Analysis of neural coding of speech in monaural and binaural conditions in children with speech sound disorder.
Marciana da Costa Carlos, Thaís Nobre Uchôa Souza, Ranilde Cristiane Cavalcante Costa and 1 others
Children with phonological disorder showed longer brainstem responses to a speech sound than typically developing children, in every listening condition tested.
This objective measure could complement clinical assessment, but the study does not show it tracks therapy progress.
Key findings
1Wave V latency of the Frequency Following Response was longer in children with phonological disorder than in typically developing children across all three stimulation conditions (right monaural, left monaural, binaural), with a significant group effect (p = 0.006).
2FFR amplitude did not differ significantly between the two groups (p = 0.055), meaning amplitude was not sensitive enough to distinguish children with phonological disorder from typically developing children in any condition.
3Binaural stimulation produced significantly larger amplitudes than either monaural condition (p < 0.001), a binaural summation effect that was consistent across both groups, while no significant difference was found between the right and left monaural conditions (p > 0.05).
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What it does not show
Cross-sectional design: a single time-point comparison cannot show that the latency difference is caused by the phonological disorder, that it changes with therapy, or that it predicts outcomes. It shows an association, not a trajectory. Small sample: 21 children per group at a single site. The amplitude result (p = 0.055) sits just above the conventional threshold, and with a larger sample the picture could shift. Control group was selected by convenience sampling rather than drawn from the same clinical population, which may introduce subtle differences in background, language exposure, or socioeconomic factors. Socioeconomic and environmental variables (maternal education, family income, school type) were not controlled or matched between groups, and the authors acknowledge this as a limitation that could confound the results. No correlational analysis was performed between the severity of the phonological disorder (PCC-R scores) and the FFR parameters; the authors state this is the subject of a separate study. The FFR stimulus was a single syllable (/da/), so the findings speak to encoding of one specific speech sound and may not generalise to all phonemes or to connected speech. Children were awake and watching a silent film during recording; the effect of this on FFR quality compared to sleep recordings is not discussed.
Declared interests
Funded by FAPEAL, a state research foundation in Alagoas, Brazil (grant E:60030.0000001502/2023). No industry funding, no conflicts of interest declared, and no commercial entity was involved in study design, data collection, or manuscript preparation.
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