1. Compared to students who had recovered post-concussion, actively symptomatic youth reported greater concern about the impact of their concussion on school performance and more school-related problems.
2. Regardless of time since injury, more severe post-concussion symptoms were associated with increased school-related and academic problems.
Evidence Rating Level: 2 (Good)
Study Rundown: Evidence-based policies on the post-concussion reintegration of youth to athletics are prevalent. However, although there is much support for standardized guidelines for students to return to their academic environments after a concussion, little research has quantified the academic struggles post-concussion. This study seeks to empirically describe the academic effects of concussions on students ages 5 to 18 years. Students from a single outpatient clinic were divided into 2 groups: actively symptomatic/not recovered and recovered. There were significant differences in neurocognitive performance between the 2 groups, as well as more post-injury school problems, difficulty in more than 1 class, and worry about school performance in the symptomatic group. Furthermore, students who experienced more severe post-concussive symptoms reporter greater academic difficulty. These findings may be limited by the subjective nature of student and parent self-reports. However, this study provides evidence of the negative impact of concussions on academic performance, thus emphasizing the need for evidence-based policies that effectively re-introduce students to their academic environment.
Relevant Reading: Returning to learning following a concussion
In-Depth [retrospective cohort]: Participants included 349 youths, ages 5 through 18 years, from the outpatient concussion clinic of a large regional medical center. The students were divided into 2 groups: actively symptomatic/not yet recovered (Rc-, n=240) and recovered (Rc+, n=109). Males made up 80% of the Rc+ group and 61% of the Rc- group. Participants and their parents were asked to fill out the Post-Concussion Symptom Inventory as well as the Concussion Learning Assessment and School Survey (CLASS) to measure the academic experience post-injury. Fifty-nine percent of Rc- students and 64% of their parents reported moderate or serious concern of recovery status and school performance compared to 16% of students and 30% of parents in Rc+ (P < .001). Of note, more high school students in the Rc- reported feeling high levels of concern (67%) compared to those in middle school (52%) and elementary school (38%, P < .05), while high school and middle school students reported significantly more academic problems compared to elementary school students (P < .001). Overall, 88% of students in Rc- (vs. 38% in R+) reported greater than 1 school problem related to concussion symptoms, while 77% (vs. 44% in R+) reported decreased academic skills (e.g. difficulty taking notes). The vast majority of students (90%) and parents (75%) in the Rc- group reported trouble with 1 or more classes, compared with less than half of Rc+ children and parents and children (48% and 27%, respectively).
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