaoud-Galusi et al., 2011).
Good temporal processing is also required for musical perception and performance. Music
unfolds over time and requires the ability to detect changes that occur rapidly (Huss, Verney,
Fosker, Mead, & Goswami, 2011). The sequential pattern of music, including stressed and
unstressed rhythmic auditory information, can be compared to that of language (Ayotte, Peretz,
& Hyde, 2002; Goswami, Huss, Mead, Fosker, & Verney, 2013; Leong & Goswami, 2014;
Tierney & Kraus, 2013). Therefore, one might expect language processing abilities (or lack
thereof) to be similarly reflected in the realm of musical abilities, including the perception of
rhythm, pitch, and spectrum; slow-change detection; and auditory imagery.

Musical abilities

Rhythm Indeed, studies show that children with dyslexia perform more poorly than children
without dyslexia in tasks requiring perception of musical meter and rhythm (Huss et al., 2011;
Ziegler & Goswami, 2005). In these tasks, children with dyslexia have a lower accuracy rate
when asked to discriminate between same or different metrical structures, i.e., rhythmic
patterns composed of different stresses, or when asked to tap a rhythmical pattern
(Atterbury, 1985; Lee, Sie, Chen, & Cheng, 2015; Thompson, Fryer, Maltby, & Goswami,
2006; Thompson & Goswami, 2008; Wolff, 2002). Studies also show positive correlation
between music perception abilities and reading, and phonological awareness. For example,
Douglas and Willatts (1994) pointed out the positive effect of a structured program of musical
activities on reading abilities among children in their fourth year of primary school.
Flaugnacco et al. (2014) showed rhythm perception and production to predict reading abilities
among children (aged 8–11 years). Goswami et al. (2013) found the non-linguistic musical
beat structure task as a predictor of variance in reading attainment by children (aged 8–
14 years). Huss et al. (2011) found that musical metrical sensitivity predicts phonological
awareness and reading development among children (aged 8–13 years). Moreover, studies
show that musical training, which boosts temporal processing, has a positive effect on
phonological awareness skills among children (aged 7–11 years) and young adults (aged
20–35 years) with dyslexia (Flaugnacco et al., 2015; Fostick et al., 2014; Overy, 2003; see
Tierney & Kraus, 2013 for a review). Therefore, there is enough current evidence to show a
dyslexia-related inferiority in metrics, beat, and rhythm, although a few studies did not report
such a relationship (Anvari, Trainor, Woodside, & Levy, 2002; Forgeard et al., 2008; Overy,
2003).
Music-related abilities among readers with dyslexia 321

Pitch In the matter of pitch, the picture is less clear. Pitch perception, or frequency discrim-
ination, is found in some studies to be impaired in readers with dyslexia (Ahissar, Protopapas,
Reid, & Merzenich, 2000; Anvari et al., 2002; Baldeweg, Richardson, Watkins, Foale, &
Gruzelier, 1999; Foxton et al., 2003; Santos, Joly-Pottuz, Moreno, Habib, & Besson, 2007;
Ziegler, Pech-Georgel, George, & Foxton, 2012). In these studies, children with dyslexia were
less sensitive to changes in tone pitch, as reflected by brain activity and behavioral measures
soliciting identification of same/different tone pitches. Interestingly, in a reverse design,
participants with deficits in musical pitch recognition (“tone deaf”) were also found to have
lower phonological and phonemic abilities than control participants (Jones, Lucker, Zalewski,
Brewer, & Drayna, 2009). Studies have found positive correlations between the ability to
detect changes in pitch and accuracy in reading and phonological tasks in English among
children (aged 4–7 years) and university students (aged 19–24 years) (Anvari et al., 2002;
Foxton et al., 2003; Lamb & Gregory, 1993). However, other studies have found either no
difference between children (aged 7–11 years) with and without dyslexia in pitch perception
(Lee et al., 2015; Overy, Nicolson, Fawcett, & Clarke, 2003, study 1; Ziegler et al., 2012) or,
interestingly, that pitch perception might be more accurate among children with strong risk for
dyslexia (based on the Dyslexia Screening Test, Fawcett & Nicolson, 1996) compared to
children with no such risk (Overy et al., 2003, study 3). It is important to note that although
Lee et al. (2015) studied children using Chinese, which is a tonal language, they found effects
similar to those found in alphabetic languages.

Spectrum Studies of musical abilities and linguistic skills mostly use pitch- and rhythm-
related tasks. However, these tasks do not model the complex structure of speech, such as
formant perception (i.e., perception of the acoustical features of phonemes, which are con-
structed of energy in different frequencies). Spectrum, or spectral, perception, which represents
the ability to integrate different frequencies into one sound, may more closely represent speech
stimuli, and therefore, tests of spectral perception may be a better indicator of the relationship
between music and language. Unfortunately, spectral perception has been significantly less
studied. Two studies that tested children’s literary abilities in relation to spectral perception
were conducted by Barwick, Valentine, West, and Wilding (1989) and Anvari et al. (2002).
They showed that being able to determine whether a pair of chords was the same or different is
related to phonological awareness and early reading development. The lack of further attention
in the literature to spectral perception in relation to phonological abilities may be due to
music’s temporal nature being its main connection to language. Spectrum perception also
involves the vertical structure of music and speech that underlies the melody and words.
Therefore, it might seem less related when testing the ability to perceive speech, and its
association to music. However, spectrum perception involves global perception of pitch
discrimination, which was found to be inferior among children with dyslexia (Foxton et al.,
2003; Ziegler et al., 2012). Moreover, when appearing in a sequence, changes in spectrum may
represent perception of a more complex musical pattern resembling speech to a greater extent.

Slow changes As discussed above, dyslexic readers have difficulty in temporal processing,
reflecting their deficit in processing rapid temporal changes. But what about detecting changes
that occur at a very slow pace? Detection of slow changes in stimuli refers to the ability to
detect visual and auditory changes that occur continuously and in small steps. The reverse
phenomenon, “slow change blindness/deafness,” refers to the inability to detect these changes;
it has been studied in the context of attention, encoding, and cognitive representations (Fenn
322 Lifshitz-Ben-Basat A., Fostick L.

et al., 2011; Gregg & Samuel, 2008; Neuhoff, Schott, Kropf, & Neuhoff, 2014; Neuhoff et al.,
2015; Rensink, 2002; Rensink, O'Regan, & Clark, 1997; Simons & Levin, 1998; Simons &
Rensink, 2005; Vitevitch, 2003). Some of the studies on slow-change deafness utilize gradual
changes in the speaker’s fundamental frequency (Neuhoff et al., 2014, 2015). Such manipu-
lation measures the participant’s detection of slow changes in auditory stimuli, as well as
sensitivity to pitch and frequency, in a task using naturalistic stimuli (voice). While such
studies have indeed shown that dyslexic readers have difficulties in pitch perception, these
difficulties were usually tested with rapidly changing stimuli. Therefore, a slow-change
detection task could isolate sensitivity to pitch from sensitivity to temporal changes, and reveal
the main difficulty for this group.

Auditory imagery Another auditory-musical ability found to be related to reading is auditory

imagery. Auditory imagery refers to one’s ability to hear an auditory signal (such as tune,
voice, or environmental sounds) in one’s mind. The classic examples of this ability are when a
tune gets stuck in one’s head (an “earworm”) or when one is remembering a tune or a song. It
is the skill that enabled Beethoven and Smetana to continue composing once they became
deaf. In fact, the ability to actively think and imagine a tune or sound was found to be
associated with the involuntary auditory imagery, like earworms (Beaman, 2018; Beaman,
Powell, & Rapley, 2015). Studies show that when individuals imagine a song, a tune, or a
sound, even without external stimuli, the auditory areas in the cortex are active, along with
other areas (Halpern, 2012; Halpern, Zatorre, Bouffard, & Johnson, 2004; Halpern & Zatorre,
1999; Herholz, Halpern, & Zatorre, 2012; Kraemer, Macrae, Green, & Kelley, 2005; Leaver,
Van Lare, Zielinski, Halpern, & Rauschecker, 2009; Schürmann, Raij, Fujiki, & Hari, 2002;
Yoo, Lee, & Choi, 2001; Zatorre, Halpern, Perry, Meyer, & Evans, 1996). When studied in the
context of reading, it has been shown that, while reading, participants imagine the sound of the
items they read about and the voices of characters (Alexander & Nygaard, 2008; Brunyé,
Ditman, Mahoney, Walters, & Taylor, 2010; Kurby, Magliano, & Rapp, 2009). However,
auditory imagery has not been studied in the context of phonological abilities and reading
disabilities. Suggested to be part of the working memory phonological loop (Baddeley &
Andrade, 2000), and known to be involved in phonological representations (Hubbard, 2010), it
is highly relevant to study auditory imagery in relation to dyslexia.

The present study

When summarizing the literature on dyslexia in general, and especially when focusing on
musical abilities, one should note that most studies were conducted with children (e.g., Anvari
et al., 2002; Flaugnacco et al., 2015; Goswami et al., 2013; Huss et al., 2011; Lee et al., 2015;
Overy, 2003; Ziegler et al., 2012), with only a few being conducted with adults (e.g.,
Baldeweg et al., 1999; Thompson et al., 2006). Studying children is certainly important when
evaluating the early development of literacy skills. However, testing with adults can provide a
view into the underlying mechanisms of dyslexia that were not compensated for by training
and time. As such, the present study was designed to integrate both the known and unknown
regarding musical abilities among adults with dyslexia.
Another issue that also should be considered when testing musical and linguistic abilities
among readers with dyslexia is memory. Poor short-term memory and, more specifically,
working memory are characteristics of dyslexia, and, as mentioned above, are suggested to be
Music-related abilities among readers with dyslexia 323

part of its underlying cause (Banai & Ahissar, 2004; Garcia et al., 2014; Gathercole &
Pickering, 2000; Gathercole et al., 2005; Zhao et al., 2015). While some studies of music
and dyslexia have shown an association between musical abilities and memory (Flaugnacco
et al., 2015; Thompson et al., 2006), others have demonstrated deficits in the musical abilities
of those with dyslexia when controlling for performance on memory-related tasks, or when
memory load was low (Huss et al., 2011; Ziegler et al., 2012). However, since impaired
performance on short-term memory and working memory tasks has a strong association with
dyslexia, when testing musical abilities among those with dyslexia, their effect should be
controlled.
Therefore, in the present study, we asked whether adult participants with dyslexia would
differ from those without dyslexia in their perception of rhythm, pitch, and spectrum, as well as
their capacity for auditory imagery and detection of slow changes in auditory stimuli, while
controlling for working memory. In light of the literature showing deficits in temporal and
rhythm processing in dyslexia, we expected participants with dyslexia to be less accurate in
rhythm perception. Also, as most of the evidence shows that readers with dyslexia demonstrate
poorer performance in speech perception tasks, we expected them to be less accurate in tasks
involving pitch, frequency, and spectrum perception. Lastly, as there is some evidence that
auditory imagery is related to reading, we also predicted that dyslexic readers would score
lower in this measure as well. We expected working memory to be lower among readers with
dyslexia than those without dyslexia, and therefore measured this ability in order to control for
these differences.

Method

Participants

Two groups of native Hebrew-speaking undergraduate students, aged 20–35 years, participat-
ed in the study: 26 readers with dyslexia (dyslexia group: 14 women, 12 men) and 30 typical
readers (control group: 18 women, 12 men). This sample size was calculated based on effect
size of 0.8 and power of 80%, with significance level of 5%. Recruitment was done using
advertisements placed around the university, and in the vicinity of programs designed for
students with learning disabilities. Participants with dyslexia had already been diagnosed with
developmental phonological dyslexia prior to, and independent of, the study. Most were
diagnosed as children, but all were diagnosed or re-diagnosed at age 15 or older. Included in
the study were only those who were diagnosed by a specialist that used a normative diagnostic
battery for reading processes in Hebrew provided by the Nitzan Israeli Association for the
Advancement of Children with Learning Disabilities (Shalem & Lachman, 1998). This battery
includes tests relating to oral language, reading, writing, phonological awareness, naming, and
rhyming. Participants were included in the study if their results were at least two standard
deviations below the norms for each of these tests. In order to eliminate possible confounding
factors such as difficulties in concentration, and to ensure that performance deficits were
primarily due to dyslexia, participants who reported a concomitant diagnosis of attention
deficit hyperactivity disorder (ADHD) were excluded from the study. All participants were
screened for normal hearing with audiometric thresholds of at least 20 dB HL in 500, 1000,
2000, and 4000 Hz. Two male participants from the dyslexia group had higher hearing
thresholds and were not included in the rest of the study.
324 Lifshitz-Ben-Basat A., Fostick L.

Tasks

Advanced Measures of Music Audiation (AMMA) This is a music aptitude test for music
majors and non-majors among college students, high school students, and junior high students
(Gordon, 1989). It is used to assess the potential for high achievement in music by testing the
ability to recognize the similarity or difference in tone (pitch) or rhythm. Consequently, the
AMMA tests two musical constructs: pitch and rhythm. Following three examples, the listener
is presented with 30 trials of two short melodies. For each trial, the listener marks on an answer
sheet whether the melodies were the same or different and, if different, whether the difference
was in tone or rhythm. Scores for tone, rhythm, and a combined composite are obtained. The
split-half reliability for AMMA is r = .77 (Stringham, Snell, & Grunow, 2011).

Spectral-Temporally Modulated Ripple Test (SMRT) This is a measure of spectral perception

and tests the spectral construct (Aronoff & Landsberger, 2013). The test is conducted in a two-
down, one-up, three alternative forced-choice paradigm. In each trial, the listener is presented
with two intervals of a standard stimulus and a third interval that is an inverted stimulus; all
three intervals possess the same number of ripples per octave (RPO). The listener is asked to
select the interval that is different by pressing a button on a graphic interface. After two
consecutive correct responses, the number of RPOs is increased by a ratio of 1.414 (with the
increase of RPOs, the standard and inverted stimuli sound more similar). Following an
incorrect response, the number of RPOs decreases to the previously tested value. The test
terminates after 13 reversals, and the spectral ripple discrimination threshold is calculated as
the mean of the last eight reversals. Test-retest reliability was found to be high (r = .9)
(Drennan, Anderson, Won, & Rubinstein, 2014).

Bucknell Auditory Imagery Scale (BAIS) This is a scale for measuring the vividness of
auditory imagination and the ability to manipulate it. It has two subscales: vividness of
auditory imagery (BAIS-V) and control of auditory imagery (BAIS-C). The BAIS-V consists
of 14 descriptions of sounds to be imagined that are rated on a 1 (no image present at all) to 7
(image as vivid as actual sound) scale. The BAIS-C consists of 14 descriptions of pairs of
sounds. The participant is asked to imagine the first sound and then the second. On a scale of 1
(no image present at all) to 7 (extremely easy to change the image), the participant rates how
easy it is to make the imagery change. The BAIS-V was found to correlate with performance
on musical imagery tasks (Herholz et al., 2012; Pfordresher & Halpern, 2013; Zatorre,
Halpern, & Bouffard, 2010), and the BAIS-C has been shown to correlate significantly with
performance on a pitch discrimination task (Pfordresher & Halpern, 2013). For divergent
validity, the total BAIS scores were found to correlate only mildly (r = ~ .30) with musical
training or experience (Herholz et al., 2012; Pfordresher & Halpern, 2013).

Slow-change detection This task measures the ability to detect changes in the pitch of
auditory stimuli that occur slowly over time (Neuhoff et al., 2015). Participants are presented
with 2 min of continuous speech in “rising” or “falling” pitch versions. Each version starts 1.5
semitones below or above (respectively) the actual voice pitch, and rises or drops gradually
and continuously over the duration of the clip. During the clip, participants are requested to
press a keyboard key each time they hear the speaker take a breath. The end of the clip is 1.5
semitones above or below the actual pitch of each voice, resulting in a total of three-semitone
changes in pitch from beginning to end.
Music-related abilities among readers with dyslexia 325

Letter-number sequencing This is a subtest from the WAIS-III (Wechsler, 2008) designed to
measure working memory (along with attention and mental control). In this test, the experi-
menter reads aloud sets that include both letters and digits, at a rate of one item per second.
Immediately after the set has been read, participants are instructed to report back the items in
the following order: first, numbers from the smallest to largest, then letters in alphabetical
order. The size of the sets increases from 2 to 8 items (both letters and digits) and each set size
includes three trials. The score represents the number of sets reported correctly. The split-half
reliability of this test is r = .90.

Procedure

The study was approved by the Institutional Review Board (IRB) and was conducted in
accordance with Good Clinical Practice (GCP) guidelines. Prior to participation in the study,
participants received a full explanation of the study and provided signed informed consent. All
participants were then screened for their hearing level. Then, all subsequent tests were
completed in a single session that lasted 45 min. The tests were presented in a random order
across participants.

Results

Table 1 presents the scores and analyses for each of the tests used in the study. The a priori
hypothesis of the study was that dyslexic readers would show lower scores in each of the
measures. Accordingly, separate analyses were planned for each of the measures, with group
(dyslexia, control) as the independent variable.

Table 1 Test scores and group differences for measures used in the study

Dyslexia group Control group

Advanced Measures of Music Audiation (AMMA)

Composite score 46.87 (5.14) 53.37 (7.67) 8.748**1
Tonal score 22.07 (2.76) 25.40 (4.33) 7.349*1
Rhythm score 24.80 (3.61) 27.97 (3.78) 7.218*1
Spectral-Temporally Modulated Ripple Test (SMRT), mean (SD)
Number of RPOs 8.49 (0.99) 7.09 (1.20) 15.177***2
Bucknell Auditory Imagery Scale (BAIS), mean (SD)
BAIS-Vividness 5.02 (0.70) 5.19 (0.73) 0.0031
BAIS-Control 5.20 (0.84) 5.18 (0.80) 1.0201
Slow-change detection, percentage
Percentage of participants detecting change 0.53 0.50 0.443
Letter-number sequencing, standardized score
Standardized score 16.88 18.13 2.13†4
† p = .08; *p < .05; **p < .01; ***p < .001
1 Multivariate analysis of covariate
2 Univariate analysis of covariate
3 Chi square
4t test
326 Lifshitz-Ben-Basat A., Fostick L.

Working memory

In order to test the hypothesized group differences in working memory, a t test was performed
on the Letter-Number Sequencing Standardized score. The scores for the dyslexia group were
found to be marginally, but not significantly, lower than those for the control group. Never-
theless, due to our hypothesis regarding group differences in working memory, it was included
as a co-variate in the analyses of the AMMA, SMRT, and BAIS tests.

Rhythm and pitch

Multivariate analyses of covariance (MANCOVA) were performed for the AMMA scores
(composite, tonal, rhythm), with the Letter-Number Sequencing Standardized score as the
covariate. Significant group effects were obtained (F(2,54) = 4.272, p = .02, partial μ2 = .16)
On each of the AMMA scores (composite, tonal, and rhythm), the control group scored higher
than the dyslexia group. Although the tonal and rhythm scores present different musical
constructs, they were significantly correlated (r = .714, p < .001).

Spectral perception

Univariate analyses of covariance (ANCOVA) were performed for the SMRT score, with the
Letter-Number Sequencing Standardized score as the covariate. Significant group effect was
obtained (F(2,54) = 15.177, p < .001, partial μ2 = .26). Contrary to the hypothesis, the dyslexia
group demonstrated higher scores than the control group (Fig. 1).

Slow-change detection

The percentage of participants detecting a change in the speaker’s voice in the slow changes
detection test was calculated using the chi square test. No group differences were found
(χ2(1) = .44, p = .833).

* p < .001
Fig. 1 Group differences in the Spectral-Temporally Modulated Ripple Test (SMRT). * p < .001
Music-related abilities among readers with dyslexia 327

Auditory imagery

Multivariate analyses of covariance (MANCOVA) were then performed for the BAIS subscale
scores (vividness, control), with the Letter-Number Sequencing Standardized score as the
covariate. No group differences were found (F(2,54) = 0.454, p = .638, partial μ2 = .02).

Discussion

The current study was designed to test three dimensions of music (rhythm, pitch, and
spectrum), along with auditory imagery and slow-change detection, among adults with and
without dyslexia. To the best of our knowledge, this is the first study to measure all three
dimensions on the same participants. Such a design enables a global perspective that assesses
the association between dyslexia and each of these different components. As was expected,
readers with dyslexia showed poorer performance than did controls in pitch and rhythm, as
measured by the AMMA. Interestingly, and contrary to our hypothesis, readers with dyslexia
outperformed control participants in spectral perception, as measured by the SMRT. No
differences between groups were found on the slow-change detection task and on the
auditory imagery subscales.
The fact that our participants with dyslexia showed poorer performance than participants
without dyslexia in both rhythm processing and pitch perception fits well with the literature.
Rhythm, one of the fundamental components of music, is also of high importance in speech
perception. Rhythmic periodicity in speech is a crucial element of prosody, and is related to,
among other things, the onset of vowels in stressed syllables. Thompson et al. (2006) showed a
relationship between auditory rhythm sensitivity and literacy in young adults (aged 18–
31 years) in a battery of psychometric, phonological, psychoacoustic, and motor, as well as
receptive and expressive rhythm tasks. Later, Thompson & Goswami, 2008 found similar
findings among 10-year-old children. Thompson’s research points to a more general rhythm
deficit among those with dyslexia, a deficit not limited to the analysis of speech rhythm, but
also to rhythm-related motoric function. Other studies have also demonstrated poor rhythm
abilities among children and adults with dyslexia, showing that people with dyslexia are less
accurate when asked to discriminate between same or different metrical structures, or when
asked to tap rhythmical patterns (Atterbury, 1985; Lee et al., 2015; Thompson et al., 2006;
Thompson & Goswami, 2008; Wolff, 2002). This demonstrates the importance of rhythm
abilities in dyslexia, and underscores temporal processing as a significant mechanism related to
dyslexia.
The AMMA results also revealed poorer pitch perception among readers with dyslexia
compared to the controls. However, no such differences were found when detecting slow
changes in pitch. These mixed results are also well reflected in the literature. Various pieces of
behavioral evidence, as well as findings from brain activity studies, point to less sensitivity
among readers with dyslexia to changes in tone pitch (Ahissar et al., 2000; Anvari et al., 2002;
Baldeweg et al., 1999; Foxton et al., 2003; Santos et al., 2007; Ziegler et al., 2012). For
example, Ahissar et al. (2000) found poor auditory processing abilities among adult (aged 16–
58 years) English speakers with a childhood history of reading difficulties (CHRD) compared
to age-matched controls with no history of reading difficulties; in particular, participants with
CHRD had difficulties in pure tone frequency discrimination. This difficulty in pitch discrim-
ination was also expressed in atypical mismatch negativity (MMN) brain potential, an
328 Lifshitz-Ben-Basat A., Fostick L.

attention-independent auditory brain potential. Additionally, pitch discrimination and MMN

reduction were correlated with the degree of impairment in phonological skills, as reflected in
reading errors of regular and pseudo words. Several other studies, however, did not find any
difference in pitch perception among people with dyslexia compared to controls (Overy et al.,
2003, study 1; Ziegler et al., 2012). A possible explanation for the mixed results is the rate of
pitch change utilized in the studies. As discussed previously, the main difficulty of participants
with dyslexia is with rapidly changing stimuli (Gaab et al., 2007; Temple et al., 2000). Such
rapidly changing stimuli are present in the AMMA. However, the slow change test is focused
on detecting changes in auditory stimuli pitch that occur slowly over time. Apparently, slow
changes are evident to readers with dyslexia to the same degree as typical-reading control
participants. Rapid pitch detection tasks may be more sensitive than slow-change tasks among
readers with dyslexia, as slow-change tasks may mask the true deficit in pitch perception that
may be characteristic of people with dyslexia. Hence, when testing tone perception, one should
take into account the rate of tone changes, as the results may reflect different processing and
abilities.
This is the first study to test auditory imagery among people with dyslexia; vividness and
control of auditory imagination were found not to differ, compared to those without dyslexia.
Based on studies that showed auditory imagery has a role in reading among typical-reading
participants (Alexander & Nygaard, 2008; Brunyé et al., 2010), and evidence that auditory
imagery is related to the phonological loop (Baddeley & Andrade, 2000; Soemer & Saito,
2015), we hypothesized that readers with dyslexia would score lower than controls on the
BAIS. The contrary findings might suggest that dyslexia is related to a specific deficit in the
phonological loop, and not to a general deficit in auditory imagery, and should be further
explored in future studies.
Our most interesting finding was that people with dyslexia evidenced better spectral
perception than typical-reading controls, as measured by the Spectral-Temporally Modulated
Ripple Test (SMRT). When asked to detect the inverted stimulus among two other standard
stimuli, readers with dyslexia succeeded in detecting the difference at a higher number of
RPOs than control participants, even though increasing RPOs leads to higher similarity
between the standard and inverted stimuli. This better spectral perception joins additional
domains in which readers with dyslexia outperform readers without dyslexia (Tafti, Hameedy,
& Baghal, 2009). For example, Kasirer and Mashal (2017) recently compared the generation
and comprehension of metaphors in children, adolescents, and adults with and without
dyslexia. They found that adults with dyslexia generated more metaphors than controls. Others
found that dyslexic students scored higher than typical readers in original thinking and
creativity (Tafti et al., 2009). Our finding of superior spectral perception among readers with
dyslexia might be spurious, however, and therefore warrants further replications. Notwith-
standing this possibility, it may also support our preliminary conclusion that, among readers
with dyslexia, if the critical deficit(s) can be properly isolated and controlled, one may uncover
other intact or superior abilities among this population.
The advantage in spectral perception showed by our readers with dyslexia is also a cause of
great interest. As spectrum serves as a fundamental component of speech, and people with
dyslexia show impaired speech perception (Ronen et al., 2018), one might have expected to
find lower spectral perception among readers with dyslexia. However, speech perception
requires temporal processing ability; therefore, one usually cannot distinguish between tem-
poral and spectral perception. Even in the present study, the AMMA pitch perception test
utilizes melody, which combines both pitch and rhythm perception; thus, it is impossible to
Music-related abilities among readers with dyslexia 329

separate between rhythm and pitch, and to analyze each of them independently, as is
demonstrated by high correlation between AMMA tonal and rhythm scores. The advantage
of the SMRT is that the task of detecting the inverted stimulus lacks any temporal processing
requirement. Therefore, it enabled the readers with dyslexia to reveal their superior spectral
perception abilities. Such superior abilities have been demonstrated previously (Overy et al.,
2003). As with our findings on auditory imagery, this finding makes it possible to isolate the
specific mechanism related to dyslexia. Earlier, we showed that rapid changes in pitch, rather
than slow ones, are the main difficulty for readers with dyslexia. The current finding shows
that when spectral detection is isolated—without the temporal component—not only does
difficulty disappear for readers with dyslexia, but they outperform the control group. This
strongly suggests the possibility that the core speech perception deficit among those with
dyslexia lies in temporal processing. Further studies should take this into account when testing
musical and other abilities, by keeping temporal components isolated. This finding has also
clinical implications, including the need to focus on remediation of impaired temporal abilities
that may mask the preserved, and even superior, abilities of people with dyslexia.
Finally, one should note that all the described differences between typical readers and
readers with dyslexia in our study were found despite only marginal differences in working
memory between the groups. These minor differences were also controlled in our statistical
analysis. This is in contrast to many previous studies that found inferior working memory
abilities, poorer non-word repetition, and less memory span among readers with dyslexia
(Gathercole & Baddeley, 1990; Nicolson, Fawcett, & Baddeley, 1992; Gathercole &
Pickering, 2000; Gathercole et al., 2005; Laasonen, Leppämäki, Tani, & Hokkanen, 2009).
However, most of the previous studies examined working memory among relatively young
children with dyslexia: Gathercole and Baddeley (1990), for example, studied 8-year-old
readers with dyslexia, and Gathercole et al. (2005) studied children with dyslexia at the ages
of 5 and 8 years old. These contrary findings among children with dyslexia might suggest that
the good working memory abilities demonstrated by our adults with dyslexia reflect compen-
sated abilities. Since the participants in our study were university students, one may reasonably
presume they necessarily adopted compensational strategies to achieve their academic status.
Therefore, from one angle, it might be a study limitation to test adults with dyslexia, given
their possible compensational strategies; as such, our testing may not be sensitive enough to
unmask a fundamental deficit of limited working memory. Alternatively, these findings fit well
with literature pointing to age as a main factor influencing working memory abilities among
readers with dyslexia (Emery, Myerson, & Hale, 2007; Nicolson et al., 1992). Nicolson et al.
(1992) studied two groups of readers with dyslexia with mean ages of 11 and 15 years,
together with three groups of non-dyslexic children (mean ages of 8, 11, and 15 years) matched
for IQ, chronological age, and reading age. Participants completed several phonological tests
as well as non-word repetition and memory span tasks. While the 11-year-old children with
dyslexia showed evidence of deficits in phonological skills and non-word repetition, the 15-
year-old children with dyslexia effectively overcame any earlier handicaps in phonological
discrimination, non-word repetition, and memory span, performing at levels close to those of
children without dyslexia of similar age. The researchers suggest that the 15-year-old readers
with dyslexia were likely to have had both more remedial teaching and more time to allow any
developmental lag to catch up. In relation to the current study’s participants, there is a
reasonable possibility that during their adolescence they overcame working memory deficits
and adopted techniques to cope with ongoing and increasing literacy demands. This may have
330 Lifshitz-Ben-Basat A., Fostick L.

led to the slight differences found in working memory abilities between readers with and
without dyslexia in our study.
In summary, in our testing of all three dimensions of music—rhythm, pitch, and spectrum—
we found that rapid temporal processing appears to be the main difficulty of readers with
dyslexia. This was demonstrated by finding poorer performance of this group when stimuli
were presented quickly (AMMA) rather than slowly (slow-change detection test), and better
performance when no temporal component was involved (SMRT). We also suggest that, based
on our results, difficulties related to the phonological loop among readers with dyslexia may be
specific only to it, and not generalized to auditory imagery (BAIS). On a theoretical level, these
findings emphasize temporal processing as a critical factor in dyslexia. Clinically, the current
study findings put the focus on the importance of improving temporal processing; by doing so,
abilities that utilize the temporal component are also likely to improve.

Acknowledgments The authors would like to thank Shira Chana Bienstock for her thorough editorial review of
this manuscript.

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Affiliations

Adi Lifshitz-Ben-Basat 1 & Leah Fostick 1

1
Department of Communication Disorders, Ariel University, Ariel, Israel