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

Abstract

BACKGROUND Although parents play an instrumental role in youth concussion management, few studies have qualitatively explored youth concussion recovery from the parents' perspective. This study explored parents' experiences with and perceptions of their child's recovery from concussion, particularly with regards to the return‐to‐school process. METHODS We conducted 11 face‐to‐face semi‐structured interviews with the parents of concussed youth aged 11 to 17 years between October 2018 and April 2019. We used the methods of open coding, axial coding, and selective coding to analyze the data. RESULTS We identified 7 themes during data analysis, which we divided into 2 categories: at home (prior to school re‐entry) and at school (during the school reintegration process). The at‐home category included 4 themes: (1) physical and cognitive rest; (2) child‐led decision‐making; (3) the role of parent‐child communication in recovery; and (4) feelings about returning to school following concussion. The at‐school category included 3 themes: (1) availability and utilization of academic accommodations; (2) return‐to‐school policies and procedures; and (3) support from school officials and teachers. CONCLUSIONS Parents' experiences of their child's return‐to‐school post‐concussion underscore the need for evidence‐based guidelines for cognitive rest post‐concussion and a collaborative, team‐based approach to concussion management.

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

“…Parents of younger students (aged 11‐17) also relay similar concerns both in academic and home settings, and the need for academic accommodations and team support. However, this article was not included in this review due to publication after the review period 73 …”

“…Concussion was found to interfere with students' academic experiences in all 17 studies. Four studies examined college students, 18,42,67,68 7 investigated adolescents, 12,44,[69][70][71][72][73] and 6 included mixed-age groups. 17,50,52,57,74,75 Between 15% 56 and 88% 75 of students reported concussion interfering with academics.…”

“…Academic accommodations, communication between medical providers and schools, and receiving academic accommodations and medical care, including therapy-based interventions, were positive factors for post-concussion academic experiences. 45,53,54,[66][67][68]70,73,74 However, estimates were not provided to measure the association between each post-injury factor and academic outcomes.…”

“…However, this article was not included in this review due to publication after the review period. 73 Academic accommodations were commonly recommended, but there was little research to describe fidelity of implementation or impacts on academic and psychosocial function or recovery. Given the diversity of concussion symptom profiles, students may benefit from different types of accommodations for various durations of time, or at different points in recovery.…”

Academic Accommodations for Middle and High School Students Following a Concussion: Perspectives of Teachers and School Administrators

“…3 While research in the United States has examined return to learn after concussion, especially in studentathlete and post-secondary school populations, very little research has explored school resources and supports for Canadian adolescents. [15][16][17][18][19] Additionally, much of the research on return to learn focuses on the student, 16,20 parent, 21 and/or health care providers (eg, athletic trainers, school nurses) 18,[22][23][24] and does not consider the perspectives of teachers and administrators, who are essential to ensure that accommodations are provided and implemented at school. Further, research in the United States highlights the role of athletic trainers and school nurses as key stakeholders in the return to learn process (eg, case management roles in supporting recommendations, implementation of academic accommodations).…”