Behavioral and Cortical Activation Changes in Children Following Auditory Training for Dichotic Deficits

We report changes following auditory rehabilitation for interaural asymmetry (ARIA) training in behavioral test performance and cortical activation in children identified with dichotic listening deficits. In a one group pretest-posttest design, measures of dichotic listening, speech perception in noise, and frequency pattern identification were assessed before and 3 to 4.5 months after completing an auditory training protocol designed to improve binaural processing of verbal material. Functional MRI scans were also acquired before and after treatment while participants passively listened in silence or to diotic or dichotic digits. Significant improvements occurred after ARIA training for dichotic listening and speech-in-noise tests. Post-ARIA, fMRI activation increased during diotic tasks in anterior cingulate and medial prefrontal regions and during dichotic tasks, decreased in the left precentral gyrus, right-hemisphere pars triangularis, and right dorsolateral and ventral prefrontal cortices, regions known to be engaged in phonologic processing and working memory. The results suggest that children with dichotic deficits may benefit from the ARIA program because of reorganization of cortical capacity required for listening and a reduced need for higher-order, top-down processing skills when listening to dichotic presentations.