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As reading is inherently a multisensory, audiovisual (AV) process where visual symbols (i.e., letters) are connected to speech sounds, the question has been raised whether individuals with reading difficulties, like children with developmental dyslexia (DD), have broader impairments in multisensory processing. This question has been posed before, yet it remains unanswered due to (a) the complexity and contentious etiology of DD along with (b) lack of consensus on developmentally appropriate AV processing tasks. We created an ecologically valid task for measuring multisensory AV processing by leveraging the natural phenomenon that speech perception improves when listeners are provided visual information from mouth movements (particularly when the auditory signal is degraded). We designed this AV processing task with low cognitive and linguistic demands such that children with and without DD would have equal unimodal (auditory and visual) performance. We then collected data in a group of 135 children (age 6.5-15) with an AV speech perception task to answer the following questions: (1) How do AV speech perception benefits manifest in children, with and without DD? (2) Do children all use the same perceptual weights to create AV speech perception benefits, and (3) what is the role of phonological processing in AV speech perception? We show that children with and without DD have equal AV speech perception benefits on this task, but that children with DD rely less on auditory processing in more difficult listening situations to create these benefits and weigh both incoming information streams differently. Lastly, any reported differences in speech perception in children with DD might be better explained by differences in phonological processing than differences in reading skills.

Purpose: It is generally accepted that adults use visual cues to improve speech intelligibility in noisy environments, but findings regarding visual speech benefit in children are mixed. We explored factors that contribute to audiovisual (AV) gain in young children's speech understanding. We examined whether there is an AV benefit to speech-in-noise recognition in children in first grade and if visual salience of phonemes influences their AV benefit. We explored if individual differences in AV speech enhancement could be explained by vocabulary knowledge, phonological awareness, or general psychophysical testing performance. Method: Thirty-seven first graders completed online psychophysical experiments. We used an online single-interval, four-alternative forced-choice picture-pointing task with age-appropriate consonant-vowel-consonant words to measure auditory-only, visual-only, and AV word recognition in noise at -2 and -8 dB SNR. We obtained standard measures of vocabulary and phonological awareness and included a general psychophysical test to examine correlations with AV benefits. Results: We observed a significant overall AV gain among children in first grade. This effect was mainly attributed to the benefit at -8 dB SNR, for visually distinct targets. Individual differences were not explained by any of the child variables. Boys showed lower auditory-only performances, leading to significantly larger AV gains. Conclusions: This study shows AV benefit, of distinctive visual cues, to word recognition in challenging noisy conditions in first graders. The cognitive and linguistic constraints of the task may have minimized the impact of individual differences of vocabulary and phonological awareness on AV benefit. The gender difference should be studied on a larger sample and age range.

Purpose: Data from standardized caregiver questionnaires indicate that children with fetal alcohol spectrum disorders (FASDs) frequently exhibit atypical auditory behaviors, including reduced responsivity to spoken stimuli. Another body of evidence suggests that prenatal alcohol exposure may result in auditory dysfunction involving loss of audibility (i.e., hearing loss) and/or impaired processing of clearly audible, "suprathreshold" sounds necessary for sound-in-noise listening. Yet, the nexus between atypical auditory behavior and underlying auditory dysfunction in children with FASDs remains largely unexplored. Method: To investigate atypical auditory behaviors in FASDs and explore their potential physiological bases, we examined clinical data from 325 children diagnosed with FASDs at the University of Washington using the FASD 4-Digit Diagnostic Code. Atypical behaviors reported on the "auditory filtering" domain of the Short Sensory Profile were assessed to document their prevalence across FASD diagnoses and explore their relationship to reported hearing loss and/or central nervous system measures of cognition, attention, and language function that may indicate suprathreshold processing deficits. Results: Atypical auditory behavior was reported among 80% of children with FASDs, a prevalence that did not vary by FASD diagnostic severity or hearing status but was positively correlated with attention-deficit/hyperactivity disorder. In contrast, hearing loss was documented in the clinical records of 40% of children with fetal alcohol syndrome (FAS; a diagnosis on the fetal alcohol spectrum characterized by central nervous system dysfunction, facial dysmorphia, and growth deficiency), 16-fold more prevalent than for those with less severe FASDs (2.4%). Reported hearing loss was significantly associated with physical features characteristic of FAS. Conclusion: Children with FAS but not other FASDs may be at a particular risk for hearing loss. However, listening difficulties in the absence of hearing loss--presumably related to suprathreshold processing deficits--are prevalent across the entire fetal alcohol spectrum. The nature and impact of both listening difficulties and hearing loss in FASDs warrant further investigation.

Auditory processing differences, including hyper‐ or hyposensitivity to sound, aversions to sound, and difficulty listening under noisy, real‐world conditions, are commonly reported in autistic individuals. However, the developmental course and functional impact of these auditory processing differences are unclear. In this study, we investigate the prevalence, developmental trajectory, and functional impact of auditory processing differences in autistic children throughout childhood using a longitudinal study design. Auditory processing differences were measured using the Short Sensory Profile, a caregiver questionnaire, in addition to adaptive behaviors and disruptive/concerning behaviors at 3, 6, and 9 years of age. Our results showed that auditory processing differences were reported in greater than 70% of the autistic children in our sample at all three timepoints, maintained a high prevalence through 9 years of age, and were associated with increased disruptive/concerning behaviors and difficulty with adaptive behaviors. Furthermore, in our sample of children, auditory processing differences at age 3 years predicted disruptive/concerning behaviors and difficulty with adaptive behaviors at age 9 years. These findings warrant further investigations of the potential benefit of incorporating measures of auditory processing during routine clinical evaluations as well as interventions targeting auditory processing differences in autistic children. Lay Summary: We followed a cohort of autistic children longitudinally at 3, 6, and 9 years of age and found that more than 70% of the children had caregiver‐reported difficulty listening in noisy environments at all three ages. These auditory processing differences were associated with increased hyperactivity and agitation as well as difficulty with daily living skills, suggesting that auditory processing differences should be considered during routine clinical evaluations. [ABSTRACT FROM AUTHOR]