Children With Reading Difficulty Rely on Unimodal Neural Processing for Phonemic Awareness

Phonological awareness skills in children with reading difficulty (RD) may reflect impaired automatic integration of orthographic and phonological representations. However, little is known about the underlying neural mechanisms involved in phonological awareness for children with RD. Eighteen children with RD, ages 9-13, participated in a functional magnetic resonance imaging (fMRI) study designed to assess the relationship of two constructs of phonological awareness, phoneme synthesis, and phoneme analysis, with crossmodal rhyme judgment. Participants completed a rhyme judgment task presented in two modality conditions; unimodal auditory only and crossmodal audiovisual. Measures of phonological awareness were correlated with unimodal, but not crossmodal, lexical processing. Moreover, these relationships were found only in unisensory brain regions, and not in multisensory brain areas. The results of this study suggest that children with RD rely on unimodal representations and unisensory brain areas, and provide insight into the role of phonemic awareness in mapping between auditory and visual modalities during literacy acquisition.