O3281: Post Concussion Management of Student Athletes: How School Administrators are Failing to Ensure a Successful Return to the Classroom

Background: The U.S. Centers for Disease Control and Prevention (CDC) now estimate that 3.4 million high school students reported at least one concussion related to sports or physical activity. Maryland legislation guides the identification of concussive brain injury and its management described by the Maryland Public Secondary Schools Athletic Association. The lack of consistent implementation of educational interventions to support students’ return to the classroom (Return to Learn) has not had the desired effect. Despite legislation in all 50 states for return to play, we hypothesize there is an inconsistent approach for RTL protocols in Maryland secondary schools.

Methods: This study investigated the presence of protocols and actions to ensure appropriate accommodations, adjustments, and modifications to support students’ return to the classroom. A quantitative, exploratory, cross-sectional survey of school administrators was conducted to examine resources, knowledge, and practices about their management of student athletes returning to the classroom after a concussion. The study examined if RTL practices were aligned with the recommendations suggested by the American Academy of Pediatrics and 6th International Conference on Concussion in Sport.

Results: The population was secondary school administrators; principals, and assistant principals from Maryland public schools. Of the 401 recipients, 116 (28.9 %) school administrators responded to the survey. Sixty-seven participants (57.8%) reported the presence of a RTL Plan. The results indicate that 11% (n=13) did not have a plan and a large number (n=36, 31%) did not know if their school had a plan for RTL. Those administrators who had participated in concussion training were statistically more likely to have a RTL plan (χ2=11.079, df=2, p<.004). In districts requiring mandatory concussion training the presence of a RTL plan for school administrators was significant (χ2=9.633, df=2, p<.008). Results of alignment to accommodations are shown in Table 1, with 35% of administrators indicating they are unaware of accommodations in their school. Additionally, the largest challenge for school administrators to implement a RTL was communication (54.3%) with school stakeholders: physicians, coaches, teachers, students, and parents.

Conclusion: Too much attention is devoted to return to play, for students going to back to sports, however consistent RTL supports for athletes are missing. This study shows a lack of RTL plans in schools for students returning to the classroom following a sport-related concussion. Mandatory district training is required for school administrators to address the key components necessary for a comprehensive RTL plan and strategies to facilitate communication with all members of the school community to support student athletes recovering from a concussion.