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Researchers at the Krembil Brain Institute, the Hospital for Sick Children and the University of Toronto have developed a comprehensive list of recommendations for concussion policies for the school setting.
Concussions are a significant public health issue and several government-initiated policies address concussion diagnosis, management and prevention, particularly in student athletes in elementary and secondary schools.
Dr. Charles Tator, an Emeritus Scientist at the Krembil Brain Institute and Director of the Canadian Concussion Centre, “school-based concussion policies vary widely in content and in the way that they are implemented."
Dr. Tator explains that increasing consistency between policies is an important first step towards ensuring that they are applied effectively and have a positive impact.
"If we can streamline policies, we can reduce confusion and facilitate communication among various stakeholders, including educators, students, parents and guardians, and clinicians," he says. “We can also better allocate funding to support policy development and implementation."
Dr. Tator's team is comprised of Swapna Mylabathula, an MD/PhD student in Dr. Tator's lab and first author of the study; Dr. Colin Macarthur, a Senior Scientist at the Hospital for Sick Children; and Drs. Astrid Guttmann and Angela Colantonio, professors at the University of Toronto.
The team brought together 20 experts who have roles in concussion prevention and management to form the Concussion Policy Consensus Group – tasked with reviewing school-based policies and developing recommendations to improve their consistency. This group included public health representatives, policymakers, clinicians, school board representatives, and parents and guardians of students who have experienced a concussion.
The group also included members of Parachute Canada – a national injury prevention organization – and the Ontario Physical and Health Education Association.
After providing feedback about an initial set of recommendations prepared by the research team, the experts met by teleconference to discuss recommendations and suggest revisions. This process was repeated, resulting in a comprehensive list of 30 recommendations that spanned concussion education, prevention and communication, as well as best practices for return-to-learn or play following a concussion.
Final recommendations for concussion policies included:
This list of recommendations represents the first expert consensus for school-based concussion policies and reflects the diverse perspectives of a multidisciplinary group of stakeholders in and outside the school system.
“The aim of these recommendations is to safeguard the well-being of children and youth by improving concussion management and prevention in the school setting," says Swapna Mylabathula. “An important next step is to assess the feasibility of implementing these recommendations and the impact of the new policies on concussion in schools."
This work was supported by the UHN Foundation. Dr. Astrid Guttmann holds a Tier I Canada Research Chair in Applied Child Health Services and Policy at the University of Toronto. Dr. Angela Colantonio holds a Tier I Canada Research Chair in Traumatic Brain Injury in Underserved Populations at the University of Toronto. Dr. Charles Tator is a professor in the Department of Surgery at the University of Toronto.