School Concussion Management

The School Concussion Management for a concussion begins with the Collaborative Team meeting (after confirmation from the parents/guardians that the student is returning to school). This occurs at Return to Learn (RTL) and Return to Physical Activity (RTPA) Stage 2 or Stage 3.

• Students participating in physical activity at school must complete RTL Stage 4 and successfully complete:
  • RTPA Stage 5 to fully participate in physical education and non-competitive intramurals
  • RTPA Stage 6 to fully participate in competitive intramural and interschool athletics
• Students not participating in physical activity at school continue until the completion of RTL Stage 4 and are not required to complete the RTPA Stages.

As a student progresses through the Return to Learn Stages they may experience barriers (e.g., environmental, physical, learning, assessment). By identifying and implementing strategies and/or approaches to address these barriers, schools can create the necessary conditions for students to successfully progress through the RTL process.

Return to Learn strategies and approaches should consider the following factors:

• Environmental (e.g., modified school attendance, frequent breaks, limited screen time)
• Physical (e.g., establish an environment that is predictable and controlled for students to participate in light to moderate physical activity with a low risk of contact with other students or equipment and a low risk of collision or falls)
• Learning (curriculum) (e.g., extra time to complete tasks, reduce assignments/homework, pre-printed class notes)
• Assessment (testing) (e.g., exemption from, delaying and/or permitting additional time for assessments/tests/exams).

To progress from RTPA – Stage 3 to RTPA – Stage 4, the student must receive medical clearance by a medical doctor or nurse practitioner. This can be communicated through a school-board-approved form or using the Sample Medical Concussion Clearance Form.

Note: Although medical clearance is required for the RTPA process it is not required for the RTL process.

RTL and RTPA – Stages 1 to 3

It is common and ok for a student’s symptoms to return or worsen mildly and briefly as they progress through the Return to Learn and Return to Physical Activity Stages as long as returning symptoms do not last for more than an hour. If a student’s concussion-related symptoms return or worsen for more than an hour or they cannot tolerate their symptoms:

• For Return to Learn: the student should take a break and the activities should be adapted.
• For Return to Physical Activity: the student should stop the activity and try again the next day at the same stage.

RTL – Stage 4 and RTPA – Stages 4 to 6:

If the student experiences concussion symptoms after medical clearance, they should return to RTL – Stage 3 and RTPA – Stage 3 to establish full resolution of symptoms.

Medical clearance will be required again before progressing to RTPA – Stage 4.