Difficulty hearing in noise: a sequela of concussion in children

ABSTRACT

Objective: Concussions can result in auditory processing deficits even in the absence of hearing loss. In children and adolescents, the extent to which these impairments have functional consequences for everyday listening, such as the ability to understand speech in noisy environments, is unknown.

Research design: Case-control study.

Subjects and methods: Forty youth comprised the participants: 20 had sustained a concussion and were recovering from their injury, and 20 controls had sustained non-concussive orthopaedic (e.g. musculoskeletal) injuries. All were evaluated on the Hearing in Noise Test, an audiologic index of the ability to hear sentences in adverse listening conditions.

Results: Children and adolescents recovering from concussions demonstrated an overall impaired ability to perceive speech in noisy backgrounds compared to a peer control group. This deficit also emerged across trials in the most taxing listening condition, and with respect to published, age-normative values.

Conclusions: Functional listening skills—such as the ability to understand speech in noise, and the ability to sustain performance over time in taxing auditory conditions—may be compromised in children with concussions. These impairments may exacerbate cognitive and academic challenges associated with concussion injuries, and should be considered in return-to-learn and return-to-play decisions.

KEYWORDS:

• Concussion
• post-concussion syndrome
• auditory processing
• speech-in-noise perception
• mild traumatic brain injury

Acknowledgements

Many thanks to the members of the Auditory Neuroscience Laboratory for their thoughtful feedback on the manuscript, to the members of the Sports Medicine Research Group for their assistance with recruitment, and to the patients and their families for participating in the study. This work is supported by the Knowles Hearing Center at Northwestern University.

Declaration of interest

The authors report no conflicts of interest.