Concussions in the School Setting

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Concussion Information
Notification

Communication
Monitoring

Clearance and Return to Play
Resources and Articles

Concussion Information

Does your school have a plan to support students with concussions? Where do you even start? This basic information is broken into 4 different areas of support:

Identification / Notification
Communication
Monitoring
Clearance / Return to Play

The following information provides a basic outline with resources at the end to help guide a policy making process. If you are unsure that your concussion plan is robust enough to support students and educators, points of vulnerability tool. This is a free download that you can use to better look at all areas of your plan.

Notification

After we Identify the injury, how do you hear about the student’s concussion? We need to look at all students, not just the athletes.

Parents
Teachers
Attendance Secretary
Student
Athletic Trainer

Educating your school staff to listen for key words (head hit, dizzy, vomiting, etc.) can help identify those students who sustained a concussion, but haven’t told anyone yet. Sometimes a simple conversation between your health tech/teacher/school staff and the student who is “not feeling well” can identify a previous injury or other reasons why the student is not feeling well.

Communication

Now that you have identified a concussion what do you do with that information?

The entire school building does not need to know about every students injury. However, the school staff that works with that student plus an administrator does.
Initiate TACT (Teacher Acute Concussion Tool) emails to the appropriate staff. One email will be sent to each staff member weekly for 4 weeks with recommendations to support the student at each healing period.
Communication between the student, family, healthcare provider, and school staff is imperative to be able to understand the students symptoms in all areas. If the student is still needing adjustments at school, and not showing any physical symptoms, then the provider will only hear of 1 area of impact. A medical release of information will be needed.
Different behaviors can also be a symptom of a concussion. Behaviors such as loud outbursts, being very emotional, etc. It is important to advise the family and healthcare provider so a fully informed discussion regarding concussion clearance can be completed.

A student does NOT need a prescription or written instructions from a healthcare provider to Return to School / Return to Learn. The student should not be absent from school for a prolonged period following their injury. The school’s concussion management team can support the student with physical symptoms and with their academics only when they have returned to the school setting.

A student does NOT need medical documentation to begin supporting them following an injury. If a student has sustained an injury, and are having associated symptoms call the caregivers and corroborate the story. If the story is credible, begin supporting the student at school.

Monitoring

Symptom – Health tech, Nurse or anyone that serves students when they go into the health room would be the best person to monitor the students symptoms. It is best practice to review the student’s symptoms once weekly. This should be a conversation to help develop a relationship with the student, NOT a checklist given to the student to fill out.

Academic – A counselor or teacher should help the student to monitor their academics

Missing assignments and not feeling well can be overwhelming. Having someone the student can discuss school work with and help streamline the work can be helpful.

Mental Health Monitoring

Mental health conditions, such as depression and anxiety, poor problem-solving skills, and considerations aligned with suicide risk can be associated with a traumatic brain injury in children. More than two in five (44.4%) TBI-related deaths were attributable to intentional causes (suicide and homicide). Suicide was the leading category or tied for the leading category of TBI-related deaths in 43 states in 2020. (Schuchat, et al, 2016)

Due to the serious increase of mental health issues and overall increased risk of suicide, it is important to begin mental health monitoring with the student as soon as you are aware of their injury. This monitoring should continue even after their concussion has been marked as cleared.

Clearance and Return to Play

All student athletes beginning at age 11 to 19 must have medical clearance prior to beginning a return to play. Students who are not athletes should follow best practice guidelines by being seen by a medical provider for clearance, and complete a return to play.

Students should be cleared when they no longer are having physical symptoms (at home and school), no longer needing academic adjustments, not experiencing any behavior or mental health changes. Open communication with the school team, family and healthcare provider is recommended when discussing clearance for a student with an injury.

Resources and Articles

Resources

Review the legislation and the Concussion Management Guidelines:

Read the Concussion Management Guidelines:

The Colorado REAP 2024 Concussion Guidelines

View free online training for educators and school professionals:

Children’s Hospital Colorado Concussion Program evaluates and treats children and teenagers who have sustained concussions and other mild head injuries:

Concussion Comeback Plan

To help ensure the health and safety of young athletes, the Centers for Disease Control offers information about concussions to those involved in youth sports:

Information to help everyone from students to the school administrator—recognize a concussion and know how to manage it effectively:

CBIRT – Center On Brain Injury Research & Training

Brain Line is an website dedicated to resources developed to assist in preventing, treating and helping to live with a brain injury:

Brain Line For Kids