Brainstem auditory physiology in children with listening difficulties

Area of Science:

• Neuroscience
• Audiology
• Developmental Pediatrics

Background:

• Listening difficulties (LiD) in children with normal hearing are often diagnosed as auditory processing disorders.
• Limited understanding of underlying auditory mechanisms hinders effective treatment development for LiD.
• Electrophysiologic evidence for specific auditory pathway involvement in pediatric LiD is scarce.

Purpose of the Study:

• To investigate electrophysiologic evidence of brainstem pathway mechanisms in children with and without listening difficulties (LiD).
• To compare auditory brainstem responses (ABR) and middle ear muscle reflex (MEMR) functions between children with LiD and typically developing (TD) children.
• To correlate neurophysiologic findings with speech perception abilities in noise and caregiver-reported listening behaviors.

Main Methods:

• A prospective controlled study involving 132 children (6-14 years) with normal audiometry, divided into LiD (n=63) and TD (n=69) groups based on the Evaluation of Children's Listening and Processing Skills (ECLiPS).
• Participants underwent a test battery including the Listening in Spatialized Noise - Sentences (LiSN-S) for speech perception in noise and multiple neurophysiologic measures (ABR, MEMR).
• Groups were matched for age, sex, race, and ethnicity, excluding participants with major neurological disorders or intellectual disabilities.

Main Results:

• Children with LiD performed significantly worse on all LiSN-S subtests compared to TD children.
• The LiD group exhibited significantly greater MEMR growth functions in the left ear and shorter ABR Wave III and Wave V latencies.
• Shorter ABR Wave V latency correlated with poorer parent-reported LiD, while greater MEMR growth correlated with poorer speech-talker advantage in noise.

Conclusions:

• No evidence of auditory synaptopathy was found in children with LiD.
• Observed brainstem differences in the LiD group, including shorter ABR latencies and steeper MEMR growth, suggest increased central gain.
• These neurophysiologic differences are associated with impaired speech perception in competing speech and caregiver-reported listening difficulties.