The conversation in schools about concussions is expanding beyond the football fields, the locker rooms and the health offices into guidance departments.
As noted in the March/April edition of Communique , the newspaper of the National Association of School Psychologists, “almost everyone understands the rationale for physical rest following a concussion.” Although my experience in the field out there among students, athletes, parents, coaches and others might show that this is somewhat of an overstatement, in general you might have been living under a log to have missed the recent news about the more conservative management of concussions.
In brief, we now know that a concussion is an injury to the brain at a cellular level and causes metabolic disturbances in its energy requirements such that any mental, physical or emotional demand on it can exceed its ability to cope. When that happens symptoms-the most basic of which may be a headache-will flare. Recently, however, studies have also shown that “experts have come to the realization that cognitive demands …can worsen and can delay recovery” as well. Although there are no pat formulas and each case is individual and can be a “moving target” in its recovery pathway, it is now recognized that schools will play an important role in the process of returning students to learning or RTL as much as the athletic department will be involved in RTP or return to play.
This Communique article, Return to Learning: Going Back to School Following a Concussion was written by Karen McAvoy who has been a consultant with the Colorado Department of Education and director of the Center for Concussion with the Rocky Mountain Hospital for Children. She and her colleagues developed a model program called REAP (Reduce, Educate, Accommodate and Pace) in order to help schools and communities respond to the new information, needs, changing culture and liabilities around head injuries:
REAP details how the coach, athlete, parents, school staff and medical professionals can best work together. It’s written in such a way that it’s adaptable to different school districts and communities, so as to not put a strain on resources — both financially and in terms of personnel.
The word “accommodate” makes certain ears perk up in the school community but in the Communique article, McAvoy makes a clear distinction between individual “adjustments” in the first few days to couple of weeks following a head injury (not unlike any other illness or injury, viz Mono) and the more long term and more expensive “accommodations” that may come into play later on.
The entire REAP program and its graphically engaging manual has been generously made available online to communities everywhere to help communities and schools coordinate the legal, administrative, health, athletic, medical, and family aspects of managing students brains after injury. Nothing less than their intellectual and psychosocial futures are at stake.