Multimodal lexical processing in auditory cortex is literacy skill dependent.

Literacy is a uniquely human cross-modal cognitive process wherein visual orthographic representations become associated with auditory phonological representations through experience. Developmental studies provide insight into how experience-dependent changes in brain organization influence phonological processing as a function of literacy. Previous investigations show a synchrony-dependent influence of letter presentation on individual phoneme processing in superior temporal sulcus; others demonstrate recruitment of primary and associative auditory cortex during cross-modal processing. We sought to determine whether brain regions supporting phonological processing of larger lexical units (monosyllabic words) over larger time windows is sensitive to cross-modal information, and whether such effects are literacy dependent. Twenty-two children (age 8-14 years) made rhyming judgments for sequentially presented word and pseudoword pairs presented either unimodally (auditory- or visual-only) or cross-modally (audiovisual). Regression analyses examined the relationship between literacy and congruency effects (overlapping orthography and phonology vs. overlapping phonology-only). We extend previous findings by showing that higher literacy is correlated with greater congruency effects in auditory cortex (i.e., planum temporale) only for cross-modal processing. These skill effects were specific to known words and occurred over a large time window, suggesting that multimodal integration in posterior auditory cortex is critical for fluent reading.