July 30, 2009

Review of Auditory Dysfunction in Traumatic Brain Injury

The article was informative with regards to giving a clearer picture of the growing population of veterans with hearing loss attributed to their military service. The report found that admissions for traumatic brain injury (TBI) increased 47% since the beginning of Operation Iraqi Freedom (OIF). A subgroup of blast related (BR) veterans were reported as having 62% hearing loss and 38% of this group with tinnitus. The authors indicated a gap in screening services for veterans as they had inadequate training for the management of tinnitus. The article was well organized and concise in that it gave specific representations of populations and subpopulations. The article does recognize some limitations to the service streams within the Veterans Administration (VA), but falls short in fully recognizing and advocating for the veteran.

One possibility as to the articles soft stance on identifying problems and barriers to care, it appears the target audience was for the VA. Hence, while identifying some issues with assessment and services the full exposure and extent of problems in the continuum of care and the bureaucratic entanglements might impede funding for further research monies for the authors. The article quickly lists the figures for comparisons and draws conclusions delineated from two groups. Forty months before the beginning (group I) of OIF and forty months after (group II), the two groups were compared, and found that group II had a significant amount of younger veterans with BR-TBI and hearing loss. This matter of younger veterans with TBI and hearing loss marks a significant change in the topology and identity of a growing population of veterans who have limited resources for an ever growing pool of patients.

The authors dance around the problems and charging forward with a battlement of statistics and cross analytics encompasses the VA’s endless studying the problem without addressing the quandary. More proof that was suspected and witnessed and now corroborated. Endless speculation as to the causes and no end in sight to the ramblings of those that need “proof positive” before treatment remedies can begin to trickle down to the masses of veterans needing services. A social work perspective and holistic approach would begin to recognize the problem and begin effect treatments in conjunction with research for improving modalities while building on the clients strengths. The most significant piece of information revealed in this endeavor is the low statistical and counter-intuitive expectation in the rupture of the tympanic membrane in percussion blast waves. Even more interesting, this information only covered less than half of a paragraph in the results section and missing in the discussion section.

As far as helping the social worker, this article does little to add to the discussion in helping the veterans. Except that it might add to the growing avalanche of data that the government requires before allocating funding for services and care for the veteran.

Lew, H. L., Jerger, J. F., Guillory, S. B., and Henry, J. A. (2007). Auditory dysfunction in traumatic brain injury. Journal of Rehabilitation Research and Development, 44(7), 921-928.

No comments:

Post a Comment

Please share your comments, stories and information. Thank you. ~ Scott Lee