applied

sciences
Review
Deep Learning Applications for Dyslexia Prediction
Norah Dhafer Alqahtani 1,2, *, Bander Alzahrani 1 and Muhammad Sher Ramzan 1, *

1 Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
2 Information Systems, King Khaled University, Abha 61421, Saudi Arabia
* Correspondence: [email protected] (N.D.A.); [email protected] (M.S.R.)

Abstract: Dyslexia is a neurological problem that leads to obstacles and difficulties in the learning
process, especially in reading. Generally, people with dyslexia suffer from weak reading, writing,
spelling, and fluency abilities. However, these difficulties are not related to their intelligence. An
early diagnosis of this disorder will help dyslexic children improve their abilities using appropriate
tools and specialized software. Machine learning and deep learning methods have been implemented
to recognize dyslexia with various datasets related to dyslexia acquired from medical and educational
organizations. This review paper analyzed the prediction performance of deep learning models for
dyslexia and summarizes the challenges researchers face when they use deep learning models for clas-
sification and diagnosis. Using the PRISMA protocol, 19 articles were reviewed and analyzed, with a
focus on data acquisition, preprocessing, feature extraction, and the prediction model performance.
The purpose of this review was to aid researchers in building a predictive model for dyslexia based
on available dyslexia-related datasets. The paper demonstrated some challenges that researchers
encounter in this field and must overcome.

Keywords: dyslexia detection; dyslexia classification; feature extraction; diagnosing dyslexia;

machine learning; deep learning

1. Introduction
Dyslexia is a common learning difficulty that people encounter throughout their
Citation: Alqahtani, N.D.; Alzahrani, learning journey, which affects the reading, writing, spelling, fluency, word decoding, and
B.; Ramzan, M.S. Deep Learning dictation processes. However, it is not related to an individual’s level of intelligence. The
Applications for Dyslexia Prediction. term originates from the ancient Greek, with the prefix “dis” referring to disorder and the
Appl. Sci. 2023, 13, 2804. https:// root “lexia” to language. Hence, dyslexia signifies a language defect or disorder [1]. Many
doi.org/10.3390/app13052804 children with this disorder have normal intelligence and receive appropriate education
Academic Editor: José Salvador and parental support but have difficulty with learning certain skills. Today, dyslexia is
Sánchez Garreta the most frequent childhood learning disorder, accounting for up to 80% of all identified
learning disabilities [2].
Received: 27 January 2023 The World Federation of Neurology identifies dyslexia as a disturbance where the
Revised: 17 February 2023
child’s spelling, writing, or reading skills fail to meet predicted levels based on age and
Accepted: 20 February 2023
intellectual performance despite attending school regularly [3]. From a neuropsychological
Published: 22 February 2023
approach, these disorders result from one or more malfunctioning learning-related brain
systems [3], where the functions of the left hemisphere are imbalanced, such as impairment
in the area concerned with short-term memory, motor skills, visual perceptions, language
Copyright: © 2023 by the authors.
processing, auditory, speed, and speaking (Figure 1).
Licensee MDPI, Basel, Switzerland. The early diagnosis of suspected dyslexia in children is essential as it will increase
This article is an open access article the likelihood of the dyslexic child benefiting from effective intervention programs and
distributed under the terms and improving his or her abilities [4]. Traditional tests for diagnosing dyslexia depend on the
conditions of the Creative Commons evaluation of reading words and text, writing, and working memory. Experts in this field
Attribution (CC BY) license (https:// have defined and normalized the scores of these tests. Some screening tests include CASL,
creativecommons.org/licenses/by/ TAPS, CTOPP-2, WRMT, GSRT, and TEWL, which have become available on the Web due
4.0/). to ICT that authorized the digitalization of these tests [5]. ICT refers to a varied set of

Appl. Sci. 2023, 13, 2804. https://doi.org/10.3390/app13052804 https://www.mdpi.com/journal/applsci

Appl. Sci. 2023, 13, x FOR PEER REVIEW 2 of 18

Appl. Sci. 2023, 13, 2804 2 of 17

due to ICT that authorized the digitalization of these tests [5]. ICT refers to a varied set of
resources and technological tools utilized to create, transfer, store, interchange, or share
resources and technological tools utilized to create, transfer, store, interchange, or share
information. All these tests are available for subscription under specific criteria.
information. All these tests are available for subscription under specific criteria.

Figure 1. This image shows that any disorder in the brain’s left hemisphere would lead to important
Figure 1. This image shows that any disorder in the brain’s left hemisphere would lead to important
difficulties in a person’s ability to read and write and some other skills.
difficulties in a person’s ability to read and write and some other skills.
Neurological aspects have also been considered in modern technologies for diagnosing
Neurological aspects have also been considered in modern technologies for diagnosing
dyslexia, helping to increase detection accuracy and reliability. Medical devices enable
dyslexia, helping to increase detection accuracy and reliability. Medical devices enable the ob-
the observation of the brain structure of dyslexics [6]. Habib [7] proposed three triggering
servation of the brain structure of dyslexics [6]. Habib [7] proposed three triggering mecha-
mechanisms of dyslexia: attentiveness disturbance (visual–attentional dyslexia), language
nisms of dyslexia:
disturbance attentiveness
(phonological disturbance
dyslexia), and motor (visual–attentional dyslexia), form
disturbance (a dyspraxic language disturb-
of dyslexia).
anceIn(phonological dyslexia), and motor disturbance (a dyspraxic
“phonological dyslexia”, during the reading, fMRI displays paralysis of three re-form of dyslexia).
gionsIn “phonological
that are concerneddyslexia,”
with languageduring the reading,
production andfMRI displays
grasping paralysis Wernicke’s,
(Geschwind’s, of three re-
gions that are concerned with language production and grasping
and Broca’s territory) [8]. Additionally, compared to controls, DTI reveals white matter (Geschwind’s, Wer-
nicke’s, and Broca’s territory) [8]. Additionally, compared to controls,
variation in the language area [9]. In visual attentional dyslexia, when dyslexic participants DTI reveals white
matter
are taskedvariation in thecongruous
to recognize language area stimuli[9].pairs,
In visual
fMRIattentional
displays a dyslexia,
separation when
betweendyslexic
the
participants are tasked to recognize congruous stimuli pairs, fMRI
temporal visual system and parietal attentional system as well as a disconnection, in the left displays a separation
between the of
hemisphere, temporal visualand
the temporal system and parietal
occipital attentional
zones [9]. system asform
In the “dyspraxic wellofasdyslexia”,
a discon-
nection, in the left hemisphere, of the temporal and occipital zones
there is inactivation in the cerebellum–ventral frontotemporal and cerebellum–dorsal fron- [9]. In the “dyspraxic
form of dyslexia,”
toparietal pathway there is inactivation
[10]. Besides fMRI, the in the cerebellum–ventral
surface measurement offrontotemporal
brain potential,and knowncer-
ebellum–dorsal frontoparietal pathway [10]. Besides fMRI, the
as EEG, assists in identifying brain activation patterns. During spelling tests, phoneme dele-surface measurement of
brain potential, known as EEG, assists in identifying brain activation
tion, the rapid naming of letters, and articulation, increased vigor is observed in the theta patterns. During
spelling
and deltatests,
EEG phoneme
frequencydeletion,
bands in thethe rapid
frontalnaming
and rightof letters,
temporal and articulation,
zones in dyslexics increased
[11].
vigorResearchers
is observedhave in the theta anddifferent
suggested delta EEG MLfrequency
methods bands in the frontal
for predicting dyslexia andinright tem-
children
poral zones
utilizing in dyslexics
datasets related[11].to dyslexics. Such datasets can be acquired from medical and
Researchers
educational have suggested
institutions as well asdifferent
throughML methods
special games forconstructed
predicting dyslexia
speciallyinfor children
them.
utilizing
For example,datasets related tobrain
eye tracking, dyslexics.
imaging, Such datasets
EEG, can beand
test scores, acquired from medical
handwriting have been and
educational
used in dyslexiainstitutions
prediction. as well as through special games constructed specially for them.
For example,
AI refers to eyethe tracking,
development brain imaging,
of machines EEG,andtest scores,toand
systems handwriting
enable have been
them to implement
used in dyslexia
functions and tasks prediction.
that demand human intelligence, such as translation, decision making,
visualAI perception,
refers to the anddevelopment
speech recognition.
of machinesML is considered
and systems a part of AI, them
to enable whichto concentrates
implement
on the evolution of computer programs that use different datasets
functions and tasks that demand human intelligence, such as translation, decision mak- to learn for themselves.
DL
ing,isvisual
a subset of ML that
perception, and seeks
speechtorecognition.
simulate the MLhuman brain, allowing
is considered a part of DL AI, systems
which con- to
cluster
centratesdataonandthemake incredibly
evolution accurateprograms
of computer predictions.thatTheuseliterature
differenthas demonstrated
datasets to learnthe for
success of MLDL
themselves. methods in classification
is a subset of ML thatproblems, particularly
seeks to simulate thethe classification
human of diseases.
brain, allowing DL
Moreover,
systems toML methods
cluster data haveand been
makefound to have
incredibly outstanding
accurate accuracy
predictions. Thefor diagnosing
literature has
dyslexia [12]. However, traditional ML methods fail to use raw
demonstrated the success of ML methods in classification problems, particularly the clas- data to implement these
tasks [13]. of
sification Todiseases.
overcome this obstacle,
Moreover, ML models
ML methods havehave
been used
found a layered
to havelearning
outstanding approach,
accu-
known as the DL. The general difference between DL models
racy for diagnosing dyslexia [12]. However, traditional ML methods fail to use raw and traditional ML models
data
is that DL models do not require the engineering step of feature extraction, which is
inherent to conventional models, as they automatically learn abstract hierarchical feature
Appl. Sci. 2023, 13, 2804 3 of 17

representations from data [14]. ML might be utilized to accomplish specific tasks, for
instance, the identification of objects in images, speech-to-text transformation, and isolation
of items in categories [13].
DL utilizes ANNs that simulate the brain’s function. Since ANNs were introduced,
they have undergone considerable alteration and development; however, the basic principle
has remained the same [13]. The ANN structure essentially comprises nodes and edges
that, together, create a structure that resembles a neuron and are in charge of transmitting
the information [13]. It consists of three strata: input strata, several hidden strata, and
output strata. In each layer, every node is linked to every other node in the next layer.
The network becomes deeper as the number of hidden layers increases, leading to a DNN
model. A DNN converts raw inputs to helpful features. Subsequent layers elicit a group of
features that are considered more abstract and help to achieve a desired task. The essential
processes in DL are feature extraction and selection [13]. DNNs have various architectures.
A basic one is a feed-forward network, in which the structure has links among layers in a
single direction (forward), and there are no existing loops or cycles in the whole structure.
Other architectures include particular functions, such as RNNs, which are implemented
with sequential datasets, whereas CNNs are implemented with grid-structured data-like
images. MLP and CNN models have been applied at different times and places to reveal
and classify dyslexia utilizing special data related to dyslexic children. This review paper
focuses on the use of advanced ML methods (DL) to help in diagnosing dyslexia disorder
and constructing a predictive model for prediction. The following points are investigated:
- The types of datasets that are used by prediction models.
- Different DL models that are utilized to predict dyslexia disorder.
- The performance of DL models in dyslexia prediction.
To the best of our knowledge, this is the first review to investigate current works that
specifically utilized DL models to diagnose dyslexia. This will allow us to investigate the
points above, seeking to find a new way to predict dyslexia. Previous reviews on dyslexia
prediction have focused on ML models in general, not on DL models.
Following this initial introduction, Section 2 provides an overview of related works,
both review papers and systematic reviews, and illustrates the difference between previous
reviews and the current work. Section 3 discusses the search strategy and explains the
stages of the article selection process, including the criteria. Section 4 provides a detailed
explanation of every article in the results section, including information on dataset acquisi-
tion, dataset preprocessing, feature selection, and model prediction performance. Section 5
lists and discusses some challenges related to scanning the articles, and Section 6 presents
concludes the paper.

2. Related Work
Several surveys and review papers have addressed the use of ML in dyslexia disorder
classification. During the research process, we found nine papers that were related to the
diagnosis of dyslexia disorders using ML methods. In a review paper [15], the research
covered several dimensions related to dyslexia prediction with ML methods and image
processing techniques. In addition, regarding design assessment tests and tools for prop
dyslexics, most of the research utilized ML techniques to predict dyslexia. A survey
paper [16] summarized the techniques for diagnosing dyslexia that use ML approaches. It
screened 13 studies that applied ML methods, and only one of these studies applied DL
methods for dyslexia classification. In three review papers [6,17,18], the authors conducted
literature surveys focused on ML methods utilized in dyslexia prediction. The surveys did
not include studies on dyslexia prediction based on handwriting datasets, which started
in 2019. A systematic review [19] has focused on ML and DL methods that have been
utilized for identifying dyslexia and its biomarkers and concluded that Support Vector
Machine (SVM) is the most frequently applied ML method for identifying and predicting
dyslexia. Moreover, it noted that the utilization of DL algorithms is still in its infant stage.
An extensive review [20] focused not only on the prediction of dyslexia disorder using
 surveys did not include studies on dyslexia prediction based on handwriting datasets,
which started in 2019. A systematic review [19] has focused on ML and DL methods that
have been utilized for identifying dyslexia and its biomarkers and concluded that Support
Vector Machine (SVM) is the most frequently applied ML method for identifying and pre-
Appl. Sci. 2023, 13, 2804 4 of 17
dicting dyslexia. Moreover, it noted that the utilization of DL algorithms is still in its infant
stage. An extensive review [20] focused not only on the prediction of dyslexia disorder
using ML methods but also included studies on the prediction of attention deficit hyper-
ML methods
activity but also
disorder. Ahireincluded studies
et al. [21] on the
conducted prediction of attention
a comprehensive review deficit
on the hyperactivity
classification
disorder.
of dyslexiaAhire
using et
MLal.methods,
[21] conducted
focusingaspecifically
comprehensive review
on studies onused
that the classification
EEG signals forof
dyslexia usingThey
classification. ML found
methods,
thatfocusing specificallyother
SVM outperformed on studies that used
ML methods EEGsignal
in EEG signals for
clas-
classification.
sification. They found
Poornappriya andthat SVM outperformed
Gopinath [22] consideredother ML methods
studies in EEG signal
that implemented ML
classification. Poornappriya and Gopinath [22] considered studies that implemented
methods for dyslexia prediction in addition to studies that helped dyslexics to improve ML
methods for dyslexia prediction in addition to studies that helped dyslexics to
their reading and other skills. Their review was different from the other review papers, as improve
ittheir reading
focused on and other skills.ofTheir
the utilization review was
DL methods different
in the from of
prediction thedyslexia
other review
usingpapers, as
different
it focused on thedatasets.
dyslexia-related utilization of DL methods in the prediction of dyslexia using different
dyslexia-related datasets.
3. Research Strategy
3. Research Strategy
In this paper, a critical review of the literature has been performed to collect a broad
In this paper, a critical review of the literature has been performed to collect a broad
variety of studies that used DL methods for dyslexia prediction and classification and to
variety of studies that used DL methods for dyslexia prediction and classification and to
investigate the research points listed above. The identification and selection of pertinent
investigate the research points listed above. The identification and selection of pertinent
articles followed the Preferred Reporting Items for Systematic Reviews and Meta-Anal-
articles followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
yses (PRISMA) guidelines [23]. As shown in Figure 2, the article selection process included
(PRISMA) guidelines [23]. As shown in Figure 2, the article selection process included three
three phases: identification, screening, and inclusion phases.
phases: identification, screening, and inclusion phases.

Figure
Figure 2.
2. PRISMA
PRISMA flow
flow diagram
diagram for
for selecting
selecting 19
19 definitive
definitive articles.
articles.

In the identification phase, we searched for appropriate articles from 2010 to 2022 in
different databases (Figure 2), including IEEE Xplore, Google Scholar, PubMed, Springer,
Web of Science (WoS), and Science Direct. The following keywords were used in the
search queries: “Dyslexia classification”, “Dyslexia Prediction”, “ML in Dyslexia”, “Deep
Learning in Dyslexia”, “Diagnosis Dyslexia”, and “CNN in Dyslexia”. The search produced
1995 articles, of which 138 were from IEEE, 667 from Google Scholar, 665 from PubMed,
Appl. Sci. 2023, 13, 2804 5 of 17

217 from Springer, and 248 and 60 from WoS and Science Direct, respectively. We excluded
13 non-English articles and 411 duplicate articles.
In the screening phase, there were 1571 articles we needed to screen. The reviewers
excluded 1428 irrelevant articles. Then, of the remaining 143 articles, 101 articles were
excluded for different reasons. Some of the articles focused on dyslexia with other learn-
ing disorders, some focused on predicting dyslexia using games and applications, and
some others were review papers. Then, the screening advanced after fulfillment of the
inclusion criteria.
As shown in Table 1, the inclusion criteria were as follows: (1) articles released
between 2010 and 2022 in English, (2) articles that utilized a DL method or combinations
with traditional ML for the identification of dyslexia, and (3) articles that utilized datasets
related to dyslexia.

Table 1. Inclusion and exclusion criteria.

Inclusion Criteria Exclusion Criteria

Articles released between 2010 and 2022 in Articles not relevant to dyslexia
English (AND) classification (AND)
Articles that utilized DL methods (OR) DL
Articles that used only traditional ML methods
methods combined with traditional ML for the
to prediction dyslexia (AND)
identification of dyslexia
(AND) Articles that utilized datasets related
Articles that did not meet the inclusion criteria
to dyslexia

Subsequently, in the inclusion phase, the articles were reviewed for further considera-
tion of their eligibility, based on the criteria shown in Table 1. Ultimately, only 19 articles
were chosen for critical review. Following a previous study [13], we included ANN and
Appl. Sci. 2023, 13, x FOR PEER REVIEW
MLP models in this review, where ANN include DL feed-forward networks as 6 of 18 as MLP.
well
Figure 3 illustrates the number of articles selected per year from 2010 to 2022.

Annual distribution of nineteen articles carefully screened.

6

5
NO. OF ARTICLES

0
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022
YEAR OF PUBLICATION

Figure 3.
Figure 3.Annual
Annualdistribution
distributionof the 19 articles
of the that were
19 articles carefully
that were screened.
carefully screened.

4. Research
4. ResearchResults
Results
Dyslexia
Dyslexiaprediction using
prediction DLDL
using models involves
models several
involves steps, starting
several from acquiring
steps, starting from acquiring
the datasets to evaluating the prediction models. This can be seen in the articles selected
the datasets to evaluating the prediction models. This can be seen in the articles selected
for review.
for review.
4.1. Data Acquisition
The first step in predicting dyslexia disorders using DL methods is the acquisition of
datasets related to dyslexia. As mentioned above, brain imaging and eye-tracking data in
addition to traditional data (e.g., test scores and time consumption when performing spe-
cific tasks) can be used to diagnose dyslexia. In [19], the dyslexia datasets were divided
Appl. Sci. 2023, 13, 2804 6 of 17

4.1. Data Acquisition

The first step in predicting dyslexia disorders using DL methods is the acquisition of
datasets related to dyslexia. As mentioned above, brain imaging and eye-tracking data
in addition to traditional data (e.g., test scores and time consumption when performing
specific tasks) can be used to diagnose dyslexia. In [19], the dyslexia datasets were divided
into three classes. The first category was related to behavioral symptoms in dyslexics, the
second category was related to brain imaging, and the last was related to eye movements
during cognitive tasks. The behavioral symptoms of dyslexics manifest through reading,
writing, working memory, phonological awareness, and facial reactions throughout the
learning process. Reading and writing are inextricably linked, and children who struggle
to read also struggle to write. Hence, dyslexics have problems when writing letters. For
example, instead of starting from the top, they start from the bottom when writing letters,
inverting the letters, skewing some, and erasing frequently [24]. Spoon et al. [25] were
the first to use handwriting datasets to predict dyslexia. They compiled a handwritten
dataset on 88 subjects (11 from dyslexics and 77 from normal subjects), demonstrating the
possibility of using these types of data for predicting dyslexia.
In another study, 100 handwriting samples were collected (22 dyslexia and 78 non-dyslexia)
from children in grades K-6 [26]. Isa et al. [27] collected 30 handwriting samples from
the ADM. The dataset included eight selected numbers and small letters (6, 7, 2, 5, c, b,
p, and f). The main reason for selecting these numbers and letters is that they are the
most commonly associated with writing errors among dyslexics. In India, Yogarajah and
Bhushan collected 54 handwriting samples from the notebooks of children (18 females,
36 males) from first to fifth grade [28]. Fourteen Hindi words were selected from the
children’s notebooks, representing varying degrees of difficulty. Five words consisted
of two letters, six words had vowel signs, and three were conjoined consonants words.
Isa et al. [4,29] used a dataset collected from three sources: uppercase letters were taken
from NIST Special Database 19, lowercase letters were taken from the Kaggle dataset,
and testing data were collected on Seberang Jaya Primary School’s dyslexic students.
These two studies used data augmentation techniques to generate the dyslexic datasets,
using noise injection and rotation techniques to generate reversal handwriting datasets.
Kohli and Prasad [30] collected a dataset from the test scores of dyslexic students on
reading, spelling, speech deficits, deficits in writing, and mathematical abilities as well as
motor skills.
The second category of dyslexia datasets is related to brain imaging, where the modali-
ties of brain imaging identify special behaviors and activations of the brains of participants
in the studies [19]. EEG is a brain imaging modality that can be utilized to observe the
brain’s function through electrodes placed on the scalp. In the studies, the researchers
examined “neurological” aspects to identify unique patterns in dyslexia [31]. For example,
Karim et al. [32] collected EEG signal data from six participants between four and seven
years of age (three dyslexic and three non-dyslexic). The normal children were selected ran-
domly from various schools, while the dyslexic children were from the Titiwangsa and Am-
pang Hilir branches of the Dyslexia Association of Malaysia. In the KSA, Al-Barhamtoshy
and Motaweh [33] compiled a dataset on 80 children between 7 and 13 years of age with
the help of the “Brain training and consultation center”. Normal children were randomly
selected from the cities of Jeddah and Makah. In another study [34], a dataset was compiled
on 32 children who were native Hebrew speakers in grades 6–7 (17 dyslexics and 15 skilled
readers). In Spain, Ortiz et al. [35] collected a dataset on 48 native Spanish-speaking partici-
pants (32 skilled readers and 16 dyslexics). All of them were right-handed, did not suffer
from hearing impairments, and had normal vision. Usman and Muniyandi [12] used MRI
data, which is a diagnostic medical tool utilized to analyze alterations in the brain anatomy.
They collected neuroimaging data on 45 individuals (19 dyslexics and 26 non-dyslexics)
aged 15–23 years from Kaggle datasets. fMRI is a type of MRI that produces images of
brain soft tissue with the highest resolution, which has been utilized to identify and analyze
various regions in brain [36]. In another study [37], an MRI dataset of BOLD functional
Appl. Sci. 2023, 13, 2804 7 of 17

images was collected through different reading tasks: a lexical decision task, semantic
categorization task, and lexical orthographic matching. The datasets were collected from
55 Spanish children between 9 and 12 years of age, who were recruited from schools and
the University Hospital of Cruces in Spain. Chimeno et al. [38] gathered 3D images from
both DTI and fMRI scans of 52 schoolchildren between nine and 12 years of age at various
times. In 2021, an fMRI dataset was collected on 32 Portuguese children, divided into
16 typical readers and 16 dyslexics aged 8–12 years [39]. All children were right-handed
and matched for IQ, age, and sex.
The final dataset category relates to patterns of eye movement when performing
cognitive tasks, as recent studies have used eye movements to differentiate between dyslexic
and non-dyslexic individuals. Statistical measures have been used to identify features
of children’s eye movement through cognitive exercise. The authors in [40,41] used the
same dataset containing raw eye movement data on 185 subjects, 88 at low risk of dyslexia
and 97 with a high risk of dyslexia. These data were collected in 2016 [42] from a wide
population of 2165 school children in second grade. Recently, Vajs et al. [43] collected and
analyzed a dataset on 30 subjects aged 7–13 years, 15 of whom had dyslexia and 15 of
whom were normal participants (11 male and 19 female), as they read a Serbian written
text with 13 different color configurations.
One study used an EOG in the prediction of dyslexia [44]. EOG is a method that
relies on the screening of the electrical potential for eye movements, which is helpful for
analyzing various types of eye movements, such as saccades, smooth pursuits, vergence,
blinks and gaze fixation. This study collected data on 33 children aged between 8 and
11 years of age (20 with dyslexia and 13 healthy; 17 female and 16 male). None of the
Appl. Sci. 2023, 13, x FOR PEER REVIEW 8 of 18
dyslexic children had hearing or vision defects. Figure 4 illustrates the usage percentage of
different datasets in the articles that employed DL methods to predict dyslexia.

Distribution of articles that used DL methods based

on datasets from 2010 – 2022
5.30%
5.30%

EGG
21.10%
handwriting
15.79%
MRI & fMRI & DTI
Eye Tracking

31.58% test Score

21.10%
EOG

Figure 4.
Figure 4. Distribution
Distribution of
of articles
articles that
that used
used DL
DL methods
methods based
based on
ondatasets
datasetsfrom
from2010
2010to
to2022.
2022.

4.2.
4.2. Data
Data Preprocessing
Preprocessing
Datasets
Datasets related
related toto dyslexia
dyslexia need
need to
to be
be processed
processed and and prepared
prepared before
before used
used in
in DL
DL
techniques. The goal of this task is to enable the classifier to elicit the most related
techniques. The goal of this task is to enable the classifier to elicit the most related inter- interpretable
features
pretablefrom the preprocessed
features dataset. There
from the preprocessed are several
dataset. Thereobjectives of preprocessing
are several objectives ofprocesses,
prepro-
including modulation, tissue segmentation, data normalization, smoothing,
cessing processes, including modulation, tissue segmentation, data normalization, alignment with a
particular
smoothing, alignment with a particular image template, and data normalization [19]. [30]
image template, and data normalization [19]. The study by Kohli and Prasad The
was
study different
by Kohlifrom
andthePrasad
other studies
[30] wasindifferent
this review, as the
from it utilized manual in
other studies data
thispreprocessing
review, as it
methods. One study
utilized manual data[32] applied decimation
preprocessing methods.and OneSTFT to the
study [32]fMRI signals,
applied which were
decimation and
filtered
STFT tousing a bandpass
the fMRI signals,procedure to remove
which were noises
filtered usingandairrelevant
bandpassartifacts.
procedure to remove
noises and irrelevant artifacts.
In addition, an FSL instrument, the FMRIB software library, was employed for pro-
cessing DTI and fMRI [38]. Usman and Muniyadi changed all of the T1w neuro-images
(images of the brain) into a format that could be used by FreeSurfer software [12]. Then,
Appl. Sci. 2023, 13, 2804 8 of 17

In addition, an FSL instrument, the FMRIB software library, was employed for pro-
cessing DTI and fMRI [38]. Usman and Muniyadi changed all of the T1w neuro-images
(images of the brain) into a format that could be used by FreeSurfer software [12]. Then, the
intensity of the images was adjusted so that they all had the same brightness and contrast.
The normalization of intensity was based on histograms. A FSL FNIRT software instrument
was utilized for non-rigid registration in the brain template of MNI152, and a Gaussian
filter was used to minimize noise. In [37], the preprocessing step included a DICOM to
NIFTI conversion, taking the “Digital Imaging and Communications in Medicine” file
and converting it into a “Neuroimaging Informatics Technology Initiative” file. This con-
version was necessary in order to use the data in SPM (Statistical Parametric Mapping)
software to analyze the brain image data. Normalization and smoothing were applied
in addition to the adjustment of head motion. In another study [39], the preprocessing
of the task-based fMRI involved the correction of slice time and motion, smoothing, and
normalization to a template of a voxel. Barhamtoshy and Motaweh [33] used standard
algorithms to filter irrelevant records and noise from the dataset. In addition, they removed
noise from EEG scans using a Fourier transform algorithm. Other authors used various
wavelet transformation approaches to convert EEG scans into low-pass and high-pass
filters [34]. Independent component analysis was used in the preprocessing of EEG signals
to remove artifacts due to recording eye blinking signals along with EEG signals [35]. The
studies that used the eye-tracking dataset to predict dyslexia focused on eliminating blinks
and processing missing data [40,41,43]. The study that used EOG signals utilized the
Butterworth bandpass filter to eliminate noise, followed by EOG segmentation. The aim
of segmentation was to balance the dataset (dyslexic and healthy groups). With regard to
a handwriting dataset, Spoon et al. [25,26] applied the DeepWriter concept [45] to create
50 random patches of handwriting features from each image in the handwriting dataset. Yo-
garajah and Bhushan [28] utilized the same concept to process Hindi letter datasets. Some
studies included different steps for processing unstructured data (handwriting images), as
shown in [27], including RGB to grayscale conversion, maximally stable extremal region,
canny edges detector, stroke width filter, and morphology as a final step. Isa et al. [4,29]
employed the same dataset. For preprocessing, they interchanged the foreground and
background to minimize computational overhead when an image had a lower black point
(value 0) than white point (value 1), which required more memory and power consumption
in training the image. In addition, they cropped handwriting images to the actual writing
part, thus resizing the images.

4.3. Feature Extraction and Selection

Before moving on to the classification stage, we need to be able to pull useful features
from the acquisition dataset. Feature extraction refers to the process of converting raw
data into numerical (or categorical) features that could be handled in classifier model
without lost valuable data in original dataset [46]. The purpose of this operation to remove
excrescent data and produce the most pertinent and highly informative features from the
original ones. It is possible to extract features manually or automatically: Manual extraction
demands defining and explaining the important features relevant for a given situation, as
well as designing a method for extracting those features. In many circumstances, having a
solid grasp of the context or domain can aid in making well-informed decisions regarding
which features may be valuable.
Automated feature extraction utilizes skilled algorithms or deep networks to elicit fea-
tures automatically from the dataset, with no human intervention required. An automatic
feature extraction could be very helpful in assisting to move speedily from the original
dataset to improve ML algorithms.
With the rise of DL, the first layers of deep networks have mostly taken the place of
feature extraction. The features extracted for predicting dyslexia differed in the dyslexia-
related datasets, as shown in Table 2.
Appl. Sci. 2023, 13, 2804 9 of 17

Table 2. Feature extraction methods for dyslexia disorder detection utilizing Deep Learning Methods.

Reference Dataset Feature Extraction Method and Selected Features

The study extracted features manually based on cognitive
and evaluation test results. These included an IQ test,
[30] Test score rapid naming test, evaluation of short-term memory,
sequencing skills, and non-word reading to evaluate
phonological coding skills.
Using a kernel density estimation process, brain activity
features were extracted from EGG signals (353 features).
[32]
The ksdensity () function in MATLAB was used to derive
features depending on the normal kernel function.
To extract features from the EGG signals, the study used
SSA, which divides the raw signal into additive
components representing various oscillatory manners.
Five components were generated that might be utilized to
explain the data. For each component, Pearson’s
[35]
correlation among various channels of the PSD of each
singular SSA component was calculated. Pearson’s
correlation represents the degree of similarity between
two channels, thus helping to differentiate between
dyslexia and normal functioning.
Brain electrical signal features were extracted from EGG
EGG
signals utilizing Fourier transform algorithms and
[33] statistical functions. The algorithms used the rule-based
model to filter non-related features and eliminate noise
from the electrical signal records.
The study used discrete wavelet transform techniques to
extract the most beneficial ERP signals from EGG, which
have a waveform linked both in frequency and time
domain. The signal was divided into low pass and high
pass. A group of temporal features were extracted from
the low-pass portion such as latency, absolute amplitude,
[34] positive area, and entropy, while a group of statistical and
spectral features were extracted from the high-pass
portion such as mean, skewness ratios, standard deviation,
and zero crossing rate. Moreover, some features relevant
to the frequencies’ structure were extracted such as
spectral flatness measure, spectral centroid as well as
power spectral density.
The various eye movement events for preprocessed data
have been analyzed, such as saccades and fixations.
Different features relevant to these events have been
extracted using major statistical measures, dispersion, and
[41]
approaches velocity-based. Two algorithms for feature
selection have been used in this study, which are
Recursive feature Elimination with Cross-Validation
(RFE-CV) and PCA.
Eye Tracking
In this study, the CNN model extracted, implicitly,
substantial features scattered either in time or frequency
[40] from preprocessed eye-tracking data and nonlinearly
bound them using machine learning to minimize
detection error.
The velocity features which extracted from eye-tracking
[43]
events discriminate between dyslexic and control.
Appl. Sci. 2023, 13, 2804 10 of 17

Table 2. Cont.

Reference Dataset Feature Extraction Method and Selected Features

The study used a 1D CNN model that generated feature
maps through operations in layers. These feature maps
[44] EOG contained significant features from the vertical and
horizontal EOG signals, allowing the differentiation of
dyslexic and normal readers.
Features of the phonological and cognitive brain systems
related to gray matter, white matter, and cerebrospinal
[12]
fluid were extracted from fMRI utilizing
CAT12 implemented in MATLAB.
The study used FDT, BET, and TBSS to extract FA from
DTS signals, and used two tools (BET and FEAT) to elicit
[38] features from fMRI. These two features (activation pattern
and FA) are associated with speech, language, and
lexical decisions.
MRI and fMRI After preprocessing fMRI dataset, SMP12 has been
implemented in MATLAP 2018b to extract cognitive
[37]
features pertaining to grey and white matter and the
volumetric biomarkers of cerebrospinal tissues.
This study was considered unique due to its visualization
of features, which differentiated dyslexic readers from
normal ones, such as activation patterns of anterior
right-hemisphere prefrontal areas as well as activation
[39] patterns in the left occipital and inferior parietal areas that
distinguished groups based on brain networks related to
lexical and phonological processes in reading. The feature
extraction has been carried out in the layers of the
LeNet-5 model.
These studies used behavioral and cognitive biomarkers
(picture patches of handwriting features) to differentiate
[25,26] between dyslexic and normal readers. A CNN model
extracted high features from processed handwriting
images when implemented in Python.
Hindi words have some prodigious features, such as
diacritics (matras), conjoined consonants, and killer
[28] strokes (halants). The study used patches of handwriting
features to differentiate between dyslexics and normal
readers, which have been extracted in the CNN model
Handwriting
The study used an OCR technology to identify letters in
handwriting images. The rectified characters are
[27] displayed in the command box after picture extraction
and character recognition, manually the total of correct
detection was been calculated.
These studies used a CNN model to extract features and
predict dyslexia from handwriting images. The
preprocessed handwriting images were fed to the CNN
[4,29]
model, and a feature map was created through the
convolution layer, which contained highly
informative features.

4.4. Classification and Performance of Deep Learning Models

As illustrated in traditional studies, ML methods have been used in the prediction of
dyslexia, and recent advances in ML methods (DL) have resulted in outstanding accuracy.
The use of DL models in dyslexia prediction varies based on the dataset used. For example,
CNN models are appropriate for handling unstructured data, as shown in all studies
Appl. Sci. 2023, 13, 2804 11 of 17

presented in this paper except [30], which dealt with numerical data. Although some
studies used ANNs to deal with EGG datasets and achieved high accuracy (96%) [33], others
achieved lower accuracy (78%) [34]. In addition, some studies that adopted handwriting
datasets used CNN models and reported accuracies between 86% and 95% [4,28,29], while
others achieved low accuracy (maximum 77%) [22,23,25]. Typically, the datasets were
partitioned to train and test the prediction models. Most of the data (approximately more
than or equal to 70% of all the data) were utilized for training, and the smaller part was
allocated for testing model. Some studies allocated part of the dataset (might be 10% or
20%) as a validation dataset, which is a sample of data that is restricted from the process of
the training model. These data are used to provide an estimate of the model’s skill while
the hyperparameters are being tuned. This division varied between studies. In refs. [12,29],
70% of the dataset was allocated for training, and the remainder was allocated for validation
and testing. Some studies used a higher percentage. For example, refs. [39,41,43] allocated
80% for training, while study [40] allocated 90%. Recent studies have utilized ANN, MLP,
Appl. Sci. 2023, 13, x FOR PEER REVIEW
and CNN models for dyslexia prediction and most have reported high accuracy in12most of 18
studies. Figure 5 organizes the reviewed studies according to the DL algorithms adopted.

Figure 5. The reviewed studies organized according to the DL algorithms that each model adopted.
Figure 5. The reviewed studies organized according to the DL algorithms that each model adopted.

TheANN
The ANNmodel
modelsuggested
suggestedby bythe
theauthors
authorsin in[30]
[30]achieved
achievedananaccuracy
accuracyof of75%
75%after
after
ten-fold cross-validation when used with a dataset on pupils’ performance acquired
ten-fold cross-validation when used with a dataset on pupils’ performance acquired from from
aastructured
structuredquestionnaire.
questionnaire. In
In addition,
addition, the
the same
samemodel
modelachieved
achieved the
thehighest
highestaccuracy
accuracy
amongother
among othermodels
modelsinin two
two studies
studies (89.7%
(89.7% andand 94.87%)
94.87%) [29,33,34].
[29,33,34]. SpoonSpoon
et al.etwere
al. were the
the first
first to use a handwriting dataset for the prediction of dyslexia disorder. They
to use a handwriting dataset for the prediction of dyslexia disorder. They proposed a CNN proposed
a CNN model to automatically recognize dyslexic children based on their handwriting
[25]. They achieved an accuracy of 55.7 ± 1.4% by employing five-fold CV. Then, they
developed their model further [26], reaching an accuracy of 77.6%. Yogarajah et al. [28]
utilized handwriting images from children’s notebooks as a dataset to build a CNN
model, achieving good accuracy of 86.14 ± 1.02%. Two consecutive studies [4,29] used the
Appl. Sci. 2023, 13, 2804 12 of 17

model to automatically recognize dyslexic children based on their handwriting [25]. They
achieved an accuracy of 55.7 ± 1.4% by employing five-fold CV. Then, they developed their
model further [26], reaching an accuracy of 77.6%. Yogarajah et al. [28] utilized handwriting
images from children’s notebooks as a dataset to build a CNN model, achieving good
accuracy of 86.14 ± 1.02%. Two consecutive studies [4,29] used the same datasets from
NIST 2019 to build a prediction model. The first used different CNN models, such as
CNN-1, CNN-2, CNN-3, and LeNet-5, to compare the prediction performance. All models
showed an accuracy of more than 87%, with CNN-1 providing the highest accuracy. The
second study utilized a LeNet-5 model and achieved an outstanding accuracy of 95%, which
is the highest accuracy for predicting dyslexia using a handwriting dataset. Regarding the
performance of DL models for predicting dyslexia using MRI and fMRI, Zahia et al. [37]
presented a 3D CNN model that achieved an accuracy of 72.7%, a sensitivity of 75%, an
F1-score of 67%, a precision of 60%, and a specificity of 71.4%. Muniyandi and Usman [12]
proposed a two-path cascading CNN model and achieved an accuracy of 84.6%, a specificity
of 78.2%, and a sensitivity of 76.5%. In addition, Silva et al. [39] developed a CNN model
and obtained the highest accuracy of 94%. Karim et al. utilized an MLP classifier to monitor
accuracy with eyes opened and closed, reporting accuracies of 86% and 84.95% for eyes
opened and closed, respectively.
Eye-tracking datasets have been used to build a CNN model for dyslexia prediction,
which showed good results [40,41,43]. Nerušil et al. [40] achieved the highest accuracy
of 96.6%, while Vags et al. [43] achieved an accuracy of 87%. Moreover, Appadurai and
Bhargavi [41] achieved an accuracy of 82% for scan path images and 87% for fixation images.
Table 3 summarizes the performance of the predictive model of each study in this review.

Table 3. Summarizes the performance of the predictive model of each study in this review.

Reference Datasets DL Model No. of Subjects Performance

[30] Test score ANN Not mentioned Accuracy: 75%
N = 6 kids
Accuracy: 86% for eye opened
[32] EGG MLP Normal = 3
and 85% for eye closed.
Dyslexics = 3
N = 56 kids Accuracy: 94.8%, Sensitivity:
[38] fMRI and DTI ANN
aged (9–12 years) 94.7%, Specificity: 95%
N = 80 kids
[33] EGG scan ANN Accuracy: 89.9%
(7 to 13 ages)
N = 32
[34] EGG ANN Normal = 15 Accuracy: 78%
Dyslexics = 17
N = 88
[25] Handwriting image CNN Normal = 62 Accuracy: 55.7%
Dyslexics = 11
[26] Handwriting image CNN N = 100 Accuracy: 77.6%
[27] Handwriting image ANN/MLP N = 30 Accuracy: 73.33%
[12] MRI CNN N = 45 Accuracy: 73.2%
Accuracy: 72.7%, F1 score: 67%,
N = 66 children
[37] fMRI 3D CNN Sensitivity: 75.0%, Specificity:
(9 and 12 years)
71.4%, Precision: 60%%
N = 54 children
[28] Handwriting image CNN Accuracy: 86.14 ± 1.02%
(267 samples)
The study did not mention the
N = 48
accuracy but stated the effectiveness
[35] EEG CNN 32 skilled readers
of CNN for eliciting informative
16 dyslexic readers
features to diagnose dyslexia.
Appl. Sci. 2023, 13, 2804 13 of 17

Table 3. Cont.

Reference Datasets DL Model No. of Subjects Performance

Accuracy of CNN1: 86%
Accuracy of CNN2: 87%
[4] Handwriting image CNN Normal = 78,275 letters Accuracy of CNN3: 86.5%
Dyslexic = 52,196 letters Accuracy of LeNet-5: 86%
[29] Handwriting image CNN Accuracy: 95.34%
N = 185
[40] Eye tracking CNN 88 low risks Accuracy: 96.6%
97 high risks
N = 32 children
[39] fMRI CNN 16 typical readers Accuracy: 94.8%
16 dyslexic readers
N = 185
[41] Eye tracking CNN 97 dyslexics Accuracy of CNN: 87%
88 non-dyslexics
N = 30
[43] Eye tracking CNN (VGG 16) 15 dyslexics Accuracy: 87%
15 normal
Accuracy for horizontal channel
N = 33
EOG signals: 98.70%
[44] EOG CNN 20 dyslexics
Accuracy for vertical channel EOG
13 normal
signals: 80.94%

5. Discussion and Challenges

Dyslexia disorder is a learning difficulty that hinders an individual’s learning skills.
Commonly, this disorder is pointed to as a neurological trouble that complicates remember-
ing and addressing information in dyslexics. Artificial intelligence methods (ML and DL)
have been vastly utilized for the prediction of dyslexia over recent years. The detection
processes involved successive steps starting from data acquisition and preprocessing, then
the extraction and selection of features, and thereafter the training process, to the model
estimation process. The prediction of dyslexia disorder based on ML, particularly DL
methods, was successful in the studies included in this review, achieving high accuracies
of 94.8% [34], 94.8% [35], 95.34% [25], and 96.6% [36], respectively. CNN models were the
most commonly used models for dyslexia prediction and showed the highest accuracy.
However, there were some challenges.
The acquisition of dyslexia datasets is not easy. The studies that utilized handwriting
datasets encountered difficulties in acquiring data from dyslexia children [25,26] in addition
to their limited size. Furthermore, as shown in Table 3 (column three), the number of
subjects did not exceed 185, but DL models require large-scale data to improve predictive
model performance. In addition, the high cost of brain-imaging technology limits its usage,
and, therefore, some studies tended to use cheaper EEG and eye-tracking systems.
Often, CNN models lead to overfitting problems in the training phase, where the
accuracy of the model is high with the training set but low with the testing set due to
involving a large number of parameters [47]. Moreover, the dyslexia datasets suffer from
their small scale, leading to overfitting. To avoid this, several techniques have been
suggested, such as:
- The dropout technique that commonly employs the method of generalization. Through-
out each training period, the neurons are randomly eliminated. In doing so, the power
of feature selection is divided uniformly over the entire group of neurons, and the
model is forced to learn multiple independent features [48].
- Data augmentation: Training the model on a substantial amount of data is the simplest
method for avoiding overfitting [49]. Several strategies are employed to augment
Appl. Sci. 2023, 13, 2804 14 of 17

the size of the training dataset, such as cropping, translation, and rotation. Rotation
and noise injection techniques have been used in the study [29]; they contributed to
enlarging the training size dataset and solved the imbalanced class problem.
The dataset preprocessing step is a critical step, and the formative features extracted
from datasets using DL models, especially CNNs, depend on good processing, which
affects the classification accuracy. The better and more accurate the processing, the better
the performance of the model.
Hyper-parameter selection has a substantial effect on CNN performance. Any vari-
ation in the values of the hyper-parameters will affect the CNN’s overall performance.
Consequently, proper parameter selection is a crucial factor that should be considered
throughout the creation of optimization schemes [48].
Effective CNN training necessitates powerful hardware resources, such as GPUs,
which are robust concerning memory usage and processing speed. Implementing DL
models on a system with these hardware resources will increase the classification speed
for dyslexia.
The classification of dyslexia using DL methods requires more attention and research.
In particular, DL models have a strong ability to extract features from unstructured data
and, thus, to perform accurate classification. Moreover, some tools may be developed to
assist in diagnosing dyslexia, such as handwriting images, which were first utilized in
2019 for prediction.

6. Conclusions
Dyslexia is a learning difficulty that impacts the reading, writing, spelling, and dicta-
tion processes. It usually results from a deficit in the language phonological component,
which is often unforeseen by teachers or parents of kids who suffer from this disorder.
About 10% of the world’s population suffers from this disorder, and it is important to
discover it early to reduce its impact and improve the skills of dyslexics. Researchers
have suggested multiple techniques for identifying dyslexia in children. Recently, DL
methods have contributed significantly to diagnosing dyslexia. This review summarized
the dyslexia detection techniques that have employed DL approaches. Furthermore, this
review investigated the significant factors related to dyslexia prediction, seeking to help
researchers build a predictive model with good accuracy. In the future, more attention
could be given to the collection of dyslexia-related datasets.

Funding: This research received no external funding.

Data Availability Statement: This review paper, as we see, does not require collecting new data,
it just analyzes the data related to dyslexia according to 19 papers. The handwriting dataset re-
lated to dyslexia it is available at: https://www.kaggle.com/datasets/drizasazanitaisa/dyslexia-
handwriting-dataset. The other studies, which have used brain screening data (fMRI & MRI) and
eye-tracking data are not available on the common database, therefore could be available on request
from the authors.
Conflicts of Interest: The authors declare no conflict of interest.

Abbreviations

ICT Information and Communication Technologies

CASL Comprehensive Assessment of Spoken Language
CTOPP-2 Comprehensive Test of Phonological Processing-2
WRMT Woodcock Reading Mastery Test
GSRT Gray Silent Reading Test
MRI Magnetic Resonance Imaging
DTI Diffusion Tensor Imaging
GPUs Graphics Processing Units
AI Artificial Intelligence
Appl. Sci. 2023, 13, 2804 15 of 17

ANN Artificial Neural Networks

MLP Multi-layer Perception
PRISMA Preferred Reporting Items for Systematic review and Meta-Analyses
ERP Event-Related Potentials
RFE-CV Recursive feature Elimination with Cross-Validation
BET Brain Extraction Tool
TBSS Track-Based Spatial Statistics
OCR Optical Character Recognition
ADM Association of Dyslexia Malaysia
SSA Singular Spectrum Analysis SSA
PCA Principal Component Analysis
ML Machine Learning
SVM Support Vector Machine
DL Deep Learning
3D Three-Dimensional.
TEWL Test of Early Written Language
fMRI Functional MRI
EEG Electroencephalography
IEEE Institute of Electrical and Electronic
CNN Convolutional Neural Network
DNN Deep Neural Network
RNNs Recurrent Neural Networks
PCA Principal Component Analysis
FA Fractional Anisotropy
FEAT FMRI Expert Analysis Tool
FDT FMRIB Diffusion Toolbox
EOG Electrooculogram
STFT Short-Time Fourier Transform
PSD Power Spectral Density

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