Evaluation of auditory processing disorders after whiplash injury

Abstract

Whiplash patients often have many subjective complaints, such as headaches, concentration difficulties, fatigue, neck pain and vertigo. Objective assessment of these complaints is difficult and neurological and neuropsychological signs of damage are not obvious. Other complaints frequently expressed after whiplash injury are diminished speech intelligibility in noisy environments and decreased tolerance to ‘loud’ sounds. In the present study, the latter complaints were evaluated with behavioural auditory tests. A test battery for auditory processing disorders was administered to 22 chronic whiplash patients with normal peripheral hearing. The test battery consists of seven tests: a sentences-in-noise test, pattern recognition tests, words-in-noise test, dichotic digit test, filtered speech test, binaural fusion test and backward masking tests. The uncomfortable loudness level (UCL) was also assessed using speech material. In addition, a questionnaire on auditory handicap was administered. The results were compared to those obtained from a control group of 28 healthy subjects with normal hearing. Significant differences were found on all subtests between the whiplash patients and the control group, except for the sentences in continuous noise test, the filtered speech test and the binaural fusion test. Whiplash subjects scored at least two tests below the 10th percentile of the control group. The UCL was significantly lower in the whiplash group. Correlation analyses showed a relationship between the subjective complaints reported in the questionnaire and several test scores. Test results indicate that the whiplash patients had auditory processing disorders, although headaches and attentional deficits might interfere with auditory test performance. The AP test battery proved to be useful in assessing the auditory processing problems of whiplash patients.

• hearing impairment
• speech intelligibility in noise
• uncomfortable loudness level