Academic outcomes following adolescent sport-related concussion or fracture injury: A prospective cohort study

Abstract

Objectives The objectives were 1) to compare the effects of adolescent sport-related concussion (SRC) and sport-related extremity fracture (SRF) on academic outcomes including change in school grades and school attendance; and 2) to determine which specific academic accommodations were most helpful during recovery from these injuries. Methods A prospective cohort study was conducted to compare changes in school grades, school attendance and academic accommodations among students (grades 8–12) with an SRC or SRF. School grades were extracted from student immediate pre- and post-injury report cards. Students completed attendance log books and an exit interview to determine which accommodations were helpful and how accommodating they perceived their school to be during their recovery. Results Overall, 124 students (92 with SRC and 32 with SRF) submitted both pre- and post-injury report cards. Students who sustained an SRC or SRF experienced similar decreases in grades post-injury (SRC: -1.0%; 95% CI: -2.1, 0.1 and SRF: -0.9%: 95% CI: -2.1, 0.3). Students with an SRC missed significantly more days of school compared to those with an SRF (median of 4 days [IQR: 1, 7] versus 1 day [IQR: 0, 4], p<0.0001). In total, 60/113 (53.1%) SRC students reported their school to be very accommodating while only 31/77 (40.3%) SRF students reported their school to be very accommodating (p = 0.082). Conclusions Students who sustain an SRC miss significantly more days of school but demonstrate similar changes in school grades post-injury compared to those with an SRF. Future studies are needed to identify the pre- and post-injury factors associated with poor academic functioning following concussion and identify measures that can be taken to help optimize academic outcomes in these patients.

Academic Performance Following Sport-Related Concussions in Children and Adolescents: A Scoping Review

“…In a 2019 paper, Russel et al conducted a prospective cohort study to once again show that no significant difference existed between pre-injury vs. post-injury overall or core grades amongst SRC students. In relation to accommodations, 53.1% of students with SRC reported their school was very accommodating [ 15 ]. Following a cross-sectional study, Moore et al reported that the arithmetic score was significantly lower in the concussion group when compared to the control group.…”

“…In one study analyzing the perspectives of the adolescent athlete, found that not being able to keep up with school-work, missing academic activities, and losing the ability to successfully complete activities, was distressful [ 7 ]. Several studies demonstrated an increased likelihood of a decline in measured academic performance following SRC [ 14 , 15 ]. Prior to resumption of academic work, it is important to assess a student’s readiness to return to learning [ 7 ].…”

“…Six studies used numerical measures to assess academic decline following SRC, while other studies used subjective methods such as surveys assessing adolescent or parent perspectives on academic challenges experienced while returning to school post-concussion [ 10 , 11 , 14 , 15 , 16 , 17 , 18 ]. Of the studies that reported survey-based data on adolescent or parent perspectives, all reported a significant level of concern with respect to academic difficulty [ 7 , 12 , 13 , 19 , 20 , 21 ].…”

“…However, this does not preclude the possibility of short-term decline in academic performance or long-term adverse psychological consequences [ 17 , 20 ]. The differences in the effects of concussions on academic function could be variably attributed to differences in accommodations provided, the time period over which academic performance was assessed, or simply a lack of sufficient data [ 15 ]. For example, Russel et al reported no significant change between pre-concussion and post-concussion overall or core grades [ 15 ].…”

“…The differences in the effects of concussions on academic function could be variably attributed to differences in accommodations provided, the time period over which academic performance was assessed, or simply a lack of sufficient data [ 15 ]. For example, Russel et al reported no significant change between pre-concussion and post-concussion overall or core grades [ 15 ]. Appropriate accommodations in the learning environment were reported by 53.1% of participants in this study; it is likely that these accommodations played a role in preventing a significant decline in academic function [ 15 ].…”