OBJECTIVE To explore speech-in-noise abilities and cognitive performance in young adult contact sport athletes exposed to repetitive head impacts (RHI). DESIGN An exploratory cross-sectional study using standardized speech-in-noise and neuropsychological assessments alongside self-reported sporting history, listening‑in‑noise ability, and concussion history as proxy indicators of exposure. STUDY SAMPLE Twenty-four athletes (17 females, 7 males; median age 20 years, range 18-29 years) actively participating in the contact sport of rugby union in Sheffield, UK. RESULTS Elevated rates of impairment relative to normative expectations were observed on the Listening in Spatialized Noise-Sentences (LiSN-S) High Cue (30.8%) and Low Cue (38.5%) tests and the Trail Making Test (TMT) A (19.2%) and B (73.1%). Low rates of impairment were observed on the LiSN-S Total Advantage test (3.8%), the Montreal Cognitive Assessment (3.8%) and the Rey Auditory Verbal Learning Test trials (0%) and long delay (3.8%). Statistically significant (p < 0.01) group-level Z-score deviations were observed for the LiSN-S High Cue, LiSN-S Low Cue, RAVLT total, and TMT B tests. No significant correlations were observed between exposure proxies (years of participation and self-reported number of concussions) and any speech-in-noise measures and cognitive measures. CONCLUSIONS These exploratory findings, while not establishing causality or clinical impairment, warrant further investigation into speech-in-noise performance as a potential and previously under-considered area of vulnerability in contact sport athletes exposed to repetitive head impacts (RHI).
