PROJECT SUMMARY
According to the developmental comorbidity framework, listening difficulties in children (despite clinically normal
hearing) may occur due to multiple sources of deficits. Hence, in this study, key auditory processing, cognitive, and
linguistic factors are conceptually integrated to model how listening ability in noise relates to a crucial language outcome,
i.e., sentence comprehension in school-age children. Deficits in speech perception in noise (SPiN) are salient
characteristics of children diagnosed with auditory processing disorder and those with a history of recurrent childhood
middle ear infection. Furthermore, the majority of children with parental and teacher concern of listening difficulties have
coexisting impairments in language, attention, and learning. Existing theories suggest that lexical knowledge and working
memory (WM) capacity are crucial for children's listening in adverse situations. However, a direct test of these models
within the same study is absent in children. In this study, we will model the relationship between listening in noise ability
and sentence comprehension ability in school-age children, controlling for individual differences in attention and with
lexical knowledge as a mediator and WM capacity as a moderator. We chose sentence comprehension as the dependent
variable because it is a strong predictor of reading comprehension and academic success. Children (7- to 11 years old;
N=130) representing a continuum of listening abilities will participate in this prospective cross-sectional study that
employs standardized measures with strong psychometric properties. Based on the Lexical Restructuring model and the
previous literature, we hypothesize that lexical knowledge as a mediator will explain the causal relationship between SPiN
and sentence comprehension (i.e., why better SPiN ability may be positively associated with better sentence
comprehension skills). Based on the Ease of Language Understanding model, we predict that WM will moderate the
relationship between SPiN and sentence comprehension because this relationship is expected to be stronger for children
with high WM capacity than those with low WM capacity. In addition, we predict that WM will moderate the relationship
between lexical knowledge and sentence comprehension. This study will fill a significant gap in the developmental
literature on the nature of the relationship between listening in noise ability and language comprehension. This is
important because many children with listening concerns are reported to have failure in at least one academic area that
may not be fully explained by other diagnoses. Study findings will have direct clinical implications to assess listening in
noise abilities in a significant number of children. Results will guide long-term intervention objectives on targeting
mechanisms such as SPiN and lexical abilities in children taking into consideration WM capacity/cognitive load, to
improve their speech perception in realistic situations. This project aligns with NIDCD priority areas across Hearing and
Language to understand the influence of auditory perception in realistic listening environments.
