Long-Term Speech Deficits are Observed in Former Athletes with History of Sport-Related Concussion

Slurred speech is a common symptom of a sport-related concussion. When it is observed on the field, the injured athlete should be removed and evaluated appropriately.

But evaluations specifically for slurred speech are lacking. And speech is more than what meets the eye… or, should we say… ears. Listeners untrained in speech disorders are usually unable to identify the subtle indicators of slurred speech.

Speech can be objectively measured, as demonstrated by a collaborative team of investigators whose research will be featured on the blog today.

The speech measurements used in their research show promise as clinical evaluation tools for concussed athletes, both in the short-term and long-term.

Speech Research following Sport-Related Concussion

In their innovative research, a team of investigators of various clinical backgrounds evaluated speech timing and acoustic measures with support from the American Speech Language Hearing Foundation and the National Institute on Deafness and Other Communication Disorders.

The purpose of their research was to determine if there were differences in speech between concussed and non-concussed athletes.

The researchers tested 30 individuals aged 19-22 years who were former high school or college athletes with history of sport-related concussion within the past 2 years. Importantly, the included participants did not have lingering symptoms from their concussion. The researchers compared these 30 individuals to 30 control participants (both former and current athletes) who did not report a history of sport-related concussion.

Participants were fitted with microphones to measure sound and sensors to measure muscle activity of the jaw and tongue. They completed a series of speech tasks, called diadochokinetic tasks. This included saying single-syllable words (“puh” and “tuh”) and real words (“pattycake” and “buttercup”) repeated 10 times as fast as possible. Speech samples were analyzed for timing, and the sensors recorded the amount of muscle activation. The speech samples were also evaluated by trained speech and language pathologists (SLP).

The researchers collected over 1,110 speech samples from the included athletes with sport-related concussion, in addition to samples from the control group.

Compared to controls, participants with previous sport-related concussion demonstrated slower speech rates, evidenced both from the objective measures as well as the subjective analysis from the SLPs. They also demonstrated increased muscle activation during the speech tasks, indicating more labored speech.


Although the participants with previous sport-related concussion did not technically have slurred speech, they did demonstrate speech timing deficits compared to athletes with no history of concussion.

These findings of speech deficits are concerning – remember the included athletes were seemingly recovered from their previous sport-related concussions, as they were required to not have lingering signs or symptoms of concussion.

The researchers also discussed the optimistic future of this research! They showed that speech characteristics can indeed be measured, which means speech deficits in concussed athletes can be identified. Measurement of speech characteristics may have a place in the future of concussion evaluation and treatment both acutely on the field and in the long-term.


Russell E. Banks, Deryk S. Beal & Eric J. Hunter (2021) Sports Related Concussion Impacts Speech Rate and Muscle Physiology, Brain Injury, 35:10, 1275-1283, DOI: 10.1080/02699052.2021.1972150

About the Author

Dr. Jennifer Hunnicutt is a licensed athletic trainer with a PhD in Health and Rehabilitation Science, who has worked with all types of athletes, including professionals and Olympians. She has held prominent research positions at Emory Sports Medicine and the NBA Hawks Center in Atlanta, GA, as well as serving on the national network of healthcare providers for U.S. Figure Skating. Now the owner of Hunnicutt Writing and Consulting, LLC, Dr. Hunnicutt collaborates with global institutions, spearheading innovation and research among professionals and businesses in Sports Medicine and Orthopedics. Learn more at