Establishing Consensus for Essential Elements in Returning to Learn Following a Concussion

Abstract

BACKGROUND Returning to learn following a concussion is the process of managing a student's recovery during the school day by implementation of academic supports with varying intensity. Due to a lack of consensus or even guidance on Return to Learn, this paper set out to establish cross discipline consensus on some essential elements of Return to Learn using a Delphi method. METHODS Sixteen national organizations participated in a Delphi process to reach consensus on overarching themes of Return to Learn focused on: returning a student to school, composition of the school‐based concussion management team, progress‐monitoring, educational safeguards, neuropsychological testing, and legislation. Two rounds of questionnaires were disseminated via email using a Delphi process. Consensus was established during round 2. RESULTS Twelve national organizations were able to reach consensus and endorse 13 essential elements of Return to Learn following a concussion. CONCLUSIONS There continues to be limited research on concussion Return to Learn leading to confusion in the field. In this paper, we demonstrate consensus on a number of essential elements, from a wide variety of professional disciplines who participate in the care of students following a concussion, as a starting place for some guidance on Return to Learn.

Concussion Recovery in Children and Adolescents: A Qualitative Study of Parents' Experiences

“…It appears that there is a fine balance between too much rest and too little rest, both of which could potentially hinder recovery from concussion and lead to negative recovery outcomes. This is consistent with prior studies 19‐22 . Further research is therefore needed to determine optimal cognitive and physical activity levels needed to promote concussion recovery and facilitate successful reintegration into the academic environment post‐concussion.…”

The Association Between School District‐Based Policies Related to Concussions and Concussions Among High School Students

“…Second, monitoring a student's recovery and ensuring they have medical clearance prior to returning to sports-or physical activity generally entails coordination between school professionals, the student's parents, and the student's health care provider. 15,22,23 A student recovering from a concussion may have school accommodations in place that may evolve from day to day or from class to class. 15 As such, schools with RTS policies that require returning to the classroom before returning to athletics may have more robust efforts to address and prevent concussion.…”

“…3 Encourage school administrators to establish concussion management teams, including identifying a point person at their school who is trained and knowledgeable about concussion management. 22,23 • To limit the burden on parents and other school staff, prior studies note that the establishment of a school concussion management team may be beneficial. 13 A school point person (such as a school nurse or teacher), who is part of the concussion management team, may also be identified for each individual student.…”

“…13 A school point person (such as a school nurse or teacher), who is part of the concussion management team, may also be identified for each individual student. 22,23 The school point person can assist with coordination and communication between the student's family, medical provider, and other school professionals. A school point person may also facilitate professional development opportunities on concussion prevention, detection, and management for other school staff that support concussion policy implementation.…”

Exploring the outcomes and experiences of Black and White athletes following a sport-related concussion: a retrospective cohort study

“…Returning to school following SRC is receiving increased attention; however, currently there exists substantial variability in RTL definitions and methodologies, causing confusion in the field. 37 The Centers for Disease Control and Prevention suggests that youths with SRC can return to school within 2-3 days after an injury, 38 but studies demonstrate disparate timelines in full RTL, ranging from 0 days 39 to 35 days. 40 Furthermore, practice patterns vary from half-day return to full-day return to individual, customized learning plans for each athlete.…”