Formal Auditory Training with Individuals after Traumatic Brain Injury

Purpose: Establishing the effects of a formal auditory training program on individuals, after a traumatic brain injury by means of behavioral and electrophysiological tests. Study Design: Longitudinal study. Setting: Study conducted at the electrophysiology clinic of the Federal University of Sao Paulo. Patients: Nine individuals with normal hearing, 20 to 37 years old, who were exposed to severe traumatic brain injury (score of 3 - 8 on the Glasgow Coma Scale upon hospital admission), 6 - 24 months earlier (11 months on average) and had imaging tests showing diffuse axonal injury with or without associated focal lesion. Intervention(s): subjected to a formal auditory training program in an acoustic booth involving eight 45-minute sessions aiming at training the auditory temporal order judgment (frequency and duration of sounds), auditory closure, and figure-ground separation skills for verbal and nonverbal sounds in monotic and dichotic listening tasks. The sessions and activities, in each session, were organized in increasing order of complexity to challenge the auditory system. In order to establish the efficacy of the auditory training, all participants were subjected to behavioral and electrophysiological assessments of the auditory processing, before and after the formal auditory training. Results: On the electrophysiological assessment, the absolute latencies of waves III and V, and of interpeak interval I-V decreased after the auditory training. However, the P300 did not exhibit a significant difference in either the latency or the amplitude parameters. Regarding the behavioral assessment of the auditory processing, it was verified that adequacy of the auditory figure-ground skills for verbal sounds, and the temporal order judging skills. Conclusions: individuals with diffuse axonal injury following a severe traumatic brain injury exhibited an improvement of central auditory processing after formal auditory training, as manifested on electrophysiological and behavioral assessments.