Concussion symptoms and temporary accommodations using a student-centered return to learn care plan

Abstract

BACKGROUND: Many students return to school after concussion with symptoms but without formal support. OBJECTIVE: To examine concussion symptoms and temporary academic accommodations during school use of a four-week student-centered return to learn (RTL) care plan. METHODS: Five public high schools used the RTL care plan and contributed student-level data after student report of concussion. Data on concussion symptoms, temporary academic accommodations corresponding to reported symptoms, and accommodations provided during RTL care plan use were examined. RESULTS: Of 115 students, 55%used the RTL care plan for three (34%) or four (21%) weeks. Compared to students whose symptoms resolve within the first two weeks, students who used the RTL care plan for three or four weeks reported more unique symptoms (P = 0.038), higher total severity score (P = 0.005), and higher average severity per symptom (P = 0.007) at week one. Overall, 1,127 weekly accommodations were provided. While least reported, emotional symptoms received corresponding accommodations most often (127/155 reports: 82%of occurrences). CONCLUSIONS: Use of an RTL care plan can facilitate the RTL of students with a concussion and may aid in the identification of students who are in need of longer-term support.

Exploring the association between cognitive activity and symptom resolution following concussion in adolescents aged 11–17 years

“…The third phase starts with half-days or attending school part time before returning to school full time. This process aligns with the Centers for Disease Control and Prevention concussion management guidelines,13 suggesting that students work with school staff to set accommodations without exacerbating symptoms 42 43. These return-to-school guidelines are not strongly evidence based 34.…”

Investigating the Student in Returning to Learn After Concussion: A Systematic Review andMeta‐Analysis

“…Accommodations recommended were collected from medical records (n = 10) and accommodations received were reported by students (n = 8). Three studies reported on college students, 43,68,76 5 on high school, 16,64,[77][78][79] 1 on elementary, 80 and 9 on mixed ages. [50][51][52]54,56,57,59,74,81 Most studies reported the percentage of students receiving accommodations, 43,50-52,56,57,59,64,78,80 whereas data was limited about type or length of time of accommodations.…”

“…This review found that students who had their physical and cognitive needs met through supportive environments had better school outcomes, underscoring the positive impact of RTL interventions. 66,77,79 The literature thus far supports that interventions for RTL could improve GPA and school participation after concussion, 66,106,107 but such interventions studies were few, and represented specific student subgroups (high school ages with persistent symptoms), highlighting the need for continued research into intervention models and outcomes across ages.…”

Consensus statement: An evidence‐based review of exercise, rehabilitation, rest, and return to activity protocols for the treatment of concussion and mild traumatic brain injury

“…The evidence identified on RTA protocols comprised six studies: one RCT, 111 one prospective cohort study, 112 one retrospective cohort study, 113 two prospective case series, 23,114 and one retrospective case series. 115 The studies involved RTA protocols in adolescents with acute concussion.…”