Lack of academic accommodations
Although I told both his teacher and the school nurse I suspected my son had a concussion the morning after his injury, and expressed concerns about recess, he was sent to gym class before his first concussion evaluation while he was still experiencing a concussion headache. He told me he wasn't able to run as fast as normal, and that he had been unable to do the flex arm hang.
Based on the evaluation form prepared by his pediatrician, he was supposed to have full academic accommodations, including a reduced workload and breaks for rest/naps. At the time of his injury, I often volunteered in his classroom, and didn't notice a material reduction in his workload, nor was he given any rest breaks. He struggled with his homework and often broke down while trying to complete it. He generally had enough energy to go to school, but wanted to rest once he got home. I arranged to bring him home an hour early so he could avoid recess and rest before attempting homework.
As his symptoms persisted, we stopped taking him to any activities outside of school. His television viewing and computer usage had to be strictly limited, and video game playing had to be totally eliminated.
When his headaches continued past the first few weeks, he was accused of lying by his principal. Since his vestibular system problems were only evident during postural stability testing, the principal doubted he truly had balance problems and decided to withdraw the limited academic accommodations previously provided.
I asked my son about his headaches each day and my notes clearly show they went away on the weekends and returned during the school week. As for the possibility of him lying about them, I had no reason to be suspicious. There were consistent patterns for likely triggers, such as tests and usage of a math software program in the afternoons. At eight years of age, however, it is possible that he misinterpreted mental fatigue as a mild headache. Regardless, based on other signs and symptoms, it was clear he was not fully recovered.
When I picked him up from school for his third concussion evaluation, his hair was drenched in sweat from trying to walk as many laps as possible during gym (he was not supposed to participate in any physical activities during gym). When he failed to show any balance improvement, his pediatrician said that his lap walking had most likely exacerbated his concussion symptoms, and that we wouldn't be able to tell if his balance had improved at rest until his next visit.
The following day, even though I sent an email indicating that his balance had not shown any improvement, during a conference with his teacher and principal, I was accused of failing to recognize that he no longer required academic accommodations. I was still upset about the lack of improvement in his balance, and found it frustrating that all of my concerns were brushed aside. I was told that with the beginning of the next school week, he could no longer leave early.
I sent my son to school for two full days even though I didn't think it was in his best interest because I thought I had no other choice. Due to mandatory attendance requirements, I didn't know if I had the right to bring him home early. For recess, he went to study hall along with the students who had failed to turn in their homework, and felt as though he were being punished. I was so concerned about increasing my son's school schedule before his balance improved and while he was still experiencing frequent headaches, fatigue, and difficulties falling asleep that I literally felt ill.
After having a discussion with a bantam board member and realizing she hadn't been made aware of my son's injury, I decided to contact the Superintendent again. Once he was made aware of the situation with my son's principal and teacher, they became much more cooperative.
Unfortunately, I believe the school's lack of appropriate concussion management protocols extended my son's recovery and exposed him to potential harm. Physical and cognitive rest is critical to avoid an extended recovery, as a mother of a concussed teenager emphasized in describing her family's 14-month long journey through post-concussion syndrome, which she attributed in part to the lack of cognitive rest in the days immediately after her daughter's concussion. Sending him to gym class before his first concussion evaluation also placed him in danger of sustaining a second concussion, which increases the likelihood of an extended recovery, permanent cognitive impairment, and even catastrophic injury or death from a condition called second impact syndrome. The second concussion or impact doesn't have to occur on the football field. According to the Annual Survey of Football Injury Research report, an 11-year old youth football player most likely died in September 2010 from to a second impact sustained at recess:
I don't believe my son's teacher and principal would knowingly expose him to harm, however, their lack of awareness of the seriousness and potential long-term consequences of concussive injuries caused them to make decisions that were not, I believe, in his best interests. It is troubling that they were unreceptive to the concussion information I provided, and that they disregarded the evaluation and letter provided by his pediatrician. To ensure that no other child goes through what my son did, the state Department of Education should develop model concussion management protocols for implementation at all public schools.An 11 year old youth football player was injured in a game on September 3, 2010 and died on September 5, 2010. His injury in the game was diagnosed as a concussion. The injury that killed him happened during recess at his middle school when he accidentally hit his head while playing by the football sleds. Cause of death was possibly second impact syndrome.
