Many students not getting recommended concussion care

Prompt diagnosis and treatment can reduce risk of long-term psychological and cognitive harms, an injury-prevention specialist says.

Although public awareness of concussion dangers has improved over the years, many young people with the injury are not being diagnosed and receiving the care they need, says Dr. Monica Vavilala. She is a professor of anesthesiology and pain medicine at the University of Washington School of Medicine and director of the Harborview Injury Prevention and Research Center (HIPRC).

As many as 7% of U.S. youth will have at least one concussion before age 18, according to a recent study from the U.S. Centers for Disease Control and Prevention. Adolescents ages 13 to 17 are at the highest risk, among whom the prevalence is estimated to be as high as 18%, the study reported. 

“People used to think of concussions as being something different from a traumatic brain injury — that concussions were mild, no big deal and didn’t really require that much attention,” Vavilala said. “But work done here at UW Medicine and HIPRC has shown that there are long-term sequelae from concussions that are going under-recognized and undertreated.”

After a concussion, people often experience headaches, fatigue, difficulty with concentration, and emotional problems such as anxiety and depression. For students, these symptoms often lead to difficulty with schoolwork and lower grades.

Parents must be vigilant, aware of the signs of concussions, and not ignore them but instead seek medical attention for their child, Vavilala said.

“While most kids recover within a couple of weeks, there are some who are going to have persistent symptoms," she said. "So it’s important that they be evaluated and followed."

To help students in this circumstance, some schools in Washington state have adopted a concussion-recovery program called "Return to Learn." Developed by the CDC, the program recommends that schools make accommodations for these students. Such accommodations include physical and cognitive rest for several days after the injury and a gradual return to full academic activities based on a learning plan tailored to the individual student’s needs.

A recent study examined the implementation of "Return to Learn" protocols at 21 Washington public high schools during the COVID-19 pandemic. It found that 1 in 4 schools made no program-based accommodations during this span, and those that did still struggled to provide the recommended support. 

“I think schools really care about doing a good job with their students, but because of the pandemic they weren’t able to implement the return-to-learn policies,” Vavilala said. “If we’re really thinking about supporting these students, we need to resource schools so they are able to provide the return-to-learn accommodations.”

Washington, she noted, was the first state to pass a "Return to Play" law that requires athletes suspected of having a concussion to be evaluated by a medical professional, and be allowed to return to play only when deemed safe.

“We’re really looking forward to working with our policymakers to get a return-to-learn law passed, as well,” Vavilala said.

Download broadcast-ready soundbites with injury-prevention specialist Dr. Monica Vavilala.

Written by Michael McCarthy

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Tags:studentsconcussioncognitionhigh schoolbrain injuryyouth sports

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