Reduced neural speech tracking in adolescents with listening difficulty

OBJECTIVE: To investigate neural mechanisms underlying speech-in-speech listening in adolescents with listening difficulties (LiD). METHODS: Neural speech tracking (NST) was assessed using magnetoencephalography (MEG; 275 sensors) in 21 adolescents with LiD (11 females), identified by caregiver report, and 25 typically developing (TD) peers (10 females), all with normal audiograms and frequency-matched on age, sex, race, and ethnicity. Participants completed a cocktail-party task with target speech alone and with competing streams that varied in talker and spatial cues. NST was quantified using theta-band (4-8 Hz) inter-event phase coherence (IEPC) to acoustic edges. RESULTS: = 0.10; p = 0.037). Concurrent talker and spatial cues synergistically enhanced target-speech NST, especially in TD adolescents, but not competitor streams. CONCLUSIONS: LiD is characterized by impaired processing of attended speech rather than enhanced competitor processing or generalized auditory disengagement. Reduced integration of talker and spatial cues in LiD may contribute to real-world listening challenges. SIGNIFICANCE: Theta‑band NST provides a clinically relevant neural index of everyday listening and may guide interventions targeting selective attention and cue integration.