title: Examining Academic Support After Concussion for the Adolescent Student-Athlete: Perspectives of the Athletic Trainer.
abstract: BACKGROUND
  Student-athletes may require cognitive rest and academic support after concussion. Athletic trainers (ATs) in secondary schools are uniquely positioned to provide medical care and to collaborate with school professionals while managing concussions. However, little is known regarding return-to-learn policies and their implementation in secondary schools.
  
  
  OBJECTIVE
  To examine ATs' perspectives on return to learn, cognitive rest, and communication with school professionals after concussion.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Web-based survey.
  
  
  METHODS
  A total of 1124 secondary school ATs completed the survey (28.5% response rate). The majority of participants were employed full time (752/1114 [67.5%]) in public schools (911/1117 [81.6%]).
  
  
  METHODS
  School and AT employment characteristics, demographics, number of concussions evaluated annually, and perceptions of school professionals' familiarity with ATs' responsibilities were independent variables.
  
  
  RESULTS
  Of the ATs, 44% reported having an existing return-to-learn policy. The strongest predictor of a return-to-learn policy was frequent communication with teachers after concussion (odds ratio = 1.5; 95% confidence interval = 1.2, 1.7). Most ATs recommended complete cognitive rest (eg, no reading, television; 492/1087 [45.3%]) or limited cognitive activity based upon symptoms (391/1087 [36.0%]). Common academic accommodations were postponed due dates (789/954 [82.7%]), rest breaks (765/954 [80.2%]), and partial attendance (740/954 [77.6%]). Athletic trainers self-reported as primary monitors of health (764/1037 [73.7%]) and academic progression (359/1011 [35.5%]). The strongest predictor of ATs' communication with school professionals was their perception of school professionals' understanding of ATs' roles.
  
  
  CONCLUSIONS
  Overall, ATs followed best practices for cognitive rest and return to learn after concussion. Although ATs are central to the management of student-athletes' physical health after concussion, school professionals may be better suited to monitor academic progress. Increased communication between the AT and school professionals is recommended to monitor recovery and facilitate academic support for symptomatic student-athletes.
authors.affiliation: California State University, Fullerton;
authors.forename: Tricia
authors.initials: T
authors.lastname: Kasamatsu
authors.affiliation: Chapman University, Orange, CA;
authors.forename: Michelle
authors.initials: M
authors.lastname: Cleary
authors.affiliation: Chapman University, Orange, CA;
authors.forename: Jason
authors.initials: J
authors.lastname: Bennett
authors.affiliation: Chapman University, Orange, CA;
authors.forename: Keith
authors.initials: K
authors.lastname: Howard
authors.affiliation: A.T. Still University, Mesa, AZ.
authors.forename: Tamara Valovich
authors.initials: TV
authors.lastname: McLeod
mesh_terms: D000293:Adolescent; D001265:Athletic Injuries / Q000175:diagnosis / Q000523:psychology*; D001924:Brain Concussion / Q000175:diagnosis / Q000523:psychology*; D003071:Cognition; D003430:Cross-Sectional Studies; D005178:Faculty; D006801:Humans; D033183:Interdisciplinary Communication; D007858:Learning; D010806:Physical Education and Training; D012574:Schools; D011795:Surveys and Questionnaires
keywords: academic accommodations; return to learn; sport-related concussion