Home Audiology TBI Leaders Respond to Comments Dismissive of Traumatic Brain Injury

TBI Leaders Respond to Comments Dismissive of Traumatic Brain Injury

by Bridget Murray Law
written by

Reporters recently asked President Trump about news that U.S. troops had sustained various degrees of traumatic brain injury (TBI) in an Iranian missile strike. He responded, “I heard they had headaches and a couple of other things, but I would say, and I can report, it’s not very serious.”

An outcry followed these remarks, with military leaders and others noting that TBI has been called a “signature injury” among U.S. troops in the recent conflicts in the Middle East. Fifty U.S. troops are reported to have TBI resulting from the Iranian strike.  Research has tied mild TBI (mTBI, the predominant form) to psychiatric disorders, cognitive-communication disorders, hearing loss and tinnitus, and substance abuse, among other negative sequalae. Since 2000, over 400,000 service members have been diagnosed with TBI, according to the Defense and Veterans Brain Injury Center.

Among those expressing concern about the high-profile dismissive comments on TBI are audiologists and speech-language pathologists, who play a central role in screening for, assessing, and treating its effects. (Audiologists diagnose and treat TBI-related hearing loss, tinnitus, and balance disorders. SLPs diagnose and treat TBI-related speech, language, cognitive-communication, and swallowing disorders.)

We turned to audiologist/SLP experts on TBI to capture their reactions to the comments on TBI—and implications for those affected and their treatment. Here’s what they said:

“As a speech-language pathologist and TBI researcher, I believe it is imperative for our leaders to identify traumatic brain injury as the serious injury that it truly is. My time spent with individuals with TBI has shown me that brain injuries often have a longer lasting and more devastating impact on quality of life than physical scars. Our service members, veterans, and their families make the ultimate sacrifice for our country. In order to optimize their care and well-being, every injury, visible or invisible, needs to be addressed with validation, compassion, and urgency.”

Rocío S. Norman, PhD, CCC-SLP, assistant professor, Department of Communication Sciences and Disorders, School of Health Professions, University of Texas Health Science Center/Advisor, TBI Warrior Foundation

“The President’s frank misrepresentation and dismissal of the seriousness of brain injury is not only harmful, it is shameful. As a researcher and clinician who has studied and treated cognitive impairments due to brain injury for over 30 years, I can unequivocally state that the impact of even seemingly minor blows to the head can be devastating and disrupt the lives of those managing the aftermath of changes in their functioning. Brain injury is a public health crisis that should be at the forefront of our work in prevention and treatment.”

McKay Moore Sohlberg, PhD, CCC-SLP, HEDCO Professor/Director, Communication Disorders & Sciences, University of Oregon

“TBIs, including concussions (mTBI), can result in persisting physical, cognitive, emotional, and sleep difficulties impacting a person’s ability to participate in their social and vocational roles. Immediate and appropriate care is critical to optimize recovery. Downplaying the seriousness of TBI can be harmful and lead to barriers to appropriate care, while also creating psychological effects that contribute to chronic complications.”

Tracey Wallace, MS, CCC-SLP, speech-language pathologist, Complex Concussion Clinic and SHARE Military Initiative, Shepherd Center, Atlanta, Georgia

“Sometimes symptoms caused by mild brain trauma can resolve quickly. However, some survivors may experience very serious and persistent communication, cognitive, and emotional changes following brain injury. Getting the appropriate diagnosis and necessary treatment can make life-altering differences and significantly improve quality of life. We honor our troops and their sacrifices by providing accurate information, correcting myths, and helping them get needed supports and services.”

—Diane Paul, PhD, CCC-SLP, director, clinical issues in speech-language pathology, ASHA

“In many respects, mTBI can disrupt an individual’s life as much as a moderate-severe TBI. Although mTBI may not be accompanied by physical injury, the cognitive and communicative deficits that result are frequently subtle and may go undetected for months. Ultimately the undiagnosed deficits may hinder return to work, duty, or school, and disrupt social relationships. Consequently, regardless of TBI severity, the result is compromised quality of life.”

—Carl Coelho, PhD, professor, speech, language, and hearing sciences/TBI researcher (including collaboration with U.S. Military)/Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut

“As an SLP who worked clinically with children and adolescents with TBI, who now researches how to improve long-term outcomes for these individuals, I believe it is dangerous and irresponsible to downplay the effects of TBI on a person’s life. Individuals with TBI often ‘look’ normal—but the effects of a TBI on every aspect​ of a person’s life cannot be understated. Children with TBI are dramatically under-recognized in schools, meaning in more cases than not, they are not receiving the appropriate services to help them. We cannot and must not minimize the effects of TBI on any person. The only way to improve the care for these individuals is to first acknowledge their injury for what it is: a long-term chronic condition that can benefit from treatment only if it is identified and recognized in the first place.”

—Jennifer Lundine, PhD, CCC-SLP, research scientist, Division of Clinical Therapies & Inpatient Rehabilitation Program, Nationwide Children’s Hospital/assistant professor, Department of Speech & Hearing Science, The Ohio State University

“There is no such thing as an artificial brain and we are only just beginning to understand how to create prostheses for rehabilitation of the input to the brain, such as the cochlear implant. For this reason, it is an extremely serious problem that TBI is so widespread among our veterans. While body armor and helmets have advanced the ability to survive very intense energy discharges, pressure waves from explosions pass right through the armor and disrupt the function of the body in multiple ways. The most serious effects are on the brain. The initial effects may be short-lived, but it turns out that the long-term effects can be much more serious, are not yet understood, and are often left undiagnosed, let alone untreated. Those living with the impacts for the rest of their lives deserve to be treated with respect and compassion.”

—Frederick (Erick) Gallun, PhD, associate professor, Oregon Hearing Research Center, Oregon Health & Science University/Chair, Mentoring Core, VA RR&D NCRAR, VA Portland Health Care System
TBI resources:

Bridget Murray Law is editor-in-chief of The ASHA Leader. bmurraylaw@asha.org

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Hope Dickinson January 29, 2020 - 4:30 pm

Thank you, ASHA, and fellow SLPs (and audiologist)! As an SLP and as a person with a family member (non-military) who had a severe DAI one year ago, I was outraged (but unfortunately not surprised) by Trump’s comments last week. Thank you for all you do for people with “mild,” moderate, and severe TBI. Your work is life-saving and life-changing!

Kathy Mays January 29, 2020 - 5:40 pm

I want to express sincere appreciation for your (ASHA and my colleague’s – SLP’s and Audiologist) responses to the comments that were made regarding TBI. I, too was outraged – it brought out the “SLP Bear” in me. Our work IS life-saving and life-changing!

Carol Williford, CCC/SLP, EdD January 29, 2020 - 8:24 pm

Many many years ago when Mild TBI was first being addressed I worked in a lab using evoked potentials to map areas of concern. I presented my findings to a group of Trial Attorneys and was laughed out of the room. None of them believed that there was any residual difficulties experienced by these people. Their cases would be dismissed. Their clients were making up things to get sympathy and money. All I can say is, “Who’s laughing now?”

Elaine Sands January 30, 2020 - 9:33 am

I was also outraged by Trump’s ill informed comments regarding TBI. Clearly he did not ask anyone with any knowledge in the area of TBI.
It is frightening that the public cam be subject to the paucity and incorrectness of this quote!

Phillip J Murray January 30, 2020 - 11:20 am

A friend of mine is STILL suffering the after-effects of his time spent in Vietnam so many years ago. He requires counseling and medication to help him deal with nightmares, sleeplessness, and depression. It’s NOT helpful to have our commander-in-chief dismiss this type of disorder as if it weren’t a reality!

C Gress January 30, 2020 - 12:10 pm

I would like to know what was Trump told about their injuries? Before we assign blame to any individual, we need to know the facts. Trump’s statement was that he heard that they had headaches and other things, nothing serious. If that is what he was told by the military who had first hand information of the injuries, we can’t exactly hold him accountable for the inaccuracy of the report. Certainly TBI, even mild TBI and concussion can have significant effects on the quality of life, and ASHA members play an important role in public education. But let’s not make this about politics.

Chris Gerber January 30, 2020 - 11:20 pm

Thank you for the voice of reason. I have heard many comments from educational teams and mediczl personnel who need information. We need to continue efforts for information dissemination to the public and raise awareness.

Sandra Ulrich January 30, 2020 - 7:18 pm

These are outstanding statements regarding mTBI and its effects on individuals and families. Many thanks for such professional and educational responses. It’s important to recognize that the President’s comments were heard and repeated at face value by many with no understanding of the debilitating consequence from concussive injuries.


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