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 In most cases, these so-called "Return-to-Learn" laws hold schools
responsible for helping injured students resume regular studies, the
study found. But none of the laws spell out what support kids must
get when their symptoms linger long after a concussion.
"State Return-to-Learn laws are vague, and not uniform in their
target audience or recommendations," said senior study author Dr.
Monica Vavilala of Harborview Injury Prevention and Research Center
in Seattle.
"The focus around concussion is on return to play, and not
Return-to-Learn," Vavilala added by email. "We think that
Return-to-Learn should occur before return to play."
Each year, an estimated 1.1 million to 1.9 million children suffer a
concussion that requires them to miss school. Afterward, they must
figure out how to return to academics while they're also dealing
with physical, cognitive, emotional and sleep-related problems
stemming from the injury, researchers note in the journal
Pediatrics.
Nine in 10 of these injured students still have at least one
symptom-related academic issue when they return to school,
researchers note.
But fewer than one in five schools have formal plans in place to
help students navigate academics after a concussion, the authors
also point out.
To assess the effectiveness of laws focused on the academic aspects
of recovery, researchers examined laws on the books as of May 2016.
The study included laws in Illinois, Massachusetts, Maryland, Maine,
Nebraska, New York, Virginia and Vermont.
Since then, one more state - Oklahoma - passed a Return-to-Learn
law, Vavilala said.
Researchers considered laws to be focused on learning if they
contained language mandating specific actions at the state, local or
school level related to the academic reintegration of youth who have
sustained a concussion.
While all eight state laws required the establishment of specific
protocols for returning to academics, only half included any
standards for what should be included, the study found.
Where they did exist, standards were vague, without any specific
mechanism for assessing effectiveness or outcomes, the study found.
Only one state - Illinois - specified standards consistent with
guidelines laid out by the U.S. Centers for Disease Control and
Prevention for setting up post-concussion protocols.
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One limitation of the study is that it only examined state laws,
which may not account for policies in place at the local level or
for individual schools, the authors note. They also lacked data on
outcomes and on whether the laws worked well for individual students
or at specific schools.
It's also possible there may not be a need for state laws to spell
out the academic support students need after a concussion, a
separate team of researchers argued in an accompanying editorial.
That's because most concussion symptoms resolve within three weeks,
Dr. Mark Halstead, a sports medicine researcher at Washington
University in St. Louis, Missouri, and colleagues write.
When symptoms linger, schools are already legally required to
establish what's known as 504 Plans for students with substantial
educational difficulties, the editorialists write. Federal civil
rights laws also prohibit discrimination against students with
disabilities.
"There is already legislation in place to help support students in
the school setting, so the effort of additional legislation is
really an effort of redundancy," Halstead said by email. "What needs
to be done is making sure schools are aware and equipped on how best
to make the typical temporary adjustments that may be necessary to
help get kids through their schooling as they recover."
Concussion symptoms that hamper academics can sometimes be
invisible, though, and may include headaches, dizziness, fatigue,
emotional instability, and or sensitivity to noise or light,
Vavilala said.
"We do not want to create disability when students recover and are
no longer symptomatic but at the same time want to make sure
students receive timely and carefully crafted best practice academic
accommodations," Vavilala said.
SOURCE: http://bit.ly/2fvcu2u Pediatrics, online November 7, 2016.
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