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Returning Student-Athletes to a Learning Environment. Support Team. The student-athlete Parents/Guardian Teachers/Coaches Physician/Athletic Trainer School Nurse School Counselor Speech Language Pathologist School Administration. The First 48 Hours After a Concussion.
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Support Team • The student-athlete • Parents/Guardian • Teachers/Coaches • Physician/Athletic Trainer • School Nurse • School Counselor • Speech Language Pathologist • School Administration
The First 48 Hours After a Concussion • Physical AND cognitive rest • Avoid tasks which increase symptoms • “overstimulation” of brain • Simplify brain inputs • “live like the Andy Griffith show” • Some symptoms may evolve • especially headache, concentration
The First 48 Hours After a Concussion • Reassess by practitioner trained in concussion management • NO role for ImPACT testing in this stage • May increase symptoms • Practice effect • Does not change plan • If no symptoms for 24 hours can attempt return to class • If symptoms worsen in class should rest and may need to return home
Parent/Guardian’s RoleFirst 48 Hours • Let the student-athlete sleep • Do not them wake up regularly • Limit cognitive activity around the house • Computer time, phone/texting, video games, and television • Limit physical activity • We do not want to elevate the heart rate. • No driving
Returning to School • School specific activity should be increased gradually. • When able to tolerate 1-2 hours of homework at home, without symptoms, probably ready to return to school. • Start with ½ days back at school • Light load • Monitor for symptoms • When ½ days are tolerated, the student can return to full school days.
Returning to School • If symptoms develop, the student should take a break until symptoms resolve. • If symptoms do not resolve, the child should continue to rest or go home.
VSCC School Accommodations • Please consider the following concussion-related recommendations: • Gym Class recommendations: • ____No gym class • ____Restricted gym class as specified___________________________ • Recommended Academic accommodations: • ____Untimed tests • ____Open note/Open book or Oral tests • ____Tutoring • ____Reduced workload when possible • ____15 minute rest breaks from class every ____ hour(s) • ____Modified/reduced homework assignments • ____Extended time on homework/projects • ____Tape record class lectures • ____Should not return to school until concussion symptoms are resolved • ____Other recommendations_____________________________________
Strategies to Help in the School Setting Sign/Symptom Headache Adjustments • Frequent breaks • Planned rest periods in the nurses office or quiet location • Identify aggravators and reduce exposure to them
Strategies to Help in the School Setting Sign/Symptom Dizziness Adjustments • Allow student to put head down if symptoms worsen • Give student early dismissal from class to allow extra time and to avoid crowded, busy hallways
Strategies to Help in the School Setting Sign/Symptom Visual problems: Light sensitivity Double vision Blurry vision Adjustments • Reduce brightness on screens; use sunglasses • Turn off fluorescent lights • Seat closer to the front and center of the room for blurry vision • Cover one eye with a patch for double vision
Strategies to Help in the School Setting Sign/Symptom Noise Sensitivity Adjustments • Allow student to have lunch in a quiet area with one classmate • Limit band, choir, shop • Ear plugs if possible • Early dismissal from class to avoid noisy hallways
Strategies to Help in the School Setting Sign/Symptom Difficulty Concentrating Adjustments • Avoid testing or major projects • Extra time on tests • Postpone standardized testing
Strategies to Help in the School Setting Sign/Symptom Difficulty Remembering Adjustments • Consider 1 test per day • Consider open notes or oral testing
Strategies to Help in the School Setting Sign/Symptoms Sleep Disturbances Adjustments • Allow for late start or shortened school day to catch up on sleep • Allow rest periods
Formal Support Services • Response to Interventional Protocol (RTI) • Used for students who need adjustments for an extended period of time. • Uses a multi-step approach that allows for monitoring progress through increasing levels of the intervention. • At each level, school officials reassess to determine continued needs of the student.
Formal Support Services • 504 Plan • For students with persistent symptoms. • Will describe modifications and accommodations to help student return to pre-concussion performance levels. • Examples of modifications: • Environmental modifications • Temporary curriculum modifications • Behavioral modifications
Formal Support Services • Individualized Education Plan (IEP) • For students with certain classifications of disabilities that affect educational performance • Small percentage of concussed students will need IEP’s (Chronic cognitive/emotional disability) • These students generally require significant help • Adjustments to workload • Adjustments to teaching/learning methods • Adjustments to environment/curriculum