Journal of Rehabilitation Research & Development (JRRD)

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Volume 52 Number 3, 2015
   Pages 343 — 360

Abstract — Auditory difficulties in blast-exposed Veterans with clinically normal hearing

Gabrielle H. Saunders, PhD;1–2* Melissa T. Frederick, AuD;1 Michelle Arnold, AuD;3–4 ShienPei Silverman;1 Theresa H. Chisolm, PhD;3 Paula Myers, PhD4

1National Center for Rehabilitative Auditory Research, Department of Veterans Affairs Portland Health Care System, Portland, OR; 2Department of Otolaryngology, Oregon Health and Science University, Portland, OR; 3Department of Communication Sciences and Disorders, University of South Florida, FL; 4James A. Haley Veterans' Hospital, Tampa, FL

Abstract — Vast numbers of blast-injured Operation Iraqi Freedom/Operation Enduring Freedom/Operation New Dawn personnel report postconcussive symptoms that include headache, dizziness, poor memory, and difficulty concentrating. In addition, many report hearing problems, such as difficulty understanding speech in noise, yet have no measureable peripheral auditory deficits. In this article, self-report and performance-based measures were used to assess 99 blast-exposed Veterans. All participants reported auditory problems in difficult listening situations but had clinically normal hearing. Participants' scores on self-report questionnaires of auditory difficulties were more similar to scores of older individuals with hearing impairment than to those of younger individuals with normal hearing. Participants showed deficits relative to published normative data on a number of performance-based tests that have demonstrated sensitivity to auditory processing deficits. There were several measures on which more than the expected number of participants (15.9%) performed one or more standard deviations below the mean. These were assessments of speech understanding in noise, binaural processing, temporal resolution, and speech segregation. Performance was not universally poor, with approximately 53% of participants performing abnormally on between 3 and 6 of the 10 measures. We concluded that participants exhibited task-specific deficits that add to the evidence suggesting that blast injury results in damage to the central auditory system.

Clinical Trial Registration: ClinicalTrials.gov; Approaches to Auditory Rehabilitation for Mild Traumatic Brain Injury (mTBI); NCT00930774; https://clinicaltrials.gov/ct2/show/NCT00930774?term=NCT00930774&rank=1

Key words: auditory processing disorder, blast injuries, central auditory dysfunction, combat disorders, hearing, hearing loss, mild traumatic brain injury, rehabilitation, traumatic brain injury, Veterans, Veterans health.


View HTML ¦ View PDF ¦ Contents Vol. 52, No.3

This article and any supplementary material should be cited as follows:
Saunders GH, Frederick MT, Arnold M, Silverman S, Chisolm TH, Myers P. Auditory difficulties in blast-exposed Veterans with clinically normal hearing. J Rehabil Res Dev. 2015;52(3):343–60.
http://dx.doi.org/10.1682/JRRD.2014.11.0275
ResearcherID: Gabrielle H. Saunders, PhD: F-4768-2012; Melissa T. Frederick, AuD: F-2772-2015
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