Returning to the Classroom Following Student Concussions
To be heard and voted on in General Meeting 2 – Saturday, May 4
| 1. WHEREAS, | Concussions are a type of Traumatic Brain Injury (TBI) that require a balance between cognitive rest and reduced activity with a gradual return to both that will allow optimal brain recovery. Students who endure the symptoms of concussion may experience an increase in psychological and academic stress, and poor academic performance; and |
| 2. WHEREAS, | When a student is determined to have sustained a concussion, a medical professional can provide an individualized Return to Learn (RTL) plan indicating guidelines and accommodations needed to optimize post-concussive cognitive recovery, allowing the student to safely progress through stages of recovery that includes gradually returning to physical and cognitive activity; and |
| 3. WHEREAS, | Academic accommodations can minimize the detrimental impact of a concussion on academic progress and grades. A Return to Learn (RTL) plan helps provide a balance between promoting recovery from the brain injury by reducing the student’s cognitive load while at the same time preventing them from falling too far behind in the classroom which would add additional psychological stress; and |
| 4. WHEREAS, | Failure to implement an individualized Return to Learn (RTL) plan provided by a medical professional may cause prolonged and exacerbated concussion symptoms and recovery of the brain injury. Further academic complications may occur from the inability to match pre- concussion academic levels during recovery; and |
| 5. WHEREAS, | National and federal clinical guidelines recommend a high standard of Return to Learn (RTL) academic support for post-concussive cognitive recovery. California does not have law(s) supporting a concussed student’s Return to Learn (RTL). However, there are laws for students with concussions in all fifty states pertaining to the safe return to physical activity, known as Return to Play (RTP); now therefore be it. |
| 1. RESOLVED, | That California State PTA and its units, councils, and districts encourage the education of all members of the school and larger community regarding the cognitive impact of concussion on all students, and the need to follow nationally recognized concussion protocols for physical and cognitive recovery for all concussed students; and be it further, |
| 2. RESOLVED, | That the California State PTA and its units, councils, and districts seek and support legislation for state-wide policy change in both public and private schools that includes nationally recognized concussion recovery protocols that include individualized Return to Learn (RTL) plans to optimize a safe return to cognitive activity for all concussed students; and be it further, |
| 3. RESOLVED, | That California State PTA and its units, councils, and districts seek and support legislation for state-wide policy change for concurrent adherence to both Return to Learn (RTL) plans and Return to Play (RTP) plans for all students, based on national and federal clinical guidelines and recommendations; and be it further, |
| 4. RESOLVED, | That California State PTA and its units, councils, and districts advocate that our partners in the Education Coalition, as well as state and national organizations, provide support for implementing Return to Learn (RTL) practices and programs in both public and private schools focused on academic support aimed at counteracting concussions negative effect on academic progress and grades; and be it further, |
| 5. RESOLVED, | That this resolution be submitted for National PTA consideration. |
BACKGROUND SUMMARY
An estimated 1.5 million student concussions occur annually in children under eighteen years of age. Centers for Disease Control publishes a protocol for concussed students that includes a stepwise approach to returning to physical and cognitive activities. These protocols should be individualized by a healthcare professional to be utilized by students at home and at school to optimize recovery. Concussions, known as a Traumatic Brain Injury, typically represent neuropathological changes in the brain, showing as symptoms, the resolution of which, typically follows a course, though, in some cases, symptoms may be prolonged.
California law (and laws in all fifty states) governs the safe Return to Play (RTP) and physical activity for concussed students, via legislation AB-2127, that arose from the sharp increase in sports-related concussions in youth football, and the devastating consequences of TBI’s for students. No such California law exists to mandate a safe return to the classroom for concussed students (athlete or not). Just as RTP legislation dictates a safe return to sports and activity, a regulated, mandated and safeguarded Return to Learn (RTL) protocol policy is needed at the district, state and national level to meet the needs of concussed students. As concussion science and medicine rapidly evolves, meeting the needs of individuals with concussions in the classroom cannot be left to the best of intentions, rather it needs to be driven by a nationally recognized, peer-reviewed protocol, directed by an individualized plan from a healthcare provider and implemented by school district staff at the most local level.
Studies show statistically significant declines in academic performance following a concussion. A 2019 study showed 95% of concussed students’ grades were negatively affected, in addition to the psychological and academic stress caused by their injury. Many students diagnosed with a concussion are given detailed instructions about how to return to cognitive activity by their healthcare provider in a RTL plan (that accompanies their RTP plan), which is an individualized post-concussion school plan, based on the following important assumptions: need for flexibility and individualized academic supports, limiting cognitive activity to tolerable levels will prevent the reemergence of symptoms, varying rates of recovery, increasing/recurring symptoms require reduction/stopping cognitive activity.
Failing to adapt the academic setting, policies and procedures for an individualized RTL plan may result in the student experiencing detrimental social and emotional consequences including additional stress, pressure to keep up academically or push through symptoms to perform at the expense of healing and recovery. The state of California concussion bill AB-2127 urges the California Interscholastic Federation (CIF), the American Academy of Pediatrics (AAP) and the American Medical Society for Sports Medicine (AMSSM) to develop and adopt rules to implement the provision of AB-2127 which addresses RTP instructions for students with concussions. Importantly, CIF, AAP and AMSSM all recommend, support and publish recommendations for RTL plans to accompany RTP plans, which will ensure complete brain recovery while returning to mental and physical activity. Support from California State PTA and its units, councils, districts and lawmakers should mirror this.