5 Keys to Concussion Management Programs

The Centers for Disease Control and Prevention estimates 2.5 million sports- and recreation-related concussions occurred in the U.S. in 2016. That suggests school administrators should be ready to manage the inevitable consequences, requiring planning and serious attention, says Brenda Eagan Brown, state coordinator of BrainSTEPS, a 10-year-old program created by the Pennsylvania Department of Health.

BrainSTEPS assists school districts in developing return-to-learn concussion management programs and provides ongoing training to district staff, including superintendents.

Creating a robust program involves various parties. For superintendents, Eagan Brown points to five considerations.

Litigation

Concussion management protocols often are implemented in response to lawsuits when parents will claim their children have not received sufficient academic support during recovery. School districts are not protected from liability just because a student has returned to the classroom, Eagan Brown says. It’s critical that monitoring and care continue until all parties are satisfied the student has fully recovered.

She suggests the district retain the data and records because litigation sometimes occurs years after the actual injury. Approximately 70 percent of students will recover in four weeks, but 30 percent will take longer, according to a 2016 study published in the Journal of the American Medical Association. A small percentage will experience lifetime impacts.

Staffing

This is an enduring and chronic problem everywhere, but Eagan Brown says creating a formal return-to-learn team to handle concussion issues produces a better result than responding ad hoc.

Typical team members include principals, school psychologists, counselors and nurses who monitor academics and symptoms until the student recovers or needs to be evaluated for more formalized supports.

Funding

External resources are available at no cost, including GetSchooledOnConcussions.com, which offers free support materials. The site is run by Eagan Brown and Colorado-based Karen McAvoy, both of whom operate concussion training programs for schools. Their site provides teacher training (a bottom-up model) and principal/administrator training (a top-down approach). Both are valuable.

Priorities

If superintendents have to choose where to focus attention first, Eagan Brown says high schools top the list because that’s where concussions occur most frequently.

Outcomes 

With a management plan in place, don’t expect a drop in the number of concussions, Eagan Brown says. The benefit is a more consistent process for helping students achieve better outcomes.

In a study published in the October 2013 issue of Pediatrics, researchers found that concussed students who were on total cognitive and physical rest required 100 days to fully recover. Recovery was shortest, at 20 to 50 days, for students who returned to school and received appropriate care and academic adjustments.