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Subtle hearing loss after concussion could impair learning


Key clinical point: Concussion in children can cause subtle auditory processing deficits that could impair long-term academic success.

Major finding: Children with concussion symptoms performed significantly poorer on the Hearing in Noise Test, compared with nonconcussed peers (P = .001).

Data source: Study of 40 children in a sports medicine tertiary clinic: half experienced concussion and half served as controls.

Disclosures: Ms. Thompson had no relevant financial disclosures. The study was supported by the Knowles Hearing Center.


AT AAP 2017

CHICAGO – Children who experience concussion can develop deficits in auditory processing that could impair long-term academic performance and carry implications for return-to-play strategies, according to a study.

Investigators assessed 40 children aged 8-15 years, half of whom experienced concussion. The postconcussion group of 20 children had slower and smaller neural responses to speech, compared with 20 control children, on the noninvasive frequency-following response measure.

Students writing in a classroom. monkeybusinessimages/Thinkstock
The children who experienced concussion also performed significantly worse, compared with controls, on a Hearing in Noise Test (P = .001), which assesses the ability to hear speech with background noise. “Hearing in noise is a common challenge for everyone, like hearing in a busy restaurant or for children in a noisy cafeteria,” said Elaine Thompson, a doctoral candidate in the auditory neuroscience laboratory at Northwestern University in Evanston, Ill. Also, although evidence is very limited in children, “there is research in adults that hearing in noise ability is vulnerable to concussion.”

“The ability to hear in noise following concussion is impaired in the pediatric population, based on our results, which suggests it might pose additional challenges for classroom learning,” Ms. Thompson said. The study also suggests that auditory function should be considered part of acute and long-term assessment of children post concussion.

Importantly, all participants in the study had normal hearing. “It’s important to know these are very subtle auditory deficits that only emerge if you’re looking for them,” Ms. Thompson said at the annual meeting of the American Academy of Pediatrics.

Children in the concussion group were recruited from the concussion clinic at the Ann and Robert H. Lurie Children’s Hospital of Chicago. Patients were assessed an average of 27 days post injury, with most still symptomatic. The children in the control group had been treated for musculoskeletal injuries. The concussed and control groups were matched for sex and gender.

“We think that these results have implications beyond the classroom,” Ms. Thompson said. “Auditory deficits might increase risk of reinjury if sports are being played in loud, noisy gymnasiums or crowded soccer fields. So this is important to consider with return-to-play strategies.” She added, “There is hope. Auditory processing is a malleable skill, and it can be a useful target for rehabilitation and recovery.”

Ms. Thompson had no relevant financial disclosures. The study was supported by the Knowles Hearing Center.

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