Cited by 301Reading and Literacy DevelopmentNeurobiology of Language and BilingualismMultisensory perception and integration

Deviant processing of letters and speech sounds as proximate cause of reading failure: A functional magnetic resonance imaging study of dyslexic children.

Open access
Blau, V., Reithler, J., van Atteveldt, N., Seitz, J., Gerretsen, P., Goebel, R., Blomert, L.·2010·Brain

Abstract

Learning to associate auditory information of speech sounds with visual information of letters is a first and critical step for becoming a skilled reader in alphabetic languages. Nevertheless, it remains largely unknown which brain areas subserve the learning and automation of such associations. Here, we employ functional magnetic resonance imaging to study letter-speech sound integration in children with and without developmental dyslexia. The results demonstrate that dyslexic children show reduced neural integration of letters and speech sounds in the planum temporale/Heschl sulcus and the superior temporal sulcus. While cortical responses to speech sounds in fluent readers were modulated by letter-speech sound congruency with strong suppression effects for incongruent letters, no such modulation was observed in the dyslexic readers. Whole-brain analyses of unisensory visual and auditory group differences additionally revealed reduced unisensory responses to letters in the fusiform gyrus in dyslexic children, as well as reduced activity for processing speech sounds in the anterior superior temporal gyrus, planum temporale/Heschl sulcus and superior temporal sulcus. Importantly, the neural integration of letters and speech sounds in the planum temporale/Heschl sulcus and the neural response to letters in the fusiform gyrus explained almost 40% of the variance in individual reading performance. These findings indicate that an interrelated network of visual, auditory and heteromodal brain areas contributes to the skilled use of letter-speech sound associations necessary for learning to read. By extending similar findings in adults, the data furthermore argue against the notion that reduced neural integration of letters and speech sounds in dyslexia reflect the consequence of a lifetime of reading struggle. Instead, they support the view that letter-speech sound integration is an emergent property of learning to read that develops inadequately in dyslexic readers, presumably as a result of a deviant interactive specialization of neural systems for processing auditory and visual linguistic inputs.

AI snapshot

Written from the paper’s full text.

TL;DR

Dyslexic children showed reduced neural integration of letters and speech sounds in left planum temporale/Heschl sulcus and superior temporal sulcus, alongside weaker unisensory responses to speech sounds and letters. The integration and visual letter responses together explained almost 40% of variance in reading performance, suggesting letter-speech sound integration is an emergent property of learning to read that develops inadequately in dyslexia.

Key findings

  • Dyslexic children had reduced congruency effects for letter-speech sound pairs in left planum temporale/Heschl sulcus (117 voxels, t = 16.7, P = 0.00) and bilateral superior temporal sulcus (left: t = 7.73, P = 0.01; right: t = 8.34, P = 0.01); fluent readers showed stronger activation for congruent than incongruent pairs, while dyslexic readers showed no such modulation.
  • Unisensory group differences included weaker speech-sound responses in anterior superior temporal gyrus (left t = 2.89, right t = 2.8, P = 0.01) and weaker letter responses in fusiform gyrus bilaterally (left t = 3.83, P = 0.00; right t = 4.51, P = 0.00) in dyslexic children.
  • The congruency effect in planum temporale/Heschl sulcus and the visual response in fusiform gyrus explained almost 40% of variance in reading performance (R² = 0.39); PT/HS alone: R = 0.51, R² change = 0.27, F = 12.04, P = 0.002; combined model: R = 0.62, R² change = 0.11, F = 5.73, P = 0.023.
  • Attention task performance was comparable: fluent readers mean = 97.91, SEM = 1.55; dyslexic readers mean = 99.08, SEM = 0.55; reaction times 575 ms vs 609 ms, P = 0.10.

Methods

  • fMRI study of 18 dyslexic children (mean age 9.39, SD 0.43, one female) and 16 non-impaired readers (mean age 9.43, SD 0.44, four females), all healthy, right-handed, native Dutch speakers, matched for educational level, age, handedness and IQ.
  • Block design with four conditions: unisensory letters, unisensory speech sounds, multisensory congruent letter-speech sound pairs, and multisensory incongruent pairs; 128 stimuli per condition; children performed an attention detection task; data acquired on a 3 T Siemens scanner and analyzed in BrainVoyager QX using random-effects GLMs, including a 2 × 2 reading status × multisensory condition interaction.
  • Offline standardized battery included reading, phoneme deletion, phonological decoding, and letter-to-sound matching; correlations and stepwise multiple linear regressions related fMRI responses to reading performance.

Limitations

  • The paper states that the linear regression results should be treated with caution because of the small sample size of neuroimaging studies, and that the assumption about child-adult differences needs further empirical validation.
  • Evident from the text: the design is cross-sectional, so it cannot directly establish causality, although the authors argue the integration deficit is not merely a consequence of a lifetime of reading struggle.
  • Evident from the text: brain-behaviour correlations became non-significant when reading group was partialled out, indicating they were driven by group differences in reading ability; the total sample was small (n = 34) and the dyslexic group included only one female.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1093/brain/awp308

Cites

55 of 55 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 39 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Dyslexic children have weaker responses to speech sounds in the anterior superior temporal gyrus, planum temporale/Heschl sulcus and superior temporal sulcus.

    “as well as reduced activity for processing speech sounds in the anterior superior temporal gyrus, planum temporale/Heschl sulcus and superior temporal sulcus.”
    • Also stated in: § Unisensory activations · plain
      “Dyslexic children showed weaker activity for processing speech sounds in the anterior superior temporal gyrus (Fig. 2A)”
    Quote in the paperSubstantial claim
  • Findingown data

    The integration of letters and speech sounds in the planum temporale/Heschl sulcus and the response to letters in the fusiform gyrus together account for nearly 40% of the variance in individual reading performance.

    “Importantly, the neural integration of letters and speech sounds in the planum temporale/Heschl sulcus and the neural response to letters in the fusiform gyrus explained almost 40% of the variance in individual reading performance.”
    Quote in the paperSubstantial claim
  • Findingown data

    Dyslexic children have weaker unisensory responses to letters in the fusiform gyrus.

    “Whole-brain analyses of unisensory visual and auditory group differences additionally revealed reduced unisensory responses to letters in the fusiform gyrus in dyslexic children”
    Quote in the paperSubstantial claim
  • Findingown data

    Children with dyslexia show weaker integration of letters with speech sounds in the planum temporale/Heschl sulcus and the superior temporal sulcus.

    “The results demonstrate that dyslexic children show reduced neural integration of letters and speech sounds in the planum temporale/Heschl sulcus and the superior temporal sulcus.”
    Quote in the paperSubstantial claim
  • Findingown data

    Non-impaired and dyslexic readers responded equally quickly to attention stimuli, indicating comparable attention across groups.

    “In addition, non-impaired and dyslexic readers responded equally fast to attention stimuli (fluent: mean = 575 ms, SEM = 16.1;dyslexic: mean = 609 ms, SEM = 14.0;P = 0.10), indicating that attention levels were comparable across reading groups.”
    Quote in the paperSubstantial claim
  • May combine two claims. 19
  • Classified as probably not a substantial claim. 15
  • May combine two claims.

    Findingown data

    In fluent readers, speech-sound responses were modulated by whether a letter matched the sound, with strong suppression for mismatched letters; dyslexic readers showed no such modulation.

    “While cortical responses to speech sounds in fluent readers were modulated by letter-speech sound congruency with strong suppression effects for incongruent letters, no such modulation was observed in the dyslexic readers.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Dyslexic children had impaired reading, with word reading in the lowest 10th percentile, and poor performance on phonological awareness and phonological decoding subtests.

    “Specifically, dyslexic readers showed impaired reading (within the lower 10th percentile on a standardized test of word reading) and poor performance on subtests involving phonological awareness and phonological decoding (Table 1).”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The fMRI congruency response in the planum temporale/Heschl sulcus and superior temporal sulcus correlated positively with reading accuracy and negatively with reaction times on letter-speech sound matching.

    “Figure 4 illustrates that the fMRI congruency response in planum temporale/Heschl sulcus and superior temporal sulcus correlated positively with accuracy on the reading task and negatively with reaction times on letter-speech sound matching (Fig. 4A and B).”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: Faster processing is one of the main indices of automation for a cognitive process.
  • May combine two claims.

    Findingown data

    All reported brain-behaviour correlations became non-significant when reading group was controlled with partial correlations, suggesting they were driven by group differences in reading ability.

    “All reported correlations turned out to be non-significant when the factor reading group was controlled using partial correlations, suggesting that the brainbehaviour correlations were driven by group differences in reading ability.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The auditory response in the anterior superior temporal gyrus correlated with reading accuracy and letter-speech sound matching speed.

    “Moreover, the auditory response in the anterior superior temporal gyrus correlated with reading accuracy and the speed of letter-speech sound matching (Fig. 4C) as did the visual response in the fusiform gyrus (Fig. 4D).”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: Faster processing is one of the main indices of automation for a cognitive process.
  • May combine two claims.

    Findingown data

    Fluent readers activated the superior temporal sulcus more for congruent than incongruent letter-speech sound pairs, whereas dyslexic readers showed no congruency effect.

    “Comparable to planum temporale/ Heschl sulcus, fluent readers activated the superior temporal sulcus more for the presentation of congruent as opposed to incongruent letter-speech sound pairs, while dyslexic readers showed no congruency effect.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Between-group comparisons showed that dyslexic children had weaker activity for speech sounds in the anterior superior temporal gyrus and for letters in bilateral fusiform gyrus.

    “Dyslexic children showed weaker activity for processing speech sounds in the anterior superior temporal gyrus (Fig. 2A) and for processing letters in an area around the fusiform gyrus bilaterally (Table 2 and Fig. 2B).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Visual responses in left and right fusiform gyrus correlated with congruency effects in the planum temporale/Heschl sulcus (left R=0.38, P=0.025; right R=0.37, P=0.030), with fluent readers showing stronger letter responses and stronger congruency effects.

    “Moreover, the visual response in left and right fusiform gyrus correlated with congruency effects in planum temporale/Heschl sulcus (left fusiform gyrus: R = 0.38, P = 0.025; right fusiform gyrus: R = 0.37, P = 0.030), with fluent readers showing stronger responses to letters and a stronger effect of letter-speech sound congruency.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Weaker congruency-related effects in PT/HS and STS of dyslexic children were associated with lower reading scores, while stronger effects in fluent readers were associated with higher reading scores.

    “More concretely, weaker congruency effects in planum temporale/Heschl sulcus as well as superior temporal sulcus of dyslexic children were associated with lower reading scores, while stronger congruency effects in fluent readers were associated with higher reading scores.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Neural integration responses in PT/HS and STS correlated with speed of performance on letter-speech sound matching, with no accuracy differences.

    “neural integration responses in planum temporale/Heschl sulcus and superior temporal sulcus correlated with the speed of performance on letter-speech sound matching, in the absence of accuracy differences for judging the congruency between letters and sounds.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Reading acquisition and awareness of speech sounds likely influence each other reciprocally.

    “Thus, the relationship between reading acquisition and awareness for speech sounds is likely to be reciprocal (Perfetti et al., 1987;Wagner and Torgesen, 1987;Torgesen et al., 1994;Ehri, 2005;Ziegler and Goswami, 2005).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Perfetti et al., 1987

      Not checked in the free run.

    • cites Wagner and Torgesen, 1987

      Not checked in the free run.

    • cites Torgesen et al., 1994 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Dyslexia criteria used a discrepancy between reading test performance and IQ, classifying children with reading scores in the lowest 10th percentile but average IQ as dyslexic.

    “Criteria for dyslexia were based on a discrepancy score between performance on the reading test and IQ, according to which children with a standard reading score within the lower 10th percentile, but average IQ score were classified as dyslexic (Table 1).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    Letter-speech sound integration is an emergent property of learning to read that develops inadequately in dyslexic readers, possibly because neural systems for auditory and visual linguistic input specialize abnormally.

    “Instead, they support the view that letter-speech sound integration is an emergent property of learning to read that develops inadequately in dyslexic readers, presumably as a result of a deviant interactive specialization of neural systems for processing auditory and visual linguistic inputs.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Premisecitation

    Impaired phonological awareness is the most common behavioural explanation for reading failure.

    “Although various other factors may play a role as well (Livingstone et al., 1991;Tallal et al., 1993;Stein and Walsh, 1997;Nicolson et al., 2001), impaired phonological awareness constitutes the most common behavioural explanation for reading failure (Ramus, 2003).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ramus, 2003 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The variance inflation factor for all independent variables ranged from 1.05 to 2.29, so multicollinearity was judged not to be a concern.

    “For all independent variables the variance inflation factor was between 1.05 and 2.29 and hence multi co-linearity was considered of no concern for the present model.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    The groups were matched on educational level, age, handedness and IQ.

    “The groups were matched for educational level, age, handedness and IQ, (585, Wechsler Intelligence Scale estimated IQ within 1 SD of norm) and were tested on various measures for reading status using a standard test battery (Blomert and Vaessen, 2009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Blomert and Vaessen, 2009

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Multisubject statistical maps were corrected for multiple comparisons using false-discovery rate or cluster-size thresholding.

    “Depending on the specificity of the contrast, multisubject statistical maps were corrected for multiple comparisons using the false-discovery rate (Genovese et al., 2002) or cluster-size thresholding (Forman et al., 1995;Goebel et al., 2006).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Genovese et al., 2002

      Not checked in the free run.

    • cites Forman et al., 1995 source

      Not checked in the free run.

    • cites Goebel et al., 2006 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Acquiring letter-speech sound associations is thought to be critical for fluent reading because it affects early literacy acquisition.

    “Successful acquisition of letter-speech sound associations, in turn, has been theorized to be critical for the development of fluent reading skills by impacting the early phases of literacy acquisition (Bradley and Bryant, 1983;Ehri, 2005).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Bradley and Bryant, 1983

      Not checked in the free run.

    • cites Ehri, 2005

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Some but not all child fMRI studies report atypical frontal cortex activation.

    “Moreover, deviant patterns of activation in frontal cortex are reported in some but not all child fMRI studies (Maisog et al., 2008;Gabrieli, 2009).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Maisog et al., 2008 source

      Not checked in the free run.

    • cites Gabrieli, 2009 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    In dyslexic adults, weaker letter-speech sound integration was directly linked to reduced auditory processing of speech sounds, which predicted phonological task performance.

    “This reduced integration was directly associated with reduced auditory processing of speech sounds, which in turn predicted performance on phonological tasks.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Blau et al., 2009 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    For GLM4, the initial voxel-level threshold was P<0.01 (t=5.1) uncorrected, yielding a 115 mm3 cluster after 1000 iterations and a corrected false-positive probability of 5% or less.

    “For GLM4 (i.e. the interaction between 'multisensory condition' and 'reading status'), an initial voxel-level threshold was set to P50.01 (t = 5.1) uncorrected resulting in a cluster level of 115 mm 3 (four contiguous voxels) after 1000 iterations and a corresponding corrected false-positive probability of 5% or less.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Developmental dyslexia involves persistent reading and/or spelling difficulties that are unexpected given age, motivation or other cognitive abilities.

    “Specific reading disorder (or developmental dyslexia), which affects $4-10% of the population (Esser et al., 1990;Shaywitz et al., 1990;Blomert, 2005), is characterized by persistent difficulties in reading and/or spelling that are unexpected in relation to age, motivation or other cognitive abilities (Lyon et al., 2003).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lyon et al., 2003

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    For GLM5, the initial voxel-level threshold was P<0.01 (t=2.5) uncorrected, yielding a minimum 168 mm3 cluster at a false-positive probability of 5% or less.

    “For GLM5 (i.e. the direct comparisons between control and dyslexic readers on the auditory or visual condition), an initial voxel-level threshold was set to P50.01 (t = 2.5) uncorrected, resulting in a minimum cluster of 168 mm 3 (five contiguous voxels) at a false-positive probability of 5% or less.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Learning the mappings between visual letters and auditory speech units is the first critical step in reading development and the main focus of early reading instruction.

    “However, the first critical step in reading development and the focus of most early reading instruction is to learn the correspondences between visual letters and auditory units of speech (speech sounds) (Ehri, 2005).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ehri, 2005

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductown data

    Dyslexic participants were diagnosed through an extensive standardized cognitive-behavioural procedure.

    “Dyslexic subjects were recruited via the Dutch Regional Institute for Dyslexia and diagnosed using an extensive, standardized cognitive-behavioural test procedure.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationreasoning

    Letter-speech sound integration emerges during reading acquisition but develops poorly in dyslexic readers, possibly through deviant interactive specialization of auditory and visual language systems.

    “This suggests that letter-speech sound integration is an emergent property of learning to read that develops inadequately in dyslexic readers, presumably as a result of a deviant interactive specialization of neural systems for processing auditory and visual linguistic inputs.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    The correlations between congruency-related effects and reading scores became non-significant when reading group was partialled out, indicating they reflect reading ability.

    “These correlations turned out to be non-significant when the factor reading group was partialled out indicating that they indeed reflect an effect of reading ability.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The linear regression results should be treated with caution because of small sample size.

    “While these linear regression results should be treated with caution because of the small sample size of neuroimaging studies”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationcitation

    Problems integrating letters with speech sounds arise during reading acquisition rather than from many years of reading difficulty.

    “showing that a deficit in letter-speech sound integration is an emergent property of learning to read and not the result of a lifetime of reading difficulties”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Blau et al., 2009 source

      Not checked in the free run.

29 of 29
  • The authors state this as an assumption.

    Faster processing is one of the main indices of automation for a cognitive process.

    “Based on the assumption that faster processing is one of the main indices for the automation of a cognitive process (Schneider and Chein, 2003)”
  • The paper relies on this without support.

    The selected age range is the earliest point at which reading disabilities are typically diagnosed.

    “Importantly, the selected age range coincides with the earliest time in development at which reading disabilities are typically diagnosed and hence one of the earliest possible time-points to investigate the neurocognitive basis of letterspeech sound integration in dyslexia.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • LOTS response shaping is probably initially guided by phonological and multisensory regions in posterior STS and inferior parietal cortex.

    “The process of shaping the responses in LOTS is likely to be guided, initially, by phonological and multisensory integration regions in posterior STS and inferior parietal cortex (Blau et al., 2010; Blau, van Atteveldt, Ekkebus, Goebel, & Blomert, 2009).”

    From The Development of Cortical Sensitivity to Visual Word Forms (2011) · cites this paper as Blau et al., 2010

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • aSTG is defined as sulcus but described as gyrus

    Minor

    Table 2 defines aSTG as the anterior superior temporal sulcus, while the results describe the corresponding speech-sound region as the anterior superior temporal gyrus.

1 of 1

Cites

Flagged first, then by citations

1 of the 56 references couldn’t be matched to a known paper.

Research works printed but not linked: 6

  1. 2004, 44, 411
  2. 1987, MERILLPALMER QUART, 33, 283
  3. 2000, 28, 617
  4. 1995, 55, 151
  5. 1990, RESULTS OF THE CONNECTICUT LONGITUDINAL STUDY JAMA, 264, 998
  6. 2004, 43, 271

Cited by

Sorted by citations

Authors
Blau, V., Reithler, J., van Atteveldt, N., Seitz, J., Gerretsen, P., Goebel, R., & Blomert, L.
Affiliations
Maastricht University (NL)
Venue
Brain
Published
2010-01-07
Volume
133
Issue
3
Pages
868-879
ISSN
  • 0006-8950 (ISSN-L)
  • 1460-2156
OpenAlex
W2136056602
Cited by
301
References
56
Citations by year
2026: 9 · 2025: 11 · 2024: 13 · 2023: 25 · 2022: 16 · 2021: 19 · 2020: 7 · 2019: 20 · 2018: 26 · 2017: 18 · 2016: 24 · 2015: 21 · 2014: 23 · 2013: 20 · 2012: 23
FWCI
40.89
Type
journal article
Language
en
Open access
Locations
  • Brain (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (submittedVersion, other-oa)
  • VU Research Portal (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
European Commission
Topics
  • Social Sciences › Psychology › Developmental and Educational Psychology › Reading and Literacy Development
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Multisensory perception and integration
Keywords
developmental dyslexia, reading acquisition, planum temporale, superior temporal sulcus, fusiform gyrus, audiovisual integration, reading failure, children, neural specialization
MeSH terms
Acoustic Stimulation, Brain, Brain Mapping, Child, Dyslexia, Female, Humans, Magnetic Resonance Imaging, Male, Neural Pathways, Neuropsychological Tests, Phonetics, Photic Stimulation, Reading, Speech Perception, Visual Perception

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