edition of t t steele report. i have two very special guests with me today. i'll introduce them here momentarily. because it's a very timely topic we're talking about today. by the way, these people are dodoors, they're authors, and they're husband and wife. so it's a veryion peek combination as our special -- unique combination as our special guests today. let me introducecethem. first t all, please welcome dr. mary ann roberts of the university of iowa. dr. roberts as clinical professor of pediatrics in the carver college of medicine at city. her phd in cling consolidate psychology from the university of wisconsin. served on the faculty at the medical college of wisconsin and for many, many years researched and aluated children and young adults who have brain injuries. she's here with her husband, dr. richard roberts, a staff psychologist for unity point neural clinic in waterloo.

university of -- phd from the university of iowaand has an add joungt in the department of psychology there. for more than 35 years, he's been studying what happens to adults with histories of traumatic brain injuries. obviously, we don't have timeme to go through the complete resumes, they're awfully impressive. the roberts have written a few book and we're dog to show you that late yir. it's called "mild traumatic brain injury, episodic symptoms and treatment," and it's based on all your extensive research and fascinating research ons could cushions andmild traumatic -- concussions and mild traumatic brain injuries. what has surprised you, you think, the most over the years about the research in thisis very important topic, with kids being injure in sports and such as that? dr. mary ann roberts, why don't you start the conversation for us? >> dr. mary ann roberts: in my experience with working with child with mild traumatic brain

been most surprised that we still know so little about how to handle them and what to do when, when they occur. so that's one of the reasons why we have tried to accumulate all the clinical knowledge in the book and describe a successful methth of treatment. >> ron: and dr. roberts, this is something that, like you said, maybe more people are learning about this through the@ research, kind of research that you're doing, and tell us a little bit about why you got into this and what was so fascinating about it to you? were you seeing injuries, did you have an injury yourself or anything like that? >> dr. richard roberer: no, i got into it accidentally. >> ron: accidentally? >> dr. richard roberts: a great many important medical discoveries are accidental and the results of good observation rather than theory. i had a patient who was a veteran who was referred for psychotherapy and he happened to

smellsls that his wife couldn't smell. several times during the week, his brain was giving him what hallucinations and from there, my colleagues and i started asking him more and more about episodic symptoms that come and go, and we found out he had a history of brain injury that was related to his rather severe depression with anger outbursts, observation. >> ron: andthis is someone who had actually been a veteran. i pointed out, you do work with many of the iowa veterans at the v.a. hospital in iowa city, correct? >> dr. richard roberts: i have in the past. now i'm on my retirement jobat allen medical center unity point, and so i don't see as many veterans now, but for 27 years, i worked with those veterans at the v.a. hospital and it was my privilege to do so. the people who keep us safe are really good folks. >> ron: and you have probably seen some of the same type of

the years and a lot of ese guys are still dealing with that to this very moment, aren't they? >> dr. richard roberts: yes. when you ask -- what was surprising, i guess what surprised me is how difficult it's been for us to shift the paradigm and get other healthcare providers to consider that manyny of the classical teachings on concussion such as virtually everyone fully recovers from one instance of concussion, are actually false, and a particularly lethal combination is when more than one concussion occurs in a short time period within, say, two to three months, particularly with children children, that is a recipe for long-term problems. >> ron: now, when you say mild traumatic brain injury, the

come to mind probably is concussion and that's part of it, but there's so much more than that too. is that the main focus you're talking about, concussion, or just any injury that has to do with brain trauma? >> dr. richard roberts: for the purposes of telecast, the viewers can sort of reward mild traumatic brain injury and concussion as roughly synonymous. both imply that there's been a transient disruption of brain function, most often due to blunt force trauma to the head, but also our war fighters sustained mild traumatic brain injury and concussion due to ied blasts where there is no direct impact to the head, but the blast waves itself stretches and puts undue stress on the brain tissue. >> ron: even if they weren't really -- i mean, they may have

something that close, but even if they were a ways away, the blast would be enough to cause a mild traumatic brain injury. >> dr. richard roberts: yes, even if the person thinks that they're in a safe range, 30 to 80 yards away, if the blast is large enough, there can still bebe longer term effects and maybe they maybe just a little bit stunned or dazed at the time, but then the brain develops more symptoms over time. they're just so glad that they've escaped the blast and are still alive, so thankful, that they don't necessarililhook up the onset of certain symptoms like memory lapses and inability to converse on a consistent basis with the fact that three months ago, they were blasted. >> dr. mary ann roberts: i think that's also -- that makes me think of situations with children and teenagers where

game of football and nobody is really tackling too harked but they fall to -- too hard, but they fall to the ground and they hit their head and dazed for a little bit, may not necessarily recognize their car when they -- when they're going to go home, but it's forgotten after that. if the symptoms do not immediately occur in a severe form, oftentimes it is totally forgotten and nobody s sms to be able to attribute the symptoms that the child or teenager is having six months down the road. >> ron: i was going to say, let's talk a little bit -- in fact, the university of northern iowa quarterback playing four years, he just sustain his fourth fourth concussion here a few weeks ago. that's a dangerous situation. when someone has, maybe, a playground incident, which are some of the symptoms that parents should be looking for in the hours following that or the

what are someme of the things they should be looking for? >> dr. mary ann roberts: the kind of things i see as most risky or puts the child at risk would be if they have a severe headache, if they have changes in their vision or changes in their balance. those kind of physical symptoms will often predict that they're going to have post-concussive problems later. >> ron: wow. and just real briefly, dr. roberts, describe to me in the most simple terms, what is a concussion exactly? >> dr. richard roberts: it is a transient disruption of brain function that man fests itself -- manifests itself either a direct loss of consciousness or the person feeling dazed and confused right after the impact or the blast, and the loss of consciousness lasts no longer than 30 minutes. >> dr. mary ann roberts: but consciousness. >> dr. richard roberts: yes, there also may be no loss of consciousness at the time.

football players escorted to the sidelines to undergo what's called the concussion protocol, to see if they can go back in the game. >> ron: i remember in the michigan game last year, remember the quarterback, sean morris, basically was staggering around the field and still wanted to stay in the game and clearly he had suffered some kind of brain injury. quon if you thrapd to see -- i don't know if you that happened to see that or not. it made quite a bit of headlines around the country. >> dr. mary ann roberts: that's an issue we tend to face when i'm working with teenagers who have what they consider to be, oh, just a ding, and they want to go back to the game and they hesitate to tell the coach. they hesitate to tell the trainer or their parents, and because they really do not want to get pulled from the game. >> ron: we're going to have to take a short break here, but i'm going to give you a statistic before we go. concussion in high school sports rising at an annual rate of 15%. we'll talk about that and some other topics on this fascinating issue and important issue when

report. also a retrineer you can see

kwwl.com shortly after t >> ron: welcome back to this this week's edition of the steele report. our segment is concerning mild traumatic brain injury. we have two dr. roberts here today, dr. mary ann roberts and her husband dr. richard roberts, and right before we went to the break, i kind of gave this statistic that said concussions in high school sports are rising at an annual rate of about 15%,

medicine. i would assume you're not surprised by that at all. >> dr. mary ann roberts: no, not at all, and we are now beginning to recognize them more clearly and as dick was mentioning a bit ago, the sidelines testing is being done more routinely. athletic trainers are better trained to understand that a concussion has happened. >> ron: i think that article, if i remember right, i was reading here, the increased availability of athletic trainers recognizing the symptoms more often and, of course, the nfl has a major, major problem going on there, particularly the older -- some of the older guys now that are facing some of these very, very serious issues. university of northern iowa and many other sports teams around the country are now placing sensors inside the helmet, even during practices, and then the

example can monitor some of his players who have been injured before and that's a really great idea, isn't it? i mean to know where your person is on a particular day and can see how many hits they've had, whether or not they need to come out and all these types of things. you're all for that, i assume? >> dr. richard roberts: certainly, but this is not an area where sensors and technology is going to save us because -- >> ron: it's not part of the treatment, is it? >> dr. mary ann roberts: no. >> dr. richard roberts: truly in football, not only are the overt instances, clear instances of concussion a problem, but there are indirect but cumulative effects of sub-concussion blows to the head. the more you block somebody or the more you take a hit to the head, the more likely it is that you will end up with this

the book which is kind of a hybrid between an affective disorder such as playmajor zee progression on the one -- major depression on the one hand and a disease seizure disorder on the other hand. there was a football player autopsied by bennett atomalu -- that's tough to say on tv. maybe i'll turn that into a test. there's going to be a movie forthcoming with will smith starring in the role, but it was estimated that by the time he was done with football, that mike webster had suffered roughly 20,000 individual blows to the helmet. >> ron: wow, man. >> dr. richard roberts: and so yes, helmet sensors and blast sensors for our war fighters are

there still remains more to be done to keep our players safe. >> ron: mike webster, tony dorsett, many other players who years. when you're talking to parents and you just brought up this a little bit ago, dr. roberts, about who do you ask about these symptoms, and tell us about what you're talking about. i think you had three w's there. >> dr. mary ann roberts: yes, the three w's are who, what, and when. the who do you ask i think is a very important one. very important question, because it is often, as we said before, sometimes forgotten. and i've had children who i have the parent and the child in the room with me, we're asking questions about have you ever fallen off your bike, have you ever fallen off playground

and we'll get no, no, no. and then as we're leaving -- about ready to part ways, the child says, oh, maybe you want to know about the time i fell off an atv ten feet into the air, my helmet came off, and my grandma said i should just lay down on the couch. and then nobody tells mom about it, so nobody knew. and we were then able to successfully treat that child. >> ron: so that's a very significant clue that almost went undetected or nobody knew about it, right? >> dr. mary ann roberts: right, or it's forgotten because it happened two or three years ago, but that is when some of the symptoms started, the headaches started or the staring started, so if i can time that according to what event happened then, i can much more likely consider it a manifestation of this kind of mild traumatic brain injury. >> ron: i'm old enough to

just shake it off, get back in there, that type of thing. >> dr. mary ann roberts: oh yes. >> ron: i assume there's some of that involved today, but a lot of liability involved too and coaches doing the right thing to keep their players as safe as possible, but how often do you think a child at a play ground or youth in football my take a hit and they might feel whoozy for a while, and they just go home and nobody says anything about it and it turns out to be very serious. does that happen a lot, do you think,or what you do you see? >> dr. mary ann roberts: by the time a patience will get to phi door -- patient will get to my door, it has happened a lot. there are many patients who have concussions and they recover from that within a three-month period of time, that the symptoms are all gone and there is nothing more to be concerned about with that. but for those kids and teens who

those are the ones -- they will very likely have this sub-type of brain injury. >> ron: now, here's another interesting thing i read about girls have a higher rate of concussion than boys, just like they have a higher rate of acl and mcl injuries too, so that has to be a concern, particularly maybe for soccer players because they're just doing so many things with their legs running around and they do have head injuries once in a while, too. were you surprised by that, that girls are suffering so many injuries too? >> dr. mary ann roberts: no. >> ron: i'm asking you and you've been doing all the research. >> dr. mary ann roberts: no, i mean, the other area that i've been involved in over the years is looking at attention deficit/hyperactivity disorder, and evaluating it and treatment for kids with that disorder, and 25 years ago, we didn't think girlsed that adhd -- had adhd

have been maybe underserved or not noticed as much, but yes, they -- and you wouldn't think about it or at least i didn't think about it, that a sport like cheerleading can be very dangerous because they do all kinds of -- >> ron: very difficult tricks, yes. >> dr. mary ann roberts: yes, very difficult tricks and if they fall to the floor and hit their head, then they are going to be in serious difficulty. >> ron: yeah, because females today, their athleticism is amazing and they're working very hard and becoming stronger and faster and when that happens, they're going to have the same kinds of injuries that any man would have too. >> dr. mary ann roberts: oh yes. >> dr. richard roberts: they're breaking into sports like hockey and wrestling that have been traditionally male dominated as well. >> ron: we have to take another break. we'll talk about the book pour

with people to make that >> ron: welcome back to our final segment here of the steele report for this week as we're talking about the book written by the husband and wife team, dr. roberts and dr. roberts. how did you get it done and who helped you make sure that there was going to be an important publication that you you've released? >> dr. richard roberts: well, we've had a number of clab rairts over the years. george phillips from the -- was previously at the sports

university of iowa. jody murpha professor in the pediatrics department, and a gentleman i've never met face-to-face, but had a tremendous e-relationship -- that doesn't sound good. he's been a friend. william shehan from willmar, minnesota, who shares similar views to ours, plus it's a little known fact that there is tremendous talent here in the cedar valley, just by a number of circumstances. dr. sharif has his own practice and attends the rehab unit at allen unity point inpatient services, has been a long-time

ours, and dr. mark heinz who practices from the -- at the competing institution here in waterloo, it will remain nameless -- [ laughter ] >> dr. richard roberts: -- is a brilliant fellow -- >> ron: and they know what it is anyway. >> dr. richard roberts: yes. as brilliant fellow sta work out an anatomical model to explain what's going on in the brain in producing these transient symptoms, and he's acknowledged national expert in treatment of post traumatic headaches, which is one of the troubling symptoms we really haven't said much about. and finally, the neuroclinic at allen unity point has given me a lot of support and taken a chance on an older guy, and i really appreciate working at allen.

people she'd like to thank or acknowledge. >> dr. mary ann roberts: i also want to reiterate that george phillips has been a -- basically his interaction with me and my work with him has been kind of the highlight of my career because he and i sort of grew up together with this idea. >> ron: i see. >> dr. mary ann roberts: and i was willing to take a chance on me. i brought him some research articles and i said, i have this patient, i really would like to see if you would see her, and the young lady with two concussions within a two-week period of time in women's competitive ice hockey, so he read the articles, he called some people and he said, yeah, i'll do it. and from then on, we have been working together in my doing the neuropsychological part of it and him doing the treatment part, the medical treatment part of it. >> ron: so everybody wants to go back in the game.

someone has two or three concussions? should they be playing or what's the final result of that observation? >> dr. mary ann roberts: well, here in iowa, they certainly have to be medically cleared before they can go back in the game. now, that could be with an athletic trainer or a physician, but my recommendation for somebody who is -- a teen who is having symptoms and the four most common symptoms are severe headaches that do not get treated with -- that aren't treatable with typical over-the-counter medications, staring spells that are -- that occur multiple times throughout the day and really disrupt their school day. the affect tifr spells where they start -- affective spells where they start having anger outbursts out of proportion to the situation and out of character for the child, and the fourth one is episodic tinnitus,

or they -- noisy environments, going into the cafeteria at lunchtime is really irritating to them, and if they have those symptoms, i don't think they should go back and play until they are successfully treated. >> ron: we have about a minute to go. so the good news is this stuff can be treated and they're also some medicine out there they can take for a while that can make a big didn't, right? >> dr. richard roberts: yes, even though many of these patients in the miserable minority that don't really recovery from one or more blows to the head do not have a classical form of epilepsy, but anticonvulsant medications will be very effective in reducing the symptoms of these patients and helping them to either get back into school or get back on life. >> ron: thank you very much.

roberts, dr. richard roberts, here's the book right here "mild traumatic brain injuries," and i'll tell you, this is a fascinating subject and you got some stuff to work with here, parents, to make sure your kids are safe out there playing on the playgrounds and the sports fields. thank you very much, dr. roberts and dr. roberts. >> dr. richard roberts: thanks for the opportunity. >> ron: we'll see you next week right here on kwwl steele

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