Version June 2024
| Date: | |
| Patient name: | |
| The above patient was evaluated at _____________________________________after sustaining a head injury on __________________. | |
| The following document summarizes our academic recovery plan and recommendations. | |
| GENERAL CONSIDERATIONS: Although there is significant variability in symptom presentation and duration, all individuals who sustain a head injury will need time for their brains to recover. It is not unusual to experience headaches and difficulties with attention, concentration and memory. These symptoms resolve over time. However, if individuals return to pre-injury activity levels too quickly, there is the potential for long term impact. Getting more rest than usual, modifying daily routines, and managing expectations can all help facilitate recovery and minimize symptom severity. | |
| EDUCATIONAL ACCOMMODATIONS: The symptoms associated with head injury may affect academic performance. The cognitive exertion that school requires can provoke symptoms. Therefore, the following accommodations are recommended: | |
| School re-entry/attendance: | |
| Full days as tolerated. | Half days, may advance as tolerated. |
| Initiate homebound education. | No school until ________________, then attempt half/full days as tolerated. |
| * Full or partial days missed due to post-concussion symptoms should be medically excused. | |
| Academic testing: Students recovering from head injury often demonstrate difficulties with memory, attention, and processing speed. Highly demanding activities such as testing may exacerbate other symptoms. | |
| Extra time to complete tests. | Testing in a quiet environment. |
| Allow testing across multiple sessions. | Reduce length of tests. |
| Eliminate tests when possible. | Defer standardized or high stakes testing. |
| Reformat from free response to multiple choice or provide cueing (eg, use of a note card for helpful formulas). | Schedule no more than one test per day. |
| Curriculum accommodations: | |
| Extended time: Allow student extended time to turn in assignments. While experiencing symptoms and whenever symptoms increase, students are advised to rest, and therefore may need a modified schedule for completing assignments. | |
| Workload reduction: Reduce overall amount of make-up work, class work, and homework. Examples of how to shorten work include reducing the length of essays, have the student do every other problem in a homework assignment, or highlight key concept areas for testing while eliminating testing on less critical topics. | |
| Make up/keep up: Develop a systematic plan for balancing the "make up/keep up" challenge of recovery. The process of making up missed work can be anxiety provoking and needs to be undertaken over time, with support and supervision. | |
| Note taking: Allow student to obtain class notes or outlines ahead of time to aid organization and reduce multi-tasking demands. If this is not possible, allow the student photocopied notes from another student. | |
| Breaks: Take breaks as needed. For example, if headache worsens during class, the student may need to put his/her head on the desk to rest. For more severe symptoms, he/she may need to go to the nurse's office. In some situations, scheduled breaks interspersed throughout the day may be required. | |
| Home accommodations: | |
| Limit activities that have been found to provoke symptoms, including texting, computer games, TV, reading. | |
| Get more rest than usual. Get enough sleep. Sleep is particularly important during recovery. Avoid sleepovers and late nights. | |
| Don't over schedule. Be careful with pacing. | |
| Stay hydrated. | |
| Avoid busy, noisy, highly stimulating environments. | |
| ATHLETIC ACCOMMODATIONS: Your child should not return to athletics until allowed to do so by a physician experienced in the management of sport-related concussion. The return to athletics should be gradual, should be monitored by a physician, and should proceed in a step-wise fashion. The following steps should be monitored: | |
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| Restrictions: The patient should restrict athletic activities to those permitted below. | |
| No gym class. | |
| Restricted gym class activity as specified below: | |
| Light non-contact, non-risk exertion only. | |
| Up to moderate non-contact, non-risk exertion only. | |
| Up to heavy non-contact, non-risk exertion only. | |
| No group sport, no contact sport. | |
| Follow-up evaluation and revision of recommendation to occur ____________________________________. | |
| Sincerely, _____________________________________ | |
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