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Use of 504 Plans and IEPs in cases of concussion

Getting a concussion can be a traumatic experience for both a child and his parents. A concussion is a mild traumatic brain injury that most commonly results from a fall or a blow to the head. Signs of a concussion include: dizziness, headaches, difficulty concentrating, and sensitivity to light. While many concussions resolve in a number of weeks, in some cases, the effects of a concussion can last six months to a year. When concussion symptoms persist, parents may seek a 504 Plan or IEP from the child’s school to address what the child needs in order to continue to learn as he heals.

A physician or pediatric neurologist can diagnose a concussion. A pediatric neurologist can also be helpful in prescribing and monitoring a course of treatment tailored to the child. Treatment usually entails both physical and—importantly—cognitive rest. Activities that require sustained periods of attention and focus, such as reading, are often prohibited or greatly limited while the child’s brain heals. This prescription for recovery can impact a child’s school year greatly, especially in cases where symptoms persist.

Parents can help by encouraging doctors and school administrators to communicate about the child’s status and needs. Parents also can help by keeping a record of the child’s symptoms and progress. The child may struggle with tasks involving memory, attention, organization and processing. Anxiety and depression may also result. Children who have conditions prior to a concussion may experience a worsening of symptoms as a stress response to the concussion event. Special needs children may experience a worsening of their pre-concussion conditions, such as Obsessive-Compulsive Disorder, as a direct result of the stress of a concussion.

School administrators should work with the parents, the child and physicians to design a program of instruction suitable for the child during the healing process. Such instruction may take the form of reduced school days, modifications to the school environment, modifications to assignments and tests, and even home instruction. Parents may ask the school for a meeting to discuss appropriate accommodations for the child, and to have these accommodations and modifications embodied in a 504 Plan. A 504 Plan is a written, legally enforceable plan by the school to provide services or modifications that will allow the child access to all of the school district’s programs, including extracurricular programs. A 504 Plan falls under the Federal Rehabilitation Act of 1973, which protects people with disabilities against discrimination. Special needs children who have an existing 504 Plan or IEP may request a team meeting to discuss amending that pre-existing document.

Classroom accommodations that may be appropriate include: preferential seating, reduction in written work, extended time on tests, voice recording of lessons, copies of notes, leaving classes early or late to avoid crowded hallways, allowing the student to wear sunglasses, permitting breaks in a quiet space such as a nurse’s office, and reduced attendance in class.

Children with concussions have good days and bad days. Any plan should be flexible, and allow teachers to respond to how the child’s symptoms progress. As always, the guiding principle should be the best interests of the child.