Concussions, School Performance, and Accommodations
Concussions are on the rise. The Center for Disease Control recently reported that from 2001 to 2009, the number of emergency hospital visits for traumatic brain injury “increased significantly, from 153,375 to 248,418, with the highest rates among males aged 10-19 years.”
A concussion is the most common type of traumatic brain injury that can result in physical, cognitive, and emotional symptoms. A concussion may be caused by impact forces (which the head strikes something) or by impulsive forces (which the head moves as a result of an impact to the body). Such impact fores and impulsive forces frequently occur in contact sports games such as football, hockey, lacrosse, and soccer. But it can also occur in other “non-contact” sports such as volleyball, roller blading, skateboarding, and snowboarding.
If a concussion is not identified and treated appropriately, the individual may develop permanent, life-long symptoms including headaches, dizziness, fatigue, anxiety, memory and attention problems, sleep problems, and irritability. Subsequent concussions can result in psychiatric disorders and loss of long-term memory. Individuals who have had multiple concussions are at risk of developing Alzheimer’s disease and dementia pugilistica.
Thus, the importance of identifying and treating concussions cannot be overemphasized.
In the past, when a high school football player was struck in the head or pounded down hard, a school coach might briefly look at the player in the eye and say “You look fine. Get back out there, champ!”
Under a recently enacted New Jersey law, that can no longer happen.
New Jersey is one of a handful of states that has a concussion law. The law requires that student athletes who are suspected of having a concussion be immediately removed from the game and prohibited from playing additional games until a concussion specialist gives written approval.
Like the NJ Anti-Bullying Law, the concussion law also requires that school districts develop a written policy on concussion prevention and treatment. Additionally, athletic trainers who are licensed by the state are required to take continuing education in concussions.
The Athletic Trainers’ Society of New Jersey has published a helpful checklist that help school districts ensure it is in compliance with the NJ law.
When a student athlete suffers from a concussion, it can have a dramatic effect on the student’s academic performance and behavior. The student can suffer from memory loss; difficulties solving problems; difficulties finding the right words; have difficulties organizing information; exercise poor judgment; and experience depression and anxiety. To learn more about the effects that a concussion can have on a student, I recommend reading Educating Students with Traumatic Brain Injury.
Many experts have recommended academic accommodations to student-athletes with concussions.
Academic accommodations are important because the brain needs time to heal itself; stress and academic overload may hamper the healing process.
What types of accommodations might a student with a concussion receive? It depends. It could involve shortened school days, increased timed tests, and/or reduced homework.
On page 5 of the New Jersey Department of Education’s Model Policy and Guidance for Prevention and Treatment of Sports-Related Concussions and Head Injuries, we find the following:
Temporary Accommodations for Student-Athletes with Sports-Related Head Injuries
• Rest is the best “medicine” for healing concussions or other head injuries. The concussed brain is affected in many functional aspects as a result of the injury. Memory, attention span, concentration and speed of processing significantly impacts learning. Further, exposing the concussed student-athlete to the stimulating school environment may delay the resolution of symptoms needed for recovery.
• Accordingly, consideration of the cognitive effects in returning to the classroom is also an important part of the treatment of sports-related concussions and head injuries.
• Mental exertion increases the symptoms from concussions and affects recovery. To recover, cognitive rest is just as important as physical rest. Reading, studying, computer usage, testing, texting – even watching movies if a student is sensitive to light/sound – can slow a student’s recovery. In accordance with the Centers for Disease Control’s toolkit on managing concussions boards of education may look to address the student’s cognitive needs in the following ways.
• Students who return to school after a concussion may need to:
1. Take rest breaks as needed.
2. Spend fewer hours at school.
3. Be given more time to take tests or complete assignments. (All courses should be considered)
4. Receive help with schoolwork.
5. Reduce time spent on the computer, reading, and writing.
6. Be granted early dismissal to avoid crowded hallways.
A recent survey published in December 2011 revealed that 60% of school districts’ concussion policies do not define specific academic accommodations. This is surprising since the law requires that schools review the model policies and recommendations offered by organizations with expertise in brain injuries. The NJ Department of Education’s Model Policy and Guidance for Prevention and Treatment of Sports-Related Concussions and Head Injuries is quite helpful. However, the NJ concussion law does not specifically require that schools to draft specific academic accommodations that might be available to students with concussions. In fact, the word “accommodations” do not appear anywhere in the NJ concussion law.
Even if your child’s school has a concussion policy that does not list specific academic accommodations, it is important to remember that the NJ concussion law gives your child the right to those accommodations. Be sure to discuss with school personnel what academic accommodations may be appropriate for your child.