Open AccessPhysician recommended school accommodations and student outcomes following a mild traumatic brain injury among youth with persistent post-concussive symptoms
Author(s) -
Julian Takagi-Stewart,
Alice Johnson,
Mallory Smith,
Jin Wang,
Lyscha A. Marcynyszyn,
Douglas Zatzick,
Carolyn A. McCarty,
Frederick P. Rivara,
Monica S. Vavilala
Publication year - 2022
Publication title -
neurorehabilitation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.611
H-Index - 65
eISSN - 1878-6448
pISSN - 1053-8135
DOI - 10.3233/nre-210324
Subject(s) - concussion , medicine , anxiety , traumatic brain injury , injury prevention , depressive symptoms , post concussion syndrome , physical therapy , poison control , clinical psychology , psychiatry , emergency medicine
BACKGROUND: Post-concussion return-to-learn (RTL) guidelines include implementation of school accommodations. Yet, little is known about physician recommendations for school accommodations and their impact, particularly among youth experiencing persistent post-concussive symptoms (PPCS). OBJECTIVE: We examined the association between physician recommended school accommodations and student outcomes among youth experiencing PPCS. METHODS: Data from a randomized comparative effectiveness trial was used. Physician recommended school accommodations (≤90 days post-injury) were collected via chart abstraction. Grade point average was extracted from school records. Reports of problems at school, concussion symptoms, health-related quality of life (HRQOL), anxiety symptoms, and depressive symptoms were collected by survey (at baseline, three months, and 12 months post study entry). RESULTS: Of 200 participants (Mage = 14.7, 62% female), 86% were recommended school accommodations. Number of recommended school accommodations was positively associated with number of school problems at three months (aRR 1.18, 95% CI:1.12–1.24) and 12 months (aRR 1.11, 95% CI:1.05–1.18). No significant associations were found between recommended school accommodations and GPA, HRQOL, anxiety symptoms, or depressive symptoms. CONCLUSIONS: Physicians recommend more school accommodations for students experiencing more school problems post-concussion. Appropriate implementation of RTL recommendations made by physicians by fostering partnerships among physicians, students, and schools may be needed to achieve student-centered RTL.