Jul 19, 2018Plan in Motion
Last fall, a j.v. football player at Diamond Bar (Calif.) High School sustained a head injury at an away contest. When he returned to campus later that evening, our athletic training staff performed a full concussion evaluation, our concussion management protocol was activated, and our Concussion Management Team was notified via e-mail. The athlete was then sent home to rest, with instructions to see a physician as soon as possible.
The player’s mother took him to the doctor, who completed our Concussion Management Form. The student-athlete was officially diagnosed with a concussion and was told to return to school with the following academic supports:
• Allow extra time to complete coursework/assignments and tests.
• Lessen homework load by 50 percent.
• No significant classroom or standardized testing.
Two days following the injury, the student-athlete visited the athletic training room for his daily symptom assessment and said, “My teacher wouldn’t allow me to skip my English test today, and I totally failed. I had a headache all period, and she just didn’t believe me.”
In compliance with our return-to-learn protocol, I e-mailed his English teacher to discuss the situation. As it turned out, the teacher thought the student was simply acting out based on his previous behavior in class. I explained that concussed students can often mask their symptoms with behavioral changes or deny their symptoms because they just want to be back to normal. The teacher understood that we were collecting data on the player’s daily symptoms and that his headache always appeared while reading during English class — so he wasn’t faking it.
The teacher then complied with our supports, removed the athlete’s bad test grade, and allowed him to make up the test when he was released for full academic participation. He scored an 83 percent on the re-test, which was average for his academic performance.
Over the next few days, we continued to monitor the athlete’s symptoms daily, and his headaches eventually diminished. After a week, he was reviewed again by his physician, and his academic supports were lifted. The English teacher and I had a follow-up conversation once this happened to make sure she stayed in the loop.
One week after the athlete’s full academic release, the English teacher reported that he was acting out… The athlete admitted he had been trying to get an extension or excuse for a missed assignment. Because the teacher knew his academic supports were no longer necessary, she denied him, and he acted out in defiance.
One week after the athlete’s full academic release, the English teacher called me to discuss his behavior in class. She reported that he was acting out, being defiant, and generally making the class period a negative experience for the other students. She thought he was trying to abuse his injury and supports by blaming her for putting too much pressure on him when he was hurt.
This phone call initiated a meeting between the student-athlete, his parents, the English teacher, the student-athlete’s academic counselor, the school nurse, and me to ensure that something was not missed during recovery. The meeting unveiled no significant or lingering issues stemming from the original concussion.
Rather, the athlete admitted he had been trying to get an extension or excuse for a missed assignment. Because the teacher knew his academic supports were no longer necessary, she denied him, and he acted out in defiance. The athlete’s parents agreed that he was no longer suffering any concussion symptoms and should not have been given any more supports. Thus, all parties were on the same page once the appropriate information was communicated.
The student-athlete was reprimanded for his poor behavior in class, and the situation was resolved peacefully. Since then, he has successfully returned to play with no reoccurring issues from his original injury.
This example highlights how a return-to-learn protocol can work. Effective communication between members of the Concussion Management Team and a thorough process documenting daily symptoms kept the student-athlete’s academic performance from suffering. It also shows how teamwork among members of a concussion task force can prevent athletes from taking advantage of the system.
This article appeared in the March 2018 issue of Training & Conditioning.