Use of a frequency-modulated system for veterans with blast exposure, perceived hearing problems, and normal hearing sensitivity

Traumatic brain injury can impact the central auditory system leading to poor auditory recall and increased difficulties hearing in poor acoustic environments. In recent years, audiologists have increasingly encountered blast-exposed veterans who report speech understanding problems that are disproportionate to their essentially normal hearing sensitivity, and thus are thought to have an auditory processing disorder. In light of studies showing frequency-modulated (FM) systems to be effective rehabilitation for auditory processing difficulties, we examined the use of an FM system intervention for blast-exposed veterans with functional hearing problems in the presence of normal hearing sensitivity. The outcomes for three veterans who were provided with an FM system as part of a multisite randomized clinical trial are described. Data indicate that FM systems are beneficial for some patients reporting hearing problems in the presence of normal hearing sensitivity but factors other than audiometric profile and reported complaints influence outcome. These include understanding of speech in noise, patient communication demands, auditory lifestyle, and the presence of posttraumatic stress disorder or other mental health factors. Furthermore, education (and reeducation if necessary) of the patient and their spouse or family is critical to successful outcome.