Reentry to School After a Concussion or Closed Brain Injury

Center on Brain Injury Research and Training
Reentry to School After a Concussion or Closed Brain Injury

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

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
    • Organization 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, the student’s concerns should be further evaluated by a team, and the evaluation process for more formalized support such as a 504 plan or IEP begun. At this point, gathering more information about TBI and/or contacting a person who is knowledgeable about TBI to participate in planning is advisable.

Posted on BrainLine June 21, 2010.

Sources: This information was synthesized from Ylvisaker, M., Traumatic Brain Injury Rehabilitation, 2nd ed. Pages 381–384.

From the Center on Brain Injury Research and Training. Reprinted with permission.

Comments (1)

It is important to recognise the life changing nature of TBI and arrange lifelong support straight away. The problems will get much worse if not recognised in the first instance, especially as the victim will be under extreme pressure to deny any sort of disability due to social reasons.