Research has demonstrated that concussion and mild traumatic brain injury has been shown to result in central hearing disorders.  A large majority of these clients have normal hearing sensitivity but demonstrate a variety of auditory complaints. Such functional difficulties include hearing in noise or reverberant conditions, sound sensitivities, localization of sounds, difficulty on the phone or when the speakers face is not seen, decreased music appreciation, difficulty following group conversation and/or auditory fatigue. While complex, such processes are thought to be processed by the classical and non-classical central auditory system. The classical central auditory system includes the cochlear nucleus, superior olivary complex, lateral lemniscus, inferior colliculus, medial geniculate, subcortical and cortical structures in the temporal lobe along with connections to the corpus callosum as well as the auditory efferent system.  The non-classical auditory system is connected to other brain centres, such as the amygdala, hippocampus and reticular activation system, among others, which help integrate our auditory system into our human connectedness.  It stands to reason that trauma that can impact the brain and affect other sensory and cognitive mechanisms can therefore impact the function of the central auditory nervous system. While diagnostic imaging provides a structural view of the brain and can often be normal in such cases, audiological measures provide functional information that can shape a communication profile for the individual.  The Canadian guidelines on auditory processing disorders establish the protocol that audiologists can follow in assessing and managing clients with auditory processing disorders. Using behavioural and electrophysiological procedures, it is possible to document auditory processing deficits as a result of head trauma, and provide rehabilitative measures and monitor outcomes. While vestibular issues have been well documented as a result of head trauma, concussion guidelines neglect to focus on the communication deficits from auditory processing disorders caused by head trauma.  If such communication issues are not investigated and addressed, social isolation and reduced adherence to other rehabilitation plans may result. The audiologist working with other team members can assist with rehabilitative measures, which may include auditory training, environmental and compensatory strategies that may support the individual to re-enter the work force, or attempt to improve often impaired communicative efforts. Illustrative cases will be used to highlight the audiologist’s role in working with clients suffering from auditory deficits related to head trauma.

Audiologists: a vital team member for clients with traumatic brain injury