Study details

Researchers at Childen's National Health System, George Washington University School of Medicine, and the Brady School of Medicine at East Carolina University, studied a group of 349 youths aged 5 to 18 years who were evaluated in an outpatient concussion clinic at a large regional medical center within 28 days of injury, dividing them and their parents into two groups, depending on their recovery status at the time of the visit: (1) actively symptomatic/not yet recovered (as defined by elevated symptoms and/or impaired performance on neurocognitive tests, and (2) recovered (as definied by no elevation of symptoms and no impairment of neurocognitive test performance). The two groups were then further divided based on level of schooling.

Researchers expected to find that symptomatic students and their parents would report greater postinjury academic difficulties along a number of lines, with more widespread effects reported by students in higher grade levels, and that greater symptom severity would be associated with more adverse academic effects.

Comparing student and parent responses to the question, "How concerned are you about this injury affecting (your/your child's) school learning and performance?", the researchers found significant differences in reported level of concern based on recovery status and level of schooling with much higher percentages of students who had not recovered from their concussions and their parents (roughly six in ten) reported feeling moderately or very concerned versus roughly one in six students (16%) and one in three parents (30%) in the recovered group.

While parents of students who were still experiencing concussion symptoms reported generally consistent levels of concern across the three levels of schooling, the level of concern reported by students varied, with two-thirds (67%) of high school students saying that they felt moderately or very concerned versus only about half (52%) of middle school and four in ten (38%) elementary school students.

Not surprisingly, students still experiencing concussion symptoms reported significantly more postinjury school problems than their recovered peers. Nearly nine in ten (88%) reported one or more school problems related to concussion symptoms such as headache, fatigue, and problems concentrating; nearly eight in ten (77%) likewise reported diminished academic skills (e.g. difficulty taking notes, spending more time on homework, problems studying) versus a minority of students who were no longer experiencing symptoms (38% and 44%) respectively.

Students who continued to experience symptoms and their parents were also significantly more likely to report trouble in one or more classes than students who had recovered and their parents, although nearly half of the latter group of students and one third of their parents reported trouble in one or more classes during concussion recovery. High school and middle school students and parents reported trouble in significantly more classes than elementary school studnets and parents, with math being the most problematic subject across grade levels, followed by reading/language, arts, science, and social studies.

Students and parents in the unrecovered group perceived the effect of concussion on grades differently than those in the recovered group, with a large majority of students and parents in the former group believing grades in one or more academic subjects had been affected after concussion, while fewer than half of the students or parents in the recovered group reported a change in grades.

Sources:

Ransom DM, Vaughan CG, Pratson L, Sady MD, McGill CA, Goia GA. Academic Effects of Concussion in Children and Adolescents. Pediatrics 2015;135(6). doi:10.1542/peds.2014-3434)(published online ahead of print May 11, 2015)

Halstead ME, et al. Council on Sports Medicine and Fitness; Council on School Health: Returning to learning following a concussion. Pediatrics. 2013;132(5):949-957

Posted May 11, 2015