Post-Concussion Disability Accommodations Guidelines for Students and Faculty
Approximately 1.5 to 2 million Americans experience a traumatic brain injury, or “concussion”, annually. According to the American Academy of Neurology, a concussion is “a trauma-induced alteration in mental status that may or may not involve loss of consciousness” with “confusion and amnesia” as hallmark symptoms of concussions. Concentration difficulties can often accompany concussion symptoms as well, in addition to headaches, nausea, dizziness, and emotional liability.
Medical consultation with a provider (MD/DO/NP/PA) with appropriate training is an essential component of care for immediate concussions as well as treatment of post-concussive symptoms. Also, student athletes with access to athletic trainers should also take advantage of this important resource on campuses, as many trainers are well trained in concussion recognition and treatment, and are often able to follow students more frequently than medical providers working in a clinical setting.
Recent advances in concussion related research have provided clinicians with guidelines for diagnosis, treatment, and return to play/activity for students who have incurred concussions. The foundation of a concussive injury is neurometabolic impairment, where additional physical and cognitive activities during a period of attempted recovery may cause symptoms to reemerge-a possible signal that the brain's dysfunctional neurometabolism is being pushed beyond its tolerable limits. Although most concussions resolve spontaneously in a few weeks to 6 months, providing an environment where a concussed individual can rest can lead to a faster recovery.
Although physical rest has been emphasized in post concussive care, cognitive rest has been an often under-looked component of medical treatment that has demonstrated benefit. At Pomona College, we will attempt to provide reasonable academic accommodations to provide students with post-concussive academic support. Accommodations will only be made if a student has met with a medical provider and has appropriate documentation to show that they have been appropriately diagnosed and are undergoing treatment. Students are to meet with a Dean in the Dean of Students office to discuss these accommodations, which may include:
- An Approved Temporary Accommodation that documents recommendation to allow for both physical and cognitive rest. A recommendation to allow the student to miss classes (with a documented medical excuse) on a week-by-week basis may also be considered, with the student still responsible for work missed at the professor's discretion. During this process, students are encouraged to speak with their professors to see if course work deadlines can be postponed or course work to be excused.
- Following 1-2 weeks with concurrent medical supervision, if symptoms remain, it may be helpful to explore further accommodations including: temporarily recommending additional time on examinations (ie +50%), extra time for assignments, and possibly note taking services for a temporary basis (no longer than 1 month). Complete excusal from exams or assignments will be up to the discretion of professors/instructors, to maintain the integrity of academic expectations in the class.
- If post concussive symptoms persist beyond this time, it would be reasonable to encourage the student to consider dropping 1 vs 2 classes, taking classes Pass/No Credit, and also considering a medical leave of absence. A medical leave of absence would be a reasonable consideration if a student continues to experience post-concussive symptoms for greater than 3 weeks and if the coursework missed become too onerous to make-up.
If a student has been allowed back to physical activity, then it will be assumed that cognitive activity has already reached pre-concussive baseline and academic accommodations will not be provided.
If a student wishes to contest the accommodation guidelines, the Dean Of Students office will communicate with the appropriate Claremont Colleges training staff and physicians (with a student's consent) to further discuss this request. While the Dean Of Students office is interested in providing reasonable accommodation support to students demonstrating appropriate need, it is also balanced by the need to determine if such requests are reasonable and clearly documented.