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Journal Article

Citation

Takagi-Stewart J, Johnson AM, Smith MB, Wang J, Marcynyszyn LA, Zatzick DF, McCarty CA, Rivara FP, Vavilala MS. NeuroRehabilitation 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, IOS Press)

DOI

10.3233/NRE-210324

PMID

35180137

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.


Language: en

Keywords

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

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