Improving neural response to sound improves reading.

D espite intense focus on improving reading scores, the most recently released National Assessment of Educational Progress reported that only one in three fourth grade students in the United States read at or above a proficient level, a change of only 5% since 1992 (1). In PNAS, Hornickel et al. (2) review the growing body of evidence that links reading failure to auditory processing disorders. They report that a group of dyslexic children who used an assistive listening FM system for one school year during classroom instruction significantly increased their phonological awareness (P < 0.001) and basic reading scores (P = 0.006). These data support an increasing number of studies that demonstrate that rapid and significant improvement in reading can result from auditory interventions. Their study also provides physiological data that supports the hypothesis that children with language learning impairments, including dyslexia, respond inconsistently to the rapidly changing spectrotemporal acoustic cues in speech and that this response becomes more consistent after auditory intervention. Listening plays an essential role in learning throughout life, ranging from learning to talk and interact with family and peers, to learning in the classroom, to maintaining good interpersonal and professional relationships. The majority of formal education is delivered aurally and, as such, learning in the classroom depends on good listening skills. Learning to read proficiently is highly dependent on finegrain acoustic processing (3). To break the code for reading a child must become “phonologically aware” that words can be broken down into smaller units of sounds (phonemes) and that it is these sounds that the letters represent. Given the centrality that good listening skills play throughout life, including learning how to read, it is surprising how little we know about the biological and environmental factors driving individual differences in auditory processing or how auditory processing mechanisms interact with other neural mechanisms (such as attention and memory) that are foundational skills for learning. Listening is what we do with what we hear. In individuals with auditory processing disorder (APD) there is a mismatch between peripheral hearing (which is typically normal) and the ability to interpret, discriminate, and sequence sounds (4). Despite normal peripheral hearing, many children with a wide variety of developmental learning disabilities (including attention-deficit/hyperactivity disorder, autism spectrum disorder, specific language impairment, and dyslexia) have concomitant APD, and there is considerable debate as to how separable these diagnoses are (5). Despite the relationship between individual differences in listening skills and learning skills and the importance of good listening skills in the classroom, there is