Professional Insights: The Role of an Audiologist in Concussion Treatment
To highlight the work of our members and associates, we are launching our Professional Insights Communiqué Interview Series. We have invited a number of SAC members and associates to share their unique professional experiences, promoting the importance of the professions in communication health.
For Speech and Hearing Month, we are kicking the interview series off with two interviews spotlighting concussion management, as well as a profile of one of our communication health assistant associates.
For our audiologist feature, we interviewed Greg Noel from Hearing and Speech Nova Scotia. The interview goes over Greg’s role as an audiologist and his experience treating concussion, highlighting the important role that audiologists play in concussion management and treatment.
Read Greg’s interview below!
Q1: Can you share some details about where you work and what your role as an audiologist entails?
I am the Director of Audiology of Hearing and Speech Nova Scotia (HSNS). My job is in administration, working with over 20 audiologists, 10 communication disorder technicians (CDTs) and administrative support personnel across the province to provide audiological and balance services.
Together we provide an array of services including; newborn hearing screening, vestibular and balance testing, paediatric amplification in conjunction with our partners at Atlantic Provinces Special Education Authority (APSEA), advanced audiological testing, sound sensitivity testing and counselling, auditory processing, evoked potentials, cochlear implants and bone anchored devices, where both teams working closely with our ENT partners, to name but a few of our services.
Our audiologists are also team members on a number of interdisciplinary health care teams including cleft palate, skull-based surgery and Eskasoni First Nations to name a few. HSNS develops standards of care for the services provided to ensure that no matter where a client is accessing services in the province, they all receive the same audiological care. Our audiologists also provide placements for audiology interns, primarily from the School of Communication Sciences and Disorders at Dalhousie University.
Q2: What experience do you have in treating concussion?
I taught at the School of Communication Sciences and Disorders for 19 years and taught an advance diagnostic class to third-year audiology students. I offered a neuroaudiology clinic in conjunction with this course. It was a method to help the audiology interns gain practical administration of the advanced testing we discussed in class. A number of years ago, the clinic received a referral from a client suffering the after-effects of a concussion and desperate to receive help. The testing revealed a central component to her difficulties and with some auditory training she was able to get back to work. Since then, the clinic mostly received solely concussion-based referrals.
I was also fortunate enough to be able to work with several colleagues on a committee to help develop a SAC position statement on the role of audiologists in concussion management. The position statement highlights that audiologists are essential to quality, person-centered, interprofessional concussion care across the lifespan.
Q3: What are the most common signs of concussion from an audiologist’s point of view?
Let’s begin with some good news. It has been reported in peer review literature that approximately 75-80% of people who experience mild concussion return to their normal pre-concussive state after three months.
However, 15-20% of people with concussions continue to have problems past three months. In the population still experiencing problems, post-concussive auditory complaints and reasons for referral to an audiologist may include:
- Difficulty hearing with background noise present, with competition or in degraded acoustic environments
- Heightened sensitivity to sounds
- Balance issues (and/or being off balance when exposed to loud sounds, called the Tuillo phenomenon and it can be an important consideration with clients who have suffered head trauma).
- Tinnitus (ringing, buzzing, humming or other sounds, heard in the head)
- Difficulty locating the source of a sound
- Change in perception or enjoyment of music
- Perception of poorer hearing (either in one or both ears, subjective sense of hearing loss not consistent with the audiogram)
- Difficulty using the phone
Of course, a client who has experienced a head trauma may not likely suffer from all of the above. The severity of the head trauma will also impact the symptoms as well.
Q4: What can happen if these symptoms are under diagnosed or untreated?
Undiagnosed hearing and balance issues can become a burden on the client and their family. Unresolved hearing and balance issues can impact return to work/school, hamper social interactions, limit physical activity and place undue hardship on loved ones. In our work in developing the position statement on audiology and concussion treatment, it was noted that those individuals reporting balance issues generally had a longer rehabilitation period. It was also noted that auditory processing difficulties can linger for years after head trauma. The audiologist can assist with diagnosing audiological and balance related conditions, can offer counselling and support or specific treatments. These treatments can include hearing and assistive devices, sound sensitivity support, vestibular training, auditory processing treatment and, if such conditions exist, help monitor their course. So, audiological care, in my opinion, is vital for the caring with individuals suffering auditory and balance effects after a concussion.
Q5: If you had one take away to emphasize to the public surrounding audiology and concussion treatment, what would it be?
Well, I have two – one for those with concussion and one for audiologists. If you have hearing and/or balance related issues relating from a concussion, please seek out the help of an audiologist. For the audiologist, I think it is also worth mentioning that testing may need to go beyond the audiogram for clients reporting concussion.
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