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According to a new study in the American Journal of Public Health, students with concussions show more academic dysfunction — or inability to perform at a normal academic level — one week after injury than students who experience extremity injuries.
Researchers from the University of Rochester School of Medicine and Dentistry conducted a study from September 2013 through January 2015 of high school and college students who had visited three emergency departments in the Rochester, New York, area for a sports-related concussion or musculoskeletal extremity injury. Using telephone surveys, the researchers compared self-reported academic dysfunction between students with concussions and a comparison group of students with extremity injuries at 1 week and 1 month after injury.
Results showed that students with concussions had more academic dysfunction one week after injury than students who experience extremity injuries. Students with a concussion took longer to return to school post-injury and received more academic adjustments — such as extra time on tests and tutoring. The results also showed that female students and students with a history of two or more previous concussions were more susceptible to the effects of concussion. At one-month after injury, however, there were no observed differences between students with concussions and those with extremity injuries.
“Concussed students typically return to school within a week after injury, while their brains are likely still recovering,” the authors explain. “Our results emphasize the need for return-to-learn guidelines and academic adjustments based on gender and concussion history.”
A study by the Concussion Clinic at Children’s Hospitals and Clinics of Minnesota has revealed that a child who sustains a concussion during the school year has a longer recovery time than one who suffers the same injury over the summer.
“We were surprised at the magnitude of the differences,” Robert Doss, PsyD, co-director of the Pediatric Concussion Program and one of the study’s researchers, told the Minneapolis Star-Tribune. “We weren’t surprised that it was in that direction; just simply that the magnitude was what it was.”
The article quoted another study, “Returning to Learning Following a Concussion,” which was published in October in Pediatrics, the official journal of the American Academy of Pediatrics (AAP). The study “explains the difficulties children experience in a school setting after suffering a concussion. Post-concussive symptoms often can linger or increase in severity without proper adjustments to a child’s environment or academic routine. Research suggests that academic demands and school environment may be a barrier to recovery.
“Because each concussion and child is different, the AAP study recommends creating a multidisciplinary team to facilitate a student’s recovery and help him or her return to normal activities. Those four teams are:
- “Family (student, parents, guardians, grandparents, peers, teammates and family friends)
- Medical (emergency department, primary care provider, concussion specialist, clinical psychologist, neuropsychologist, team and/or school physician)
- School academic (teacher, school counselor, school psychologist, social worker, school nurse, school administrator, school physician)
- School physical activity (school nurse, athletic trainer, coach, physical education teacher, playground supervisor, school physician).”
Doss went on to stress the importance of the “individual child” to the paper. “It seems like our practitioners are noticing more responsiveness by the schools to put forth accommodations for these kids,” he said. “Some schools are more accommodating than others. Some seem to have a grasp of concussions.
“Overall, I think our perception is that schools are more receptive and thinking about it more actively. They’re instituting programs on their own, so they’re prepared for what comes next.”
The American Academy of Pediatrics (AAP) has released a new clinical report that suggests that student athletes may need to take a break from the classroom after suffering a concussion.
In the clinical report, “Returning to Learning Following a Concussion,” released late last month at the AAP National Conference & Exhibition in Orlando, the AAP offers guidance to pediatricians caring for children and adolescents after suffering a concussion.
“Students appear physically normal after a concussion, so it may be difficult for teachers and administrators to understand the extent of the child’s injuries and recognize the potential need for academic adjustments,” said Mark Halstead, MD, FAAP, a lead author of the clinical report. “But we know that children who’ve had a concussion may have trouble learning new material and remembering what they’ve learned, and returning to academics may worsen concussion symptoms.”
Research has shown that a school-aged student usually recovers from a concussion within three weeks. If symptoms are severe, some students may need to stay home from school after a concussion. If symptoms or mild or tolerable, the parent may consider returning him or her to school, perhaps with some adjustments. Students with severe or prolonged symptoms lasting more than 3 weeks may require more formalized academic accommodations.
The AAP recommends a collaborative team approach to help a student recovering from a concussion. This team should consist of the child or adolescent’s pediatrician, family members and individuals at the child’s school responsible for both the student’s academic schedule and physical activity. Detailed guidance on returning to sports and physical activities is contained in the 2010 AAP clinical report, “Sport-Related Concussion in Children and Adolescents.”
A symptom checklist can help evaluate what symptoms the student is experiencing, and how severe they are.
“Every concussion is unique and symptoms will vary from student to student, so managing a student’s return to the classroom will require an individualized approach,” said Dr. Halstead. “The goal is to minimize disruptions to the student’s life and return the student to school as soon as possible, and as symptoms improve, to increase the student’s social, mental and physical activities.”
Because relatively little research has been conducted on how concussion affects students’ learning, the AAP based its report primarily on expert opinion and adapted it from a concussion management program developed at the Rocky Mountain Hospital for Children, Center for Concussion in Denver, Colo. The AAP calls for further research on the effects and role of cognitive rest after concussion to improve understanding of the best ways to help a student recovering from a concussion.