PP1003 - The Role of the Audiologist with Post-Stroke Patients

Abstract: Stroke is a common cardio-vascular issue, impacting 800,000 Americans per year.  Hearing and listening issues have been documented to be a frequent outcome post-stroke, however these issues are frequently overlooked in the recovery process.  This poster will focus on reviewing current literature in stroke care related to hearing and listening issues.  The critical role of the audiologist as part of an interdisciplinary stroke team will be discussed.  Assessment and treatment protocols will be shared.  Recommendations for how audiologists can have a greater role in providing care to people that have had strokes and their families will be described.

Summary: The purpose of this poster is to raise awareness of post-stroke audiologic care for audiologists.  Stroke is common, impacting nearly 800,000 people per year.  The impact on executive functioning skills and aphasia for people that have had strokes is well known, however despite both significant research and anecdotal evidence that hearing and listening skills are impacted post-stroke, audiologists are rarely involved in the team providing care for patients post-stroke.  An informal questionnaire provided to the top 20 ranked stroke rehabilitation programs in America by the National Academies of Practice (NAP) indicated that none of the programs have an audiologist on their rehabilitation team.  In follow-up interviews, a number of physicians involved in these programs indicated they either didn't know why an audiologist would be needed on their team or that they knew about audiology but did not see the benefit that a "hearing test" would provide for this population.

Despite the lack of awareness of or interest in audiology as part of the assessment and treatment for people who are post stroke, patients with Aquired Brain Injury, of which stroke is one category present with audiologic concerns and listening and hearing complaints.  These complaints are generally consistent with hearing loss and/or issues consistent with auditory processing disorder (APD).  Minimally, this population requires a hearing screening to assure that a patient can hear their physician and is able to effectively participate in speech/language therapy to address communication issues.  It is well known that anyone to be enrolled in speech/language therapy should have a hearing screening prior to enrollment,.  However, it has been well documented that hearing screenings are NOT provided to patients who are post-stroke (Bisschop, 2022).  Family members and professionals alike report that this often results in the person who has had the stroke is thought to have dementia or significant cognitive impairment where what is being observed is actually the impact of a sensorineural hearing loss on the patient's communication.

Beyond the possible peripheral hearing loss, an auditory processing disorder may impact the listener after their stroke.  Pending the site of lesion (SOL) of the stroke, a variety of auditory processing deficits are reported.  Symptoms include poor listening skills when background sound is present, asking for information to be repeated frequently, the inability to follow speech presented at a rapid rate, among other concerns.  These deficits will have a negative synergy with other post-stroke deficits, including aphasia and executive functioning issues.  Patients report that they often withdraw from their lives due to the communication deficits they experience, including those in the auditory system.

Audiology should be a key discipline in working with people that have experienced stroke.  This patient population will have deficits in a range of skills, including language, cognition, and motor skills and the role of the audiologist can help to address and enhance communication for the patient and their significant others.  The hearing technology and rehabilitation services provided by audiologists can impact the quality of life in this patient population