Concussion Management Training

http://www.brainsteps.net

Today I spent some time outside of the middle school at the local IU for Brain STEPS (Strategies, Teaching Educators, Parents, & Students) training. Brain STEPS is a brain injury school re-entry program that assists school districts in Pennsylvania with creating educational plans for students after a brain injury. Check out their link above for more detailed information. 

We are seeing an increasing number of students, many of whom are student athletes, being diagnosed with concussions each year. I am very appreciative my district has been so supportive of this initiative. We have formed a concussion management team consisting of an academic monitor (me), a symptom monitor (the school nurse), and a supervisor (the director of special education).  Today's program provided many helpful resources, particularly related to recommended protocol for returning to school after a concussion. Below I've included ideas for accommodations outlined in Brain STEPS's, Teachers’ Desk Reference:
Practical Information for Pennsylvania’s Teachers. Whether you have a concussion management team at your school or not, I though it might be helpful for other school counselors since we are often in charge of writing and managing 504 plans.  Enjoy!

The following are common concussion accommodations that should be considered during the initial weeks of recovery to alleviate cognitive fatigue and facilitate the cognitive rest needed for recovery.

• The student should be medically managed by a physician who is experienced in the management of concussions.
•  The student should not participate in physical education, sports, or physical activity during recess until the student is medically cleared.
• Mental work should never be substituted for physical activity (such as during physical education or recess). 
•  Standardized tests should be avoided during the initial weeks post-concussion, while the student is symptomatic.
• Tests should be delayed if scheduled during the initial 1 to 2 week(s) post-concussion.
• The student should be required to complete only one test or quiz per day, as tolerated.
• Rest periods in a quiet area may need to be added to the student’s daily schedule.
• Additional time should be provided for the student to complete homework and classwork.
• All assignments should be provided to the student in writing.
• Assignments should focus on essential key content while student is recovering. Remove nonessential classwork/homework.
• Assignments should not be repetitious. Once a concept has been mastered, grade the work that the student has completed. Fifty percent of the student’s typical workload is often times recommended during recovery (for example, the student would be responsible for completing 25 of the 50 math problems assigned).
•  Provide the student with alternatives to written output for tests, assignments, projects.
• Encourage the student to use word banks, timelines, calculators, and open notes/book.

Sensitivity to Light, Sensitivity to Noise, and Headaches

• Allow the use of sunglasses or ball caps to shield light.
• Seat the student in a dim area of the classroom, away from windows.
• Allow the use of headphones/earbuds to block noise.
• Temporarily excuse the student from loud classes (e.g., music, shop, band).
• Provide a quiet environment for the student to eat lunch (e.g., nurse’s office, guidance office).
• Give the student prior notice for a fire drill, tornado drill, etc.
• Provide the student with teacher notes when notes are presented using Power Point, a projector,
  or a SmartBoard

 Dizziness

•  Allow the student extra time to get to class before the halls become busy.
• Ask a peer to walk with the student.
• Have a peer carry the student’s books to and from class.
• Allow the student to use the elevator, if available.
• Provide the student with teacher notes to prevent up and down shifting of the student’s eyes; and, have the student follow along with a highlighter for key concept recognition.

Fatigue

• Build strategic rest breaks into the student’s schedule, not just as needed. Provide a 5 to 10 minute break every 30 to 45 minutes, initially, to alleviate fatigue. 
• Allow the student to put his or her head down on desk or rest his or her eyes.
• The student may initially require a half-day modified schedule in the morning or afternoon, dependent upon the level of fatigue.
• The student may only be able to attend school for 1 to 2 core classes or 1 to 2 specials initially.

Jess