Physician recommended school accommodations and student outcomes following a mild traumatic brain injury among youth with persistent post-concussive symptoms

Julian Takagi-Stewart, Ashleigh M. Johnson, Mallory B. Smith, Jin Wang, Lyscha A. Marcynyszyn, Douglas F. Zatzick, Carolyn A. McCarty, Frederick P. Rivara, Monica S. Vavilala

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

BACKGROUND: Post-concussion return-to-learn (RTL) guidelines include implementation of school accommodations. Yet, little is known about physician recommendations for school accommodations and their impact, particularly among youth experiencing persistent post-concussive symptoms (PPCS). OBJECTIVE: We examined the association between physician recommended school accommodations and student outcomes among youth experiencing PPCS. METHODS: Data from a randomized comparative effectiveness trial was used. Physician recommended school accommodations (≤90 days post-injury) were collected via chart abstraction. Grade point average was extracted from school records. Reports of problems at school, concussion symptoms, health-related quality of life (HRQOL), anxiety symptoms, and depressive symptoms were collected by survey (at baseline, three months, and 12 months post study entry). RESULTS: Of 200 participants (Mage = 14.7, 62% female), 86% were recommended school accommodations. Number of recommended school accommodations was positively associated with number of school problems at three months (aRR 1.18, 95% CI:1.12-1.24) and 12 months (aRR 1.11, 95% CI:1.05-1.18). No significant associations were found between recommended school accommodations and GPA, HRQOL, anxiety symptoms, or depressive symptoms. CONCLUSIONS: Physicians recommend more school accommodations for students experiencing more school problems post-concussion. Appropriate implementation of RTL recommendations made by physicians by fostering partnerships among physicians, students, and schools may be needed to achieve student-centered RTL.

Original languageEnglish
Pages (from-to)467-476
Number of pages10
JournalNeuroRehabilitation
Volume50
Issue number4
DOIs
StatePublished - 2022

Keywords

  • concussion
  • physician recommendations
  • return to learn
  • school accommodations
  • Traumatic brain injury

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