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Developmental dyslexia (DD) is a learning disability affecting 5-17% of children. Although researchers agree that DD is characterized by deficient phonological processing (PP), its cause is debated. It has been suggested that altered rapid auditory processing (RAP) may lead to deficient PP in DD and studies have shown deficient RAP in individuals with DD. Functional neuroimaging (fMRI) studies have implicated hypoactivations in left prefrontal brain regions during RAP in individuals with DD. When and how these neuronal alterations evolve remains unknown. In this article, we investigate functional networks during RAP in 28 children with (n = 14) and without (n = 14) a familial risk for DD before reading onset (mean: 5.6 years). Results reveal functional alterations in left-hemispheric prefrontal regions during RAP in prereading children at risk for DD, similar to findings in individuals with DD. Furthermore, activation during RAP in left prefrontal regions positively correlates with prereading measures of PP and with neuronal activation during PP in posterior dorsal and ventral brain areas. Our results suggest that neuronal differences during RAP predate reading instruction and thus are not due to experience-dependent brain changes resulting from DD itself and that there is a functional relationship between neuronal networks for RAP and PP within the prereading brain.

Within the last decade there has been an increase in the use of structural and functional magnetic resonance imaging (fMRI) to investigate the neural basis of human perception, cognition and behavior 1, 2. Moreover, this non-invasive imaging method has grown into a tool for clinicians and researchers to explore typical and atypical brain development. Although advances in neuroimaging tools and techniques are apparent, (f)MRI in young pediatric populations remains relatively infrequent 2. Practical as well as technical challenges when imaging children present clinicians and research teams with a unique set of problems 3, 2. To name just a few, the child participants are challenged by a need for motivation, alertness and cooperation. Anxiety may be an additional factor to be addressed. Researchers or clinicians need to consider time constraints, movement restriction, scanner background noise and unfamiliarity with the MR scanner environment2,4-10. A progressive use of functional and structural neuroimaging in younger age groups, however, could further add to our understanding of brain development. As an example, several research groups are currently working towards early detection of developmental disorders, potentially even before children present associated behavioral characteristics e.g.11. Various strategies and techniques have been reported as a means to ensure comfort and cooperation of young children during neuroimaging sessions. Play therapy 12, behavioral approaches 13, 14,15, 16-18 and simulation 19, the use of mock scanner areas 20,21, basic relaxation 22 and a combination of these techniques 23 have all been shown to improve the participant's compliance and thus MRI data quality. Even more importantly, these strategies have proven to increase the comfort of families and children involved 12. One of the main advances of such techniques for the clinical practice is the possibility of avoiding sedation or general anesthesia (GA) as a way to manage children's compliance during MR imaging sessions 19,20. In the current video report, we present a pediatric neuroimaging protocol with guidelines and procedures that have proven to be successful to date in young children.