Return-to-learn after concussion Online Staff Training Public Schools of Robeson County

objectives Identify a team responsible for identifying and monitoring students who sustained an traumatic brain injury (TBI) Define Concussion State Board of Education Policy Signs and Symptoms of Concussion Concussion Recovery/Plan of Care Post-test

State board of education policy HRS-E-001 Return to Learn after Concussion Provides guidelines for the identification of students who have sustained a concussion Guides staff in the evaluation of a student with a concussion and provides guidelines for parent notification Provides parents and staff with concussion education Provides guidance for staff as they develop educational and health-related accommodations for students who have sustained a concussion Provides guidance for staff as they provide educational supports for students with prolonged symptoms related to concussion.

Hra-e-001 key components Public schools must: Develop a plan to include: Guidelines for removal Notification procedure Medical care plan/school accommodations Delineation of return to learn or play requirements Identify a team responsible for identifying and monitoring students who sustain mTBI Provide staff development on mTBI and district/school procedures (annually) Include a system of surveillance (questions about head injury) collected annually

Student or student’s parent Athletic Trainer or PE teacher R2l Team Student or student’s parent Principal School Nurse School Counselor Athletic Trainer or PE teacher 504 Coordinator

Concussion A concussion is a type of brain injury that changes the way the brain normally works. A concussion is caused by a bump, blow, or jolt to the head. Concussions can also occur from a fall or blow to the body that causes the head and brain to move rapidly back and forth. Even what seems to be a mild bump to the head can be serious

Key point !!! Preexisting problems following concussions in children are more common in those with previous head injury, as well as those who have experienced preexisting: Learning difficulties Neurological difficulties Psychiatric difficulties

How can a Concussion happen at school? Concussions can result from a fall or when a student’s head comes in contact with a hard object such as: Floor, desk, or another student’s head or body Physical education (PE class) Playground (falls off equipment) School-based activities (games such as football, volleyball, or baseball)

Concussion symptoms Physical Sensory Cognitive Blurred vision Headaches Balance issues/Dizziness Fatigue Nausea Difficulty sleeping Blurred vision Sensitivity to light or sound Mentally “foggy” Difficulty with memory and remaining focused

Return-to-learn video https://youtu.be/Z9W2kw9hUqw

Guidelines for Removal Any school employee who suspects that a student has suffered a concussion, or otherwise seriously injured their head, neck, or back will immediately remove the student from the physical or mental activity in order to reduce the risk of further injury. There is no one single indicator for concussion. The signs and symptoms of concussion can take time to appear and can become more noticeable during concentration and learning activities in the classroom. For this reason, it is important to watch for changes in how the student is acting or feeling, if symptoms become worse, or if the student just “doesn't feel right.”

Notification procedure The plan must include: a notification procedure to educate staff regarding removal from learn or play Information may be brought to school’s attention by: student or parent informing staff member Paperwork from a Medical Provider Upon notification of concussion, the team of professionals: Implements Return-to-Learn Protocol

Return to learn or play requirements Inform team of suspected or diagnosed concussion Include symptoms for parents and teachers to watch for Ask teachers to note needed accommodations or modifications List recommendations from physician (if provided) Contact 504 coordinator or School Nurse with questions or concerns regarding plan

Medical care plan and School Accommodations Medical Care Plan and School Accommodations are specific to the students’ recommendations made by the provider. If no recommendations are made by the medical provider, the nurse in consultation with the R2L Team should develop a plan of care based on student symptoms. Plans of Care Medical a document outlining the accommodations a student may need to address the medical symptoms they are experiencing following a concussion. Educational a document to address the academic and or functional difficulties a student may experience while recovering from a concussion.

School accommodations School professionals should watch for students who: show increased problems paying attention, remembering or learning new information, inappropriate or impulsive behavior during class, greater irritability, less ability to cope with stress, or difficulty organizing tasks. Students who return to school after a concussion may need to: Take rest breaks as needed, Spend fewer hours at school, Be given more time to take tests or complete assignments, Receive help with schoolwork, and/or Reduce time spent on the computer, reading, or writing. http://www.cdc.gov/headsup/pdfs/schools/tbi_classroom_tips_for_teachers-a.pdf

Plan of care Give a copy of the plan to the parent(s). Make sure all teachers are aware of the plan. If the plan crosses semesters, make sure to inform new teachers. If appropriate, make sure student is aware of plan and has steps to advocate for him/herself. The plan is reviewed as often as necessary.

Responsibilities of R2L team Parent will provide updates from physicians and notify R2L team if changes in behavior or school performance are noted. 504 Coordinator will follow up with parent as needed to insure student’s plan is being met and coordinates the development and follow-up of an educational plan of care. Teacher(s) alert parent and team to any concerns regarding behavior or school performance; participates in development of the educational plan of care; and provides accommodations as outlined in the education and medical plan of care.

Responsibilities of R2L team School Nurse contacts parent and provides educational material per nursing guidelines; completes nursing assessments; and coordinates development and follow-up of medical plan of care. Coaches/Athletic Trainers/PE Teachers follow concussion notification process and return to learn or play protocols an participate in development of educational and medical plans of care, as needed

resources http://www.cdc.gov/headsup/pdfs/custom/headsupconcussion_fact_sheet_for_sc hools.pdf http://www.cdc.gov/headsup/pdfs/schools/tbi_factsheet_nurse-508-a.pdf http://www.cdc.gov/headsup/pdfs/schools/tbi_schools_checklist_508-a.pdf http://www.cdc.gov/headsup/pdfs/schools/tbi_factsheets_parents-508-a.pdf http://www.cdc.gov/headsup/pdfs/schools/tbi_schools_magnet-508-a.pdf http://www.cdc.gov/headsup/pdfs/schools/tbi_returning_to_school-a.pdf

Complete post-test and submit to school nurse