Spatial release from masking predicts listening difficulty in children

OBJECTIVE: Children with listening difficulty (LiD) often have normal audiograms but impaired speech-in-noise perception. Although LiD is frequently linked to cognitive factors, deficits in spatial hearing may also indicate central auditory dysfunction. This study aimed to dissociate cognitive from auditory contributions to spatial release from masking (SRM). DESIGN: All children received audiometric assessments and completed the Listening in Spatialised Noise-Sentences (LiSN-S) Spatial Advantage and the sound-field Digits-in-Noise (sfDiN), with maskers either co-located with or ±90° from target stimuli. sfDiN imposes lower cognitive demands than LiSN-S. STUDY SAMPLE: Thirty-five children (17 LiD, 18 typically developing [TD]; 8-17 years). RESULTS: Both groups showed improved sfDiN SRTs with spatial separation, but the LiD group had significantly poorer ±90° SRTs, yielding significantly lower SRM. In contrast, LiSN-S Spatial Advantage did not differ between groups. sfDiN-SRM correlated significantly with LiSN-S Spatial Advantage. ROC analyses indicated that the ±90°-SRT showed the strongest discrimination (AUC = 0.71), followed by the sfDiN-SRM (AUC = 0.69), whereas the LiSN-S Spatial Advantage demonstrated weaker discrimination (AUC = 0.63). CONCLUSIONS: Reduced SRM in LiD indicates a spatial hearing deficit that is evident under conditions of reduced cognitive demand. sfDiN provides a sensitive, practical tool for identifying auditory contributions to LiD.