Despite passing standard audiological testing, 10-20% of children experience listening difficulties (LiD), particularly in noisy conditions. These children are often recommended for further auditory processing disorder (APD) assessment. In this study we examined magnetic resonance imaging magnetic resonance imaging (MRI) data from a large longitudinal study assessing whether LiD is due to sensory, cognitive or speech processing problems. We analyzed 81 children aged 6-12 years: 39 were typically developing; and 42 were classified as having LiD from caregiver reports of everyday listening difficulties (the ECLiPS).

We used resting state MRI where we can explore how different brain areas work together while the child is at rest, i.e. not performing an explicit task. We used a data driven analysis to examine the connectivity of three brain networks: Speech, Sound, and Visual. We found an extensively deficient Speech network in children with LiD compared to TD children. However, they had a very similar Sound network and no significant differences in their Visual network.

The extensive deficits in the Speech network connectivity were in higher level, speech processing brain areas rather than in the primary sensory processing brain areas. The strength of Speech network connectivity significantly related to the children’s listening skills (ECLiPS, CCC-2), auditory processing skills (SCAN-3:C) and cognition (a composite of attention and memory). But not their speech-in-noise skills (LiSN-S). Our analysis also showed a maturational increase in connectivity throughout the Speech network for children with LiD. In summary, our study shows that children identified as having LiD through a caregiver report showed extensive changes in brain network function. We conclude that listening difficulties in children are mediated by speech-specific mechanisms.