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Shepherd HA, Heming E, Reed N, Caron JG, Yeates KO, Emery CA. Describing High School Stakeholders' Preferences for a Return-to-School Framework Following Concussion. THE JOURNAL OF SCHOOL HEALTH 2024; 94:638-646. [PMID: 38263947 DOI: 10.1111/josh.13434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Return to school supports are recommended to facilitate adolescents' re-entry to school following a concussion. However, little is known as to what school stakeholders prefer for a return-to-school process. This study sought to describe the preferences of high school students, parents, and educators for a Return-to-School Framework for adolescents following a concussion. METHODS We conducted qualitative semi-structured, 1-on-1 or group interviews with high school students (n = 6), parents (n = 5), and educators (n = 15) from Calgary, Canada. Interviews aimed to describe participants' preferences for a Return-to-School Framework for students following a concussion. Interviews were analyzed using conventional content analysis. RESULTS We organized the data into 4 main themes: (1) purpose of the Return-to-School Framework; (2) format and operation of the Return-to-School Framework; (3) communication about a student's concussion; and (4) necessity of concussion education for students and educators. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY A Return-to-School Framework following concussion should be developed in consultation with families, educators, and students and supports should be tailored to each student. CONCLUSIONS Participants preferred a standardized and consistent Return-to-School Framework including ongoing communication between stakeholders as well as feasible and individualized school supports.
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Affiliation(s)
- Heather A Shepherd
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Emily Heming
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Nick Reed
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Jeffrey G Caron
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montreal, Canada
- Center for Interdisciplinary Research in Rehabilitation, Montreal, Canada
| | - Keith O Yeates
- Department of Psychology, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Carolyn A Emery
- Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
- Departments of Pediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Riccardi JS, D'Angelo E, Hagen EB, Pei Y, Ciccia A, Haarbauer-Krupa J, O'Brien KH, Lundine JP. The Importance of Identifying Children With Brain Injury in Schools: Speech-Language Pathologists as Crucial Partners. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-4. [PMID: 38857435 DOI: 10.1044/2024_ajslp-24-00107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
PURPOSE The purpose of this article is to describe the importance of and strategies to identify traumatic brain injury (TBI) and associated cognitive-communication disorders (CCDs) in children, a priority identified by the attendees at the Fourth International Cognitive-Communication Disorders Conference. Childhood TBI is associated with a range of difficulties, including CCDs, that can adversely impact functioning and participation into adulthood. Identifying a history of TBI in children in schools is the crucial first step to then monitor, assess, and provide evidence-based intervention and accommodations in collaboration with families and medical and educational professionals. CONCLUSION Given that CCDs are treatable, effective identification, assessment, and management of students with TBI and resulting CCDs can reduce adverse outcomes in adult survivors of childhood TBI. Speech-language pathologists must be aware of their expertise in assessing and treating CCDs in children with TBI and advocate for programmatic and policy changes to better identify and support children with TBI.
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Affiliation(s)
- Jessica S Riccardi
- Department of Communication Sciences and Disorders, The University of Maine, Orono
| | - Elisabeth D'Angelo
- Department of Communication Sciences & Disorders, California State University, Sacramento
- Department of Physical Medicine and Rehabilitation, University of California, Davis Medical Center, Sacramento
| | - Erika B Hagen
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Yalian Pei
- Department of Communication Sciences and Disorders, Syracuse University, NY
| | - Angela Ciccia
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | | | - Katy H O'Brien
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN
| | - Jennifer P Lundine
- Department of Speech and Hearing Science, The Ohio State University, Columbus
- Department of Speech Pathology and Inpatient Rehabilitation Program, Nationwide Children's Hospital, Columbus, OH
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Lundine JP, Hagen E, Davies S. Perspectives on care coordination for youth with TBI: Moving forward to provide better care. NeuroRehabilitation 2023:NRE220196. [PMID: 37125565 DOI: 10.3233/nre-220196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
BACKGROUND Care coordination aligns services and optimizes outcomes for children with traumatic brain injury (TBI), yet numerous obstacles can impede effective care coordination following a TBI. OBJECTIVE The goal of this work is to identify barriers and facilitators to care coordination from the perspective of individuals who care for young people impacted by TBI (e.g., medical providers, educators, caregivers). METHODS Twenty-one care providers participated in semi-structured interviews to gather their perspectives on systems of care coordination for youth with TBI and potential areas for improvement. Using reflexive thematic analysis, researchers identified key themes across interviews. RESULTS Three themes were identified: 1) gaps in knowledge; 2) poor collaboration and communication between systems and care providers; and 3) inadequate legislative and policy frameworks that fund and support pediatric TBI. Across themes, participants shared their experiences and ideas to improve each of these areas. CONCLUSION A structured, consistent, and coordinated system of care for pediatric TBI is critical to ensure optimal outcomes. Protocols that emphasize intentional and productive collaboration between healthcare settings and schools and education for all care providers are cornerstones in improving outcomes for children. Top-down action that develops policy and funding initiatives is needed to ensure equitable, consistent access to appropriate healthcare and educational supports.
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Affiliation(s)
- Jennifer P Lundine
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
- Division of Clinical Therapies and Inpatient Rehabilitation Program, Nationwide Children's Hospital, Columbus, OH, USA
| | - Erika Hagen
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, USA
| | - Susan Davies
- Department of Counselor Education and Human Services, University of Dayton, Dayton, OH, USA
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Academic and post-secondary participation of students with ABI after the BrainSTEPS program. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Purpose:
To describe and analyze educational and post-high school participation of individuals who sustained an acquired brain injury (ABI) during childhood and participated in a state-wide school-based brain injury support program, BrainSTEPS in Pennsylvania (BrainSTEPS).
Method:
Retrospective analysis of programmatic information and data collected through electronic and phone surveys during a follow-up survey for a statewide, school-based, school consultation program for students with ABI.
Participants:
Caregivers reported on 190 individuals with ABI who participated in Pennsylvania’s BrainSTEPS Program.
Results:
Individuals post-ABI who participated in the BrainSTEPS were most likely to have experienced a mild ABI in high school due to sports. Post-injury, students were most likely to be enrolled in regular education, have graduated high school, pursued four-year college education and be attending post-secondary education and living with family. Additional significant relationships were not reported within the concussion or moderate-severe traumatic brain injury subgroups. Significant relationships for educational outcomes included higher likelihood of regular educational placement at the time of referral given an older grade at injury and regular educational placement before injury. For post-high school outcomes, a younger age at survey was associated with current attendance in post-secondary education, compared to other vocational options.
Conclusions:
Individuals with a history of ABI before school age and during primary and secondary education present with heterogeneous educational and post-high school outcomes. A greater breadth of measures of formal and informal educational and vocational supports and post-high school attainment should be implemented to accurately capture the needs and outcomes of these students to inform supports and services.
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Ciccia A, Lundine JP, O'Brien KH, Salley J, Krusen S, Wilson B, Kunz J, Haarbauer-Krupa J. Understanding Cognitive Communication Needs in Pediatric Traumatic Brain Injury: Issues Identified at the 2020 International Cognitive-Communication Disorders Conference. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:853-862. [PMID: 33621119 DOI: 10.1044/2020_ajslp-20-00077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose In early 2020, the second International Cognitive-Communication Disorders Conference was held to provide an opportunity for researchers and clinician-scientists to discuss the most recent advances and pressing issues in the care of individuals with cognitive-communication disorders (CCDs). Presentations and discussions resulted in the identification of four areas in need of attention: (a) terminology, (b) training, (c) interdisciplinary teams, and (d) pediatrics. We will explore the four themes identified at ICCDC, specifically expanding on how terminology, training, and teams intersect in pediatric traumatic brain injury care. Additionally, we will provide two case studies to highlight the integration of these themes and suggest ways to advance clinical service provision across medical and educational settings for persons with CCDs through the lens of pediatrics. Conclusion While speech-language pathology has come a long way since the original discussion of CCD over 30 years ago, clinicians and researchers have ongoing opportunities to help advance the ways in which speech-language pathologists offer support to persons, specifically children, with CCDs and to continue to advance the profession.
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Affiliation(s)
- Angela Ciccia
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Jennifer P Lundine
- Department of Speech & Hearing Science, The Ohio State University, Columbus
- Division of Clinical Therapies & Inpatient Rehabilitation Program, Nationwide Children's Hospital, Columbus, OH
| | - Katy H O'Brien
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Jessica Salley
- Communication Sciences Program, Department of Psychological Sciences, Case Western Reserve University, Cleveland, OH
| | - Sarah Krusen
- Bucks County Intermediate Unit 22, Doylestown, PA
| | | | - Jasmin Kunz
- Papillion La Vista Community Schools, Omaha, NE
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McAvoy K, Eagan-Johnson B, Dymacek R, Hooper S, McCart M, Tyler J. Establishing Consensus for Essential Elements in Returning to Learn Following a Concussion. THE JOURNAL OF SCHOOL HEALTH 2020; 90:849-858. [PMID: 32939780 DOI: 10.1111/josh.12949] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 03/30/2020] [Accepted: 03/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Returning to learn following a concussion is the process of managing a student's recovery during the school day by implementation of academic supports with varying intensity. Due to a lack of consensus or even guidance on Return to Learn, this paper set out to establish cross discipline consensus on some essential elements of Return to Learn using a Delphi method. METHODS Sixteen national organizations participated in a Delphi process to reach consensus on overarching themes of Return to Learn focused on: returning a student to school, composition of the school-based concussion management team, progress-monitoring, educational safeguards, neuropsychological testing, and legislation. Two rounds of questionnaires were disseminated via email using a Delphi process. Consensus was established during round 2. RESULTS Twelve national organizations were able to reach consensus and endorse 13 essential elements of Return to Learn following a concussion. CONCLUSIONS There continues to be limited research on concussion Return to Learn leading to confusion in the field. In this paper, we demonstrate consensus on a number of essential elements, from a wide variety of professional disciplines who participate in the care of students following a concussion, as a starting place for some guidance on Return to Learn.
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Affiliation(s)
- Karen McAvoy
- Center for Concussion Rocky Mountain Hospital for Children, 10107 RidgeGate Pkwy, Suite #310, Lone Tree, CO, 80124
| | - Brenda Eagan-Johnson
- BrainSTEPS Brain Injury School Consulting Program, 1891 Old State Road, New Castle, PA, 16101
| | | | - Stephen Hooper
- Department of Allied Health Sciences, University of North Carolina, 333 S. Columbia Street, Suite 304, Chapel Hill, NC, 27514
| | - Melissa McCart
- Center on Brain Injury Research and Training, Rainier Building, 1244 Walnut Street, Suite 220, Eugene, OR, 97403
| | - Janet Tyler
- Health and Wellness, Colorado Department of Education, 201 East Colfax Avenue, Denver, CO, 80203
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Beidler E, Welch Bacon CE, Hattrup N, Powers C, Saitz L, McLeod TV. Going Beyond the State Law: Investigating High School Sport-Related Concussion Protocols. J Athl Train 2020; 57:466508. [PMID: 34129675 PMCID: PMC8775288 DOI: 10.4085/1062-6050-0505.20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
CONTEXT State laws provide general guidelines for sport-related concussion (SRC) management, but do not comprehensively address the multiple layers of management for this complex injury. While high schools are encouraged to develop a SRC protocol that includes both state law tenets and additional management practices, the execution of this warrants examination. OBJECTIVE To investigate state law compliance and practice components included in high school SRC protocols, and determine whether the degree of sports medicine coverage influenced protocol quality. DESIGN Qualitative document analysis. SETTING High school athletics. PARTICIPANTS In total, 184 Pennsylvania high schools [24.3% of schools statewide; full-time athletic trainer=149, part-time athletic trainer=13, missing=21] voluntarily provided copies of their protocol from the 2018-2019 academic year. MAIN OUTCOME MEASURES Four athletic trainers conducted document analyses using a 67-item component analysis guide. Frequencies were computed for included protocol components related to the state law, preparticipation and prevention, recognition and assessment, and management. The difference in the total number of included components (max 60) by sports medicine coverage was assessed using a Mann-Whitney U test. RESULTS There was heterogeneity in components included in the submitted protocols. Only 23.4% included all mandatory state law tenets. Immediate removal from play was noted in 67.4% of protocols, while only 1.6% contained prevention strategies. Return-to-play was addressed more frequently than return-to-learn (74.5% versus 32.6%). The sample had a mean of 15.5±9.7 total components per protocol. Schools with full-time sports medicine coverage had significantly more protocol components than those with part-time athletic trainers (15 [8.5-22.5] versus 6 [3-10.5] median components; U = 377.5, p < .001) Conclusions: School-level written SRC protocols were often missing components of the state law and additional best practice recommendations. Full-time sports medicine coverage in high schools is recommended to increase SRC protocol and healthcare quality.
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Affiliation(s)
| | - Cailee E Welch Bacon
- A.T. Still University, Athletic Training Programs, School of Osteopathic Medicine in Arizona, 5850 E Still Circle, Mesa, AZ 85206, United States,
| | - Nicholas Hattrup
- Boston University, Athletic Training Services, 285 Babcock Street, Boston, Massachusetts 02215, United States,
| | - Cassidy Powers
- Duquesne University, Department of Athletic Training, 600 Forbes Avenue, Pittsburgh, Pennsylvania 15282, United States,
| | - Lilly Saitz
- Mount Holyoke College, Department of Environmental Studies, 50 College Street, South Hadley, Massachusetts 01075, United States,
| | - Tamara Valovich McLeod
- A.T. Still University, Athletic Training Programs, School of Osteopathic Medicine in Arizona, 5850 E Still Circle, Mesa, Arizona 85206, United States,
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