Adolescent Concussion and Return-to-Learn

Abstract

Concussion is a common diagnosis in adolescents, particularly in those who play sports. Physical and cognitive rest is the mainstay of treatment. However, the guidelines for returning to full cognitive effort are more nebulous. This article examines the existing evidence on return-to-learn guidelines, and offers some ideas of school accommodations that can be made for students who have experienced a concussion. This article also reviews the situations in which it is recommended to seek guidance from a concussion specialist or sports medicine physician.

Critical Elements of Return to Learn for Students With Concussion: A Scoping Review

“…44,49,68,75 Generally, a call for education about concussion and concussion management was recommended to increase knowledge, symptom identification, and academic modifications by team members. 16,17,49,51,52,57,75…”

“…Figure 2 provides an overview of audience and student age by educational levels. Administrators, 9,11,16,17,[36][37][38][39][40][41][42][43][44][45][46][47] followed by physicians, 14,19,[48][49][50][51][52] were the most common intended audience. Other articles were directed to policymakers in education, 11,[53][54][55][56] multidisciplinary teams of school professionals (eg, school psychologists and athletic trainers), 48,[57][58][59][60] or specific specialties, such as speechlanguage pathologists (SLPs), [61][62][63][64][65] school nurses, [66][67][68][69] school psychologists, [70][71][72] and athletic trainers.…”

A review of the literature on pediatric concussions and return-to-learn (RTL): Implications for RTL policy, research, and practice.

“…While RTP practices have been extensively researched and protocols are now widely adapted, other equally important areas relevant to concussed youth, such as returning to school or return-to-learn (RTL), have received considerably less attention. Though somewhat ambiguous, RTL is the process of transitioning back to the classroom following concussion, and complete or full RTL refers to the complete reintegration of a concussed student back into the classroom without academic accommodations that were not provided prior to injury (Iverson & Gioia, 2016; Santiago, 2016). The process of RTL may consist of the number of days to return to school, as well as plans to facilitate returning to school.…”

The Mild Traumatic Brain Injury Rest and Activity Questionnaire (MTBI-RAQ): A Pilot Study

“…Rest followed by a gradual return to activity is commonly recommended for mild traumatic brain injury (mTBI; Hobbs, Young, & Bailes, 2016). There are various forms of this recommendation in return-to-play (Purcell, 2009), return-to-learn (Eastman & Chang, 2015; Kasamatsu, Cleary, Bennett, Howard, & McLeod, 2016; Popoli, Burns, Meehan, Reisner, & Children's Health of Atlants, 2014; Santiago, 2016), and return-to-work advice (Cancelliere et al, 2014b). Interest in this topic is strong, especially as the field is moving towards a consensus on this advice in specific contexts, but there are still some unanswered questions (Iverson & Gioia, 2016; McCrory et al, 2017).…”