title: Variations in State Laws Governing School Reintegration Following Concussion.
abstract: We sought to examine the prevalence, scope, and specificity of provisions governing school reintegration in current state concussion laws.
  
  
  
  State concussion laws as of May 2016 were independently assessed and classified by 2 trained coders. Statutes were classified as "Return-to-Learn" (RTL) laws if they contained language mandating institutional action at the state, district, or school level related to academic reintegration of youth who have sustained a concussion. All statutes classified as RTL laws were further analyzed to determine scope, required actions, and delineation of responsibility.
  
  
  
  RTL laws were uncommon, present in only 8 states. Most (75%) of these laws held schools responsible for RTL management but mandated RTL education for school personnel was less frequent, present in only one-quarter of the laws. None of the RTL laws provided guidance on support of students with persistent postconcussive symptoms, and only 1 recommended an evidence-based standard for RTL guidelines.
  
  
  
  Our review of state concussion laws indicates scant and vague legal guidance regarding RTL. These findings suggest an opportunity for legislative action on the issue of RTL, and reveal the need for better integration of laws and research, so that laws reflect existing best-practice recommendations and remain current as the evidence base develops.
authors.affiliation: Seattle Children's Research Institute, Seattle, Washington.
authors.forename: Leah L
authors.initials: LL
authors.lastname: Thompson
authors.affiliation: Harborview Injury Prevention and Research Center, Seattle, Washington.|Departments of Epidemiology.
authors.forename: Vivian H
authors.initials: VH
authors.lastname: Lyons
authors.affiliation: The Center on Brain Injury Research and Training, Eugene, Oregon.
authors.forename: Melissa
authors.initials: M
authors.lastname: McCart
authors.affiliation: Rehabilitation Medicine.|University of Washington Medicine Sports Health and Safety Institute, and.|University of Washington Medicine Sports Concussion Program, University of Washington, Seattle, Washington; and.
authors.forename: Stanley A
authors.initials: SA
authors.lastname: Herring
authors.affiliation: Seattle Children's Research Institute, Seattle, Washington.|Harborview Injury Prevention and Research Center, Seattle, Washington.|Departments of Epidemiology.|Pediatrics, and.
authors.forename: Frederick P
authors.initials: FP
authors.lastname: Rivara
authors.affiliation: Harborview Injury Prevention and Research Center, Seattle, Washington; vavilala@uw.edu.|Pediatrics, and.|Anesthesiology.
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000175:diagnosis* / Q000628:therapy; D002487:Centers for Disease Control and Prevention, U.S. / Q000331:legislation & jurisprudence*; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D020127:Recovery of Function; D000068958:Return to Sport / Q000331:legislation & jurisprudence*; D012574:Schools; D013219:State Government; D013997:Time Factors; D014481:United States