Reentry to School After a Concussion or Closed Brain Injury

Creating a system to identify and track students returning to school after a concussion or closed head injury is an important step to helping them. Often students return to school with subtle cognitive, academic, or behavioral needs. Addressing these changes and meeting students’ needs soon after their return to school can prevent many long-term difficulties.

Identification

Initially, it is important to inform a designated person in the school that a student has had a possible brain injury, which will most likely resolve over a few days. The identified person then watches for any of the possible red flags listed below:

• Increased absences
• Cognitive difficulties compared to pre-injury performance
  • Trouble paying attention
  • Difficulty remaining on task
  • Slowed responses and/or processing of information
  • Difficulty shifting attention from task to task or from topic to topic in conversations
  • Reduced mental flexibility
  • Organizational challenges
  • Reduced academic performance
• Social difficulties compared to pre-injury
  • Impulsive behaviors
  • Initiation difficulties (trouble starting things)
  • Changes in mood
  • Depression
  • Defiance
  • Fatigue
  • Confusion

Accommodations

If red flags appear, the designated staff person can alert the teacher to minimal temporary accommodations for the brief time that symptoms exist. Such accommodations might include:

• Reduced assignment load
• Increased time to complete assignments or exams
• Use of an organizer to track assignments
  • Check with teacher at the end of the day to make sure assignments are recorded
• Rest periods during the day
• Directions in both oral and written formats
• Clear expectations
• Large tasks broken into smaller components

If the student continues to have academic difficulty after a month, a team should further evaluate the student’s concerns, and begin the evaluation process for more formalized support, such as a 504 plan or IEP. At this point, gathering more information about TBI and/or contacting a person who is knowledgeable about TBI to participate in planning is advisable.

Adapted from:

Ylvisaker, M. (1998). Traumatic Brain Injury Rehabilitation (2nd ed.), (pp. 381–384).  Michigan: Butterworth-Heinemann.