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Helpingstudentssucceedintheirrecoveryfromaconcussionknowthefacts TeachersandparentsusethisguidefromChildrensHospitalColoradotohelpyourstudentsandchildrensucceedinschoolafteraconcussionbasedontheleadingmostup-to-dateresearch.Visitchildrenscolorado.orgconcussionforalistofcurrentresearch. knowthefactsaboutcomingbackfromaconcussion 4ConcussionComebackWhatisaTraumaticBrainInjuryTBIATBIisatypeofacquiredbraininjurythatoccurswhenanexternalforcecausesinjuryordamagetothebrain.SeverityofabraininjuryWhatisaConcussionmildmoderatesevereThemajorityofTBIsaremildinjuriesorconcussionsgenerallyresultsintemporaryproblems.Oftenrequiresextendedhospitalizationfrequentlyincludesdamagetothebrainleadingtolastingcognitiveacademicandpsychologicalproblems.AconcussionisatypeofmildtraumaticbraininjuryTBIcausedbyaforcefulbloworjolttotheheadthatdisruptshowthebrainnormallyworks.Usuallythesignsandsymptomsareimmediate.oApersondoesnotneedtobeknockedoutorloseconsciousnesstohaveaconcussion.o8090ofTBIsareconcussions.CONCUSSIONSOCCURHERE 5Formoreinformationvisitchildrenscolorado.orgConcussionSchoolpersonnelshouldbeawareofsymptomsthatcommonlyoccurafteraconcussion.Fortunatelyformoststudentsthesesymptomswillbetemporary.PhysicalHeadachesBlurredvisionNoiseorlightsensitivityNauseaDizzinessBalancedifcultiesSleepchangesEasilyfatiguedCognitiveDifcultiessustainingattentionEasilydistractedMentallyfoggySlowedthinkingEasilyconfusedMoreforgetfulDifcultyfollowingthroughontasksDifcultyfollowingdirectionsBehavioralEmotionalMoreirritableEasilyfrustratedMoreemotionalMoresadandoranxious 6ConcussionComebackTRUTH 7Formoreinformationvisitchildrenscolorado.orgConcussionThetruthaboutconcussionsoMostyoungpeoplerecovercompletelyfromaconcussionwithinacoupleofweeksmorerarelyproblemslastlonger.Persistentproblemscanberelatedtotheseverityoftheinjuryandalsotonon-injuryfactorslikestress.oAslongasanappropriatehealthcareproviderisinvolvedthestudentmayreturntoschoolevenwithmildsymptoms.Severesymptomsrequireadditionalmedicalfollow-up.Keepingachildoutofschoolforalongtimeoftencausesunintendedacademicsocialandemotionalproblems.oTheresnocompellingresearchtoindicatethatcompleterestisaneffectivelong-termtreatmentfollowingaconcussion.oAtrstitsimportanttoreducestimulationfollowingaconcussionbuttheresnogoodevidencethatreadingwatchingTVortextingwillprolongconcussionsymptoms.oMostofthetimestudentsdonotneedspecialeducationservicesusuallyshort-terminformalaccommodationsareenough. 8ConcussionComeback 9Formoreinformationvisitchildrenscolorado.orgConcussionWhatifastudenthashadaconcussionAnystudentwhohashadaconcussionshouldseekoutahealthcareproviderwhoisknowledgeableaboutconcussionsforanevaluationcareplan.Followingtheconcussionstudentsmaydisplayavarietyofsymptomsthatcouldmakeschoolworkmorechallenging.Mostkidsdontneedanextendedschoolabsenceandwillonlymissadayortwoofschooleveniftheyarenotentirelybacktonormal.Themajorityofchildrenandadolescentswhosustainconcussionswillrecovercompletelywithinaweekortwobutitmaylastlongerforsome.Seethe504Plansectionifthestudentneedslong-termsupportatschool. 10ConcussionComebackTheConcussionComebackPlan 11Formoreinformationvisitchildrenscolorado.orgConcussionCreateaConcussionComebackPlantohelpthestudenttransitionsuccessfullybacktoschool.Everystudentandconcussionisdifferentsothesestepsserveasageneralguideline.Eachstudentwillneedaplantailoredtohisorherspecicneedsandcircumstances. 12ConcussionComebackFACTAftertherstfewdaysitsimportanttoreturntonormaldailyroutineslikegoingtoschool.Knowthebasicsandtheeffectsonfunctioning.oSymptomsfromaconcussionwilllikelybemostsevereintherstfewhoursanddaysfollowingtheinjury.oRightafteraconcussionrestanddecreasedactivitycanbehelpful.Butaftertherstfewdaysitsimportanttograduallyreturntodailyroutineslikegoingtoschool.Thestudentmayneedtomodifyhisorherscheduletoensuresuccess.oAthletesshouldonlyreturntoplayafteraconcussionunderthesupervisionofaqualiedhealthcareprovider.TimeofInjuryMayormaynotloseconsciousnessorbeknockedout.FirstfewminutesSymptomsoccur.FirsthourstofewdaysSymptomsprominent.Restanddecreaseactivity.WithinafewdaysReturntoSportsReturntoschool.Returnonlyunderthesupervisionofaqualiedhealthcareprovider.TypicalConcussionTimeline1.Understandconcussion 13Formoreinformationvisitchildrenscolorado.orgConcussionThiscouldbeaschoolnursecounselorpsychologistspecialeducatororclassroomteachersomeoneatschoolwhotakestheleadincommunicatingandpartneringwiththestudentfamilyschoolstaffathleticpersonnelandhealthcareproviders.DutiesoftheComebackCoordinatoroHelpgatherinformationUnderstandanddiscussthenatureofthestudentsinjurycurrentstatusandexpectedrecoverycoursewiththestudentstudentscaregiversandorhealthcareteam.oDocumentDocumenttheinformationinthestudentsschoolandathleticrecordforlaterreference.oCommunicatewithschoolpersonnelConveytheinformationorallyandinwritingtoallrelevantschoolstaffincludingteachersadministratorsandathleticpersonnel.oCommunicateoutsidetheschoolProvideinformationtocaregiversandinvolvedhealthcarepersonnelaboutanysymptomsseenatschoolandhowthestudentismanagingtheschooldemandssoyoucancollectivelydevelopsupportifneeded.ComebackCoordinatorHelpgatherinformationDocumentCommunicatewithschoolpersonnelCommunicateoutsidetheschool2.AssignaComebackCoordinator 14ConcussionComebackTheeducationalteamisespeciallyimportantinprovidingasoftlandingbackintoschool.oForstudentswhocouldbenetfromagradualtransitionnotallwillneedthisreturningforanhourortwoatrstmaybeworthwhilebeforebuildinguptohalf-daysthenfull-days.oTheeducationalteamshouldremainexiblewiththestudentsscheduleandworkloadexpectationsuntilthestudentisfullyrecovered.oThestudentmayneedavarietyofschool-basedsupportsaslistedinthefollowingsection.Thesearetypicallybestinstitutedinformallyastheneedisusuallytemporary.oTailorsupporttothestudentsspecicneeds.HowtohelpastudentwhohashadaconcussionGeneraloExcusethestudentfromclassesoractivitiesthatrequirerigorousphysicalactivitye.g.physicaleducationrecessuntilclearedbymedicalpersonnel.oHaveaComebackCoordinatormeetwiththestudenteachdaytomonitorschooladjustmentassistwithcommunicationinsideandoutsideschoolcoordinateandmonitoraccommodationsandensuretheworkloadismanageableforthestudent.oProvideresttimeorbreaksduringthedaye.g.allowthestudenttogotothehealthcareofcewhenexperiencingheadachesandreturntoclasswhenfeelingbetter.3.Supportthestudent 15Formoreinformationvisitchildrenscolorado.orgConcussionhowtohelpsupportthestudentClassroomoProvidepreferentialseatingtoallowforcloseteachermonitoringandfacilitatefocusedattention.oAssignagoodnote-takerineachclasswhocanprovidenotestothestudentdaily.oProvidemoreopportunityforafter-classorafter-schoolfollow-uptoensuresuccessfulunderstandingandlearning.SchoolworkoDesignareasonableplanofassistancetosupportcompletionofmissingassignments.oExcusemissednon-essentialassignmentsexams.oReduceormodifyclassroomandhomeworkassignments.oGrantadditionaltimeforhomeworkexamsandassignments.oNegotiatetimingoflargeassignmentsandexamssothatduedatesdonotfallatthesametime.TestingoCarefullyconsiderwhetheranyupcomingstandardizedtestse.g.statetestingcollegeentranceexamsshouldberescheduled.oRescheduleexamsifstudentissymptomaticorcoordinateandpaceexamstonomorethanoneperday.oAllowstudentstotaketestsinadistraction-freeenvironment. 16ConcussionComebackAllinvolvedschoolstaffshouldcarefullymonitorthestudentforpotentialdifcultiesintheweeksafteraconcussion.TheComebackCoordinatorshouldberesponsibleforregularlycheckinginwithclassroomteachersandotherrelevantstaffuntilproblemshaveresolved.IfanyproblemsareapparenttheComebackCoordinatorshouldensuretheparentsandhealthcareteamarenotied.IngeneralschoolpersonnelshouldlookoutforoAnychangeinfunctioningwithintheschoolenvironmentoDropingradesoSocialoremotionalchangesoUnexpectedorprolongedabsencefromschoolThefollowingcouldindicatethestudentsufferedamoreseverebraininjurythanaconcussionandrequiresimmediatemedicalattentionSignicantdrowsinessorcannotbeawakenedAheadachethatisespeciallysevereorgetsworseanddoesnotgoawayWeaknessnumbnessordecreasedcoordinationRepeatedvomitingSlurredspeechConvulsionsorseizuresIncreasingconfusionrestlessnessoragitationUnusualbehaviorIfyounoticethesebehaviorscall911.Watchforwarningsigns4.Monitorthestudent 17Formoreinformationvisitchildrenscolorado.orgConcussionItsraretoseeseriouscomplicationsafteraconcussioniftheydooccuryougenerallyseethemwithintherstfewhourstodaysafterinjury.Howevertherearesomesituationsinwhichyoumayneedtoconsultwithoutsidehealthcareprofessionalsorbraininjuryspecialistsiftheyarenotalreadyinvolved.TheseincludeoProblemsafteraconcussionlastmorethantwoweeksoUncertaintyaboutwhichphysicalorathleticactivitiesaremedicallysafeandsensibleoCognitiveoracademicproblemsappearespeciallysevereoStudenthassustainedmultipleconcussionsoStudenthassustainedabraininjurythatinvolvesanabnormalCTorMRIscanoStudentsustainsamoreseverebraininjurye.g.amoderateorsevereTBITheappropriatespecialistwilldependuponthenatureoftheproblemandtheservicesavailableinthecommunity.Ongoingphysicalproblemse.g.headachesordizzinesswarrantinvolvementfromaqualiedmedicalprovider.Lastingorseverecognitiveoremotionalproblemswarrantinvolvementfromaneuropsychologist.5.Whentoconsultahealthcareprovider 18ConcussionComebackWhataboutstudentswhoareslowtorecoverAminorityofstudentsmaydisplaypersistentproblemsafteraconcussionthatcouldinterferewithschoolperformance.Aconcussionspecialistwhohasexpertiseincognitionandbehaviore.g.neuropsychologistshouldevaluatethesestudentstobetterunderstandwhytheyarenotrecoveringasexpected.Thesestudentsmayrequireformalaccommodationsatschoolsuchasthoseimplementedthrougha504Planasdescribedbelow.Whatisa504planASection504PlanispartoftheCivilRightsLawthatprohibitsdiscriminationagainstindividualswithdisabilities.Section504formalizesaccommodationsandmodicationstoensurestudentswithdisabilitieshaveequalaccesstoafreeandappropriateeducation.A504PlanisdifferentthananIndividualizedEducationPlanIEPwhichisamoreextensivespecialeducationplanthatisrarelyneededforchildrenrecoveringfromaconcussion.Doeseverystudentwhohashadaconcussionneeda504PlanThemajorityofstudentswhosustainaconcussionwillrecoverquicklyandwillnotneedformalizedschoolaccommodations.Formoststudentsinformalschoolaccommodationsinthedaystoweeksfollowingaconcussionwillsufce.Intherarecasesofprolongedpost-concussionsymptomsa504Planmightbehelpful.504Plan ChildrensHospitalColoradoConcussionProgramChildrensColoradooffersappointmentsintheConcussionProgramvedaysaweekinvariouslocationsthroughouttheDenvermetroareaincludingChildrensHospitalColoradoAnschutzMedicalCampusAuroraChildrensHospitalColoradoNorthCampusBroomeldChildrensHospitalColoradoTherapyCareBroomeldChildrensHospitalColoradoOrthopedicCareCentennialChildrensHospitalColoradoatSt.JosephHospitalDenverChildrensHospitalColoradoSouthCampusHighlandsRanchChildrensHospitalColoradoOutpatientSpecialtyCareParkerChildrensHospitalColoradoUrgentandOutpatientSpecialtyCareWheatRidgeChildrensHospitalColoradoOutpatientSpecialtyCareatBriargateColoradoSpringsTolearnmorevisitchildrenscolorado.orgconcussion.ToscheduleanappointmentwiththeConcussionProgramcall720-777-2806.19Formoreinformationvisitchildrenscolorado.orgConcussion AnschutzMedicalCampus13123East16thAvenueAuroraColorado80045childrenscolorado.orgconcussion