Higher Student Confidence in their Schools’ Academic Support Associated with Lower Adverse Academic Concern Following Concussion

BACKGROUND: Concussion may cause physical and cognitive deficits that can affect the ability of students to perform at their typical academic level in school. Symptomatic students and their parents have previously reported concern about the impact of concussion on school performance. However, student confidence in their school’s ability to support return to school and its relationship with recovery time and overall academic concern has not been investigated. HYPOTHESIS/PURPOSE: To determine if student confidence in their school’s ability to support return to school following concussion is associated with recovery time and other academic concerns. METHODS: Student-athletes were enrolled in the Sport Concussion Outcomes in Pediatrics (SCOPE) study by a physician or athletic trainer across seven sites. Students and their parent/guardian completed the Concussion Learning Assessment and School Survey (CLASS) along with other standardized assessments. Participants were grouped based on responses to the CLASS question about confidence in their school’s ability to support return to school (very confident vs. not/mildly/moderately confident). Symptom resolution time, initial symptom severity, academic outcomes and parent-reported expected academic supports were evaluated using separate Chi-squared analyses. RESULTS: A total of 141 patients were included; 72 (51%) reported being very confident in their school’s ability to support return to school. There was no significant difference in time to symptom resolution between groups (p = 0.84; mean difference= 0.9 days [95% CI= -7.4, 9.2]). The group who was very confident in school support reported a significantly lower initial symptom severity (p <0.001; mean difference= 0.12 [95% CI= 0.05, 0.18]). A higher proportion of those who felt very confident in school support reported no concern about concussion affecting school learning and performance (Table 2; 36% vs 10%, p=0.005). A lower proportion of those who felt very confident in their school support felt the concussion might affect their grades compared to those who expressed no/mild/moderate confidence in school support (Table 2; 56% vs 23%, p=0.001). CONCLUSION: In this multi-center study, although there was no difference in symptom resolution between groups, students who reported being very confident in their schools’ ability to support return to school had a lower initial symptom severity, expressed less concern about the concussion affecting their school learning, performance, and grades. These findings support recommendations for a collaborative team to assist students returning to school following concussion.