Building Statewide Infrastructure for the Academic Support of Students With Mild Traumatic Brain Injury

Abstract

Objectives: To focus attention on building statewide capacity to support students with mild traumatic brain injury (mTBI)/concussion. Method: Consensus-building process with a multidisciplinary group of clinicians, researchers, policy makers, and state Department of Education personnel. Results: The white paper presents the group's consensus on the essential components of a statewide educational infrastructure to support the management of students with mTBI. The nature and recovery process of mTBI are briefly described specifically with respect to its effects on school learning and performance. State and local policy considerations are then emphasized to promote implementation of a consistent process. Five key components to building a statewide infrastructure for students with mTBI are described including (1) definition and training of the interdisciplinary school team, (2) professional development of the school and medical communities, (3) identification, assessment, and progress monitoring protocols, (4) a flexible set of intervention strategies to accommodate students' recovery needs, and (5) systematized protocols for active communication among medical, school, and family team members. The need for a research to guide effective program implementation is stressed. Conclusion: This guiding framework strives to assist the development of support structures for recovering students with mTBI to optimize academic outcomes. Until more evidence is available on academic accommodations and other school-based supports, educational systems should follow current best practice guidelines.

An international perspective on educators’ perceptions of children with Traumatic Brain Injury

“…This is important to note because few teachers described formal collaboration processes within their educational settings. This suggests that emerging practices that formalize such collaboration processes (Dettmer et al, 2014;Gioia, Glang, Hooper, & Eagan Brown, 2015;Glang et al, 2010) could benefit teachers working with students with TBI.…”

Overcoming Knowledge Barriers for Inclusion of School-Based Speech-Language Pathologists in the Management of Students with Mild Traumatic Brain Injury

“…Challenges facing schools in responding, monitoring, and adapting to the needs of students with mTBI have been well described, [6][7][8][9] and a few models exist to drive implementation of "return to learn" (RTL) systems. 10,11 Although all 50 states now have laws in place that stipulate specific rules around "RTL" for student athletes, the development of RTL protocols that specify how a student should gradually increase academic activity until fully reengaged in school lags far behind.…”

Statements of Agreement From the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015

“…26 Appropriate individualized supports must be in place to facilitate recovery for the symptomatic student/employee. 170 To support this return, symptom and clinical profile-targeted accommodative supports and adjustments may be necessary to balance the goals of recovery and return to productivity. For example, in patients with vestibular dysfunction, modifications in the school environment to lessen the triggers for their symptoms, such as removal from gym or dance class, band/orchestra, or school assemblies may be employed.…”

“…In the school context, Gioia advocates for explicit training of medical and school systems to facilitate the student’s individualized program of gradual return, identifying key symptom targets tied to accommodation strategies, monitoring progress, and applying systematic criteria for progression to the next less restrictive level of support. 170 Prolonged absence from one’s school or work environment must be avoided to reduce the risk of secondary adverse social and emotional effects (eg, anxiety) from disengagement and lack of involvement in previously enjoyed activities. To inform treatment-relevant targets, Ransom et al 171 provide initial evidence for the impact of concussion on academic learning and performance (eg, headaches and fatigue interfering with learning, greater difficulty understanding new material).…”