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Multicenter Study
. 2024 Dec;52(6):592-600.
doi: 10.1080/00913847.2024.2344435. Epub 2024 Apr 22.

Variables associated with days of school missed following concussion: results from the Sport Concussion Outcomes in PEdiatrics (SCOPE) study

Jeremy Roberts  1 , Julie C Wilson  1 , Mark E Halstead  2 , Shane M Miller  3 , Jonathan A Santana  4 , Tamara C Valovich McLeod  5 , Tracy L Zaslow  6 , Christina L Master  7 , Matthew F Grady  7 , Traci R Snedden  8 , Matthew L Fazekas  9 , Rachel A Coel  10 , David R Howell  1
Affiliations
Multicenter Study

Variables associated with days of school missed following concussion: results from the Sport Concussion Outcomes in PEdiatrics (SCOPE) study

Jeremy Roberts et al. Phys Sportsmed. 2024 Dec.

Abstract

Objective: To understand factors associated with missed academic time after concussion to improve support for patients. Our goal was to assess patient-specific predictors of total school time lost after pediatric/adolescent concussion.

Study design: We performed a prospective cohort study of children and adolescents (8-18 years of age) seen within 14 days of concussion from seven pediatric medical centers across the United States. We collected outcomes via the Concussion Learning Assessment & School Survey (CLASS) and constructed a multivariable predictive model evaluating patient factors associated with school time loss.

Results: 167 patients participated (mean age = 14.5 ± 2.2 years; 46% female). Patients were assessed initially at 5.0 ± 3.0 days post-injury and had a final follow-up assessment 24.5 ± 20.0 days post-concussion. Participants missed a median of 2 days of school (IQR = 0.5-4), and 21% reported their grades dropped after concussion. Higher initial symptom severity rating (β = 0.06, 95% CI = 0.03-0.08, p < 0.001) and perception of grades dropping after concussion (β = 1.37, 95% CI = 0.28-2.45, p = 0.01) were significantly associated with more days of school time missed after concussion. Those who reported their grades dropping reported missing significantly more school (mean = 5.0, SD = 4.7 days missed of school) than those who reported their grades did not drop (mean = 2.2, SD = 2.6 days missed of school; p < 0.001; Cohen's d = 0.87).

Conclusions: Children and adolescents reported missing a median of 2 days of school following concussion, and more missed school time after a concussion was associated with more severe concussion symptoms and perception of grades dropping. These findings may support recommendations for minimal delays in return-to-learn after concussion.

Keywords: Concussion; academic adjustments; grades; mild traumatic brain injury; return-to-learn; return-to-school.

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Conflict of interest statement

Dr. Howell has received research support from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R03HD094560, R01HD108133), the National Institute of Neurological Disorders And Stroke (R01NS100952, R43NS108823), the National Institute of Arthritis and Musculoskeletal and Skin Diseases (1R13AR080451), 59th Medical Wing Department of the Air Force, MINDSOURCE Brain Injury Network, the Tai Foundation, the Colorado Clinical and Translational Sciences Institute (UL1 TR002535-05), and the Denver Broncos Foundation. Dr. Master has received research funding from the National Institute of Neurologic Diseases and Stroke (5R01NS097549-06), National Eye Institute (1R34EY030582-01A1, 2R01EY023261-06), National Institute for Nursing Research (5R01NR018425-03), Centers for Disease Control (1U01CE003479-01-00), Department of Defense (W81XWH21C0103, W81XWH2210590), Chuck Noll Foundation, Children’s Hospital of Philadelphia Frontier Programs, American Medical Society for Sports Medicine and serves in an uncompensated role as the concussion physician for Shipley School, on the medical advisory boards for Untold Foundation, Pink Concussions, Headway Foundation, and on the Board of Trustees for the American College of Sports Medicine, the Board of Directors for the American Medical Society for Sports Medicine and Pediatric Research in Sports Medicine, and the Executive Committee of the Committee on Sports Medicine and Fitness for the American Academy of Pediatrics. Dr. Miller serves on the USA Cheer Safety Council and as an assistant team physician for the Dallas Stars NHL Hockey Club. Dr. Valovich McLeod serves on the USA Swimming Concussion Task Force and the National Football League Head, Neck, and Spine Committee. Dr. Wilson has received research support from the Eunice Kennedy Shriver National Institute of Child Health & Human Development (R0) and is a network team physician for US Soccer. Dr. Halstead is the venue medical director for the St Louis City SC MLS team. Dr. Coel serves as team physician for the World Surf League and is a volunteer medical consultant and speaker for Hawai’i Concussion Awareness Management Program.

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