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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.
A federal judge has granted summary judgment to a school district and its coach, who were sued for negligence after one of their student athletes suffered a concussion and was re-inserted back in the game.
The plaintiff was a student and athlete on a varsity women’s high school basketball team. On January 4, 2011, the team played a game against a neighboring school. During the second half of the game, she was struck in the front of the head by an opponent. The coach called a timeout.
The plaintiff told the coach that she was dizzy, that her eyes were blurry, and that she needed to sit down. She sat on the bench for approximately five minutes, during which time the plaintiff alleges that she exhibited signs of a concussion and acted out of character. The coach asked the plaintiff whether she was ready to return to the game. The plaintiff re-entered the game. During one play, she lost her balance and alleges that she felt disoriented, according to the complaint. Sometime thereafter, the plaintiff was struck in the head a second time by a player on the other team. The plaintiff asked to be removed from the game. The coach removed her and did not put her back in for the remainder of the game. The plaintiff alleged that she suffered a concussion and other injuries.
The plaintiff alleged that the coach was aware of the symptoms of head injuries and concussions and had received “training and education in the prevention, recognition, and treatment of head injuries.” The plaintiff also alleged that the coach was aware that protocol required that athletes exhibiting symptoms of a concussion could not return to play before being evaluated by an athletic trainer or physician. In addition, she charged that the coach was charged with “protecting his players from injury as much as possible.”
She sued the coach and school for negligence. The defendants moved for summary judgment. (To get the details on this case and read the full summary, visit: https://concussionpolicyandthelaw.com/concussion-litigation-reporter/)
The word is getting out. That much is certain.
The National Federation of State High School Associations (NFHS) announced recently that more than one million coaches and other individuals has taken the online course it developed with the help of the Centers for Disease Control and Prevention (CDC).
Entitled “Concussion in Sports – What You Need to Know,” the course has been taken through the NFHS Coach Education Program at www.nfhslearn.com. This free online course provides an overview of how a person can recognize signs and symptoms of a concussion and the appropriate action to take. The course includes each state’s return-to-play guidelines required for high schools.
“We place great emphasis on concussion recognition and treatment, and the extraordinary success of our online course has been gratifying,” said Bob Gardner, NFHS executive director. “The course is 20 minutes long and it’s free. We commend everyone who has taken it.”
The NFHS and its Sports Medicine Advisory Committee (SMAC) have worked with the CDC on recent updates to the concussion course. Recommendations have been added regarding the prevention of concussions, and the course test has been updated. The tests (pre-test and post-test) now include 11 questions and provide immediate feedback to the user, thereby creating a better learning experience.
Michael Koester, M.D., former chair of the NFHS SMAC and director of the Sports Concussion Program at the Slocum Center for Orthopedics and Sports Medicine in Eugene, Oregon, is the on-screen host of the concussion course. Individuals have access to the course’s printable resources, including a parent’s guide to concussion in sports, a coach’s guide, an athlete fact sheet and materials to implement a protocol for concussion treatment.
“In addition to coaches, we are pleased that many contest officials, administrators, parents and students are among the one million individuals who have taken the concussion course,” said Tim Flannery, NFHS director of coach education.