Information and Recommendations for Professors or Instructors
General Information Regarding Concussions : A concussion refers to "a sudden and transient alteration in consciousness induced by traumatic biomechanical forces transmitted directly or indirectly to the brain" (Khurana & Kaye, 2012, p.1), which results in neuronal axons stretching and tearing at a microscopic level. This damage is diffuse and not typically limited to a single brain region. Although the damage is generally not detectable with modern medical technology, it results in a consistent pattern of behaviours or symptoms and concussions are most often diagnosed via these symptoms.
Symptoms : The symptoms of concussion include physical symptoms (e.g. headaches, dizziness, fatigue, lack of co-ordination, balance problems, ringing in the ears, blurred vision, nausea, and lack of consciousness), emotional symptoms (e.g. personality changes, apathy, aggression, irritability, anxiety, or depression), and cognitive symptoms (e.g. confusion, feeling stunned, attention deficits, loss of concentration, and memory problems). Some concussed individuals will report some loss of memory from the time period shortly before receiving the concussion (i.e. limited retrograde amnesia). Many concussed individuals also experience difficulties retaining newly learned information after receiving their concussion (Khurana & Kaye, 2012). The inability to retain new information generally lessens as the individual recovers from their concussion.
The cognitive symptoms of concussion are of particular concern to concussed students, as these can have a negative impact on their education.
Recovery Time : The majority of individuals recover from a concussion relatively quickly. A recent survey of previously concussed Mount A students (Barry & Tomes, 2014) found a little over half reported that their symptoms had resolved sufficiently that they were able to return to their activities within a week of receiving their most recent concussion. However, 26% of the sample indicated that their symptoms took 10 days to 1 month to resolve and 22% reported that it took longer than 1 month before they were able to return to activities. These numbers highlight the fact that there can be variability in how long it takes for an individual to recover from the immediate effects of a concussion.
Although a short recovery period (7-10 days) is most typical, many individuals will have active symptoms for longer periods of time.
Suggestions and Recommendations for Dealing with Concussed Students : It is recommended that immediately following a concussion (within the first 24 hours) students rest both physically and cognitively/academically. Following this time period, students are encouraged to assess their symptoms. If they are able to return to class and normal academic activities, they are encouraged to do so. However, if their symptoms are debilitating, they are encouraged to continue physical and cognitive rest. As soon as they are able, students should slowly return to academic activities and there is a recommended step-by-step protocol to help students return to academic activities.
Step-wise Return to School Protocol
We recommend that concussed students gradually return to their academic activities in a manner that mimics their gradual return to physical activities (outlined in our MTA Return to Play policy). Listed below are the steps students are encouraged to follow for academic activities.
1. Prepare to return to academic activities
· Begin to engage in light mental activity (for example, reading) for short periods of time (for example, 15 minutes a couple of times per day).
· Limit other mental/cognitive activities, especially those known to worsen concussion symptoms like using a computer, texting and playing videogames.
· The goal is to begin to engage in short periods of light mental activity while avoiding any activities likely to trigger or worsen symptoms.
2. Begin light academic activities
· Return to class.
· You may wish to return to a single class, or a limited number of classes at first; pick a class that is scheduled during a time period where you are typically alert and symptom-free.
· Try to arrange for someone else to take notes; focus on paying attention and participating during class times.
· Change your seating arrangement if you find you are easily distracted (for example, ask to sit at the front of the room so you are not sidetracked by students in front of you).
· Work on short/small assignments.
· Work for short periods of time and rest between academic work sessions.
· Avoid working on a computer if it causes headaches, eye strain, or neck/head tension.
· Begin reading course materials for short periods of time.
· Continue to limit other problematic cognitive activities (e.g. playing on the internet, texting, watching TV, etc.) to short periods of time.
· The goal is to increase the amount of time you can spend on mental/academic activities and also to increase the number of mental/academic activities you engage in.
3. Increase your academic workload
· Return to more/all classes.
· Begin taking notes during class time.
· Begin to complete major assignments, tests and projects.
· The goal is to return to normal levels of mental/academic activities.
4. Return to your normal academic workload
· Return to all classes.
· Arrange to take tests and complete major assignments.
As a result of this protocol, you might notice a student returning to some of their classes before they return to yours. This gradual return to classes is encouraged. The Meighen Centre will inform you when the student has recovered from their concussion and is no longer receiving temporary accommodations. If you have any concerns, please contact Anne Comfort (364-2527; email@example.com).
How Professors Can Help the Concussed Student : 
· Postpone tests and other forms of assessment until the student is symptom-free. This is the most important accommodation. Students who are actively concussed will typically have difficulty remembering, evaluating, and applying knowledge or information. For many /most students, this will likely be the only accommodation necessary.
· For students experiencing a longer recovery period, consider removing non-essential course material if possible or re-weight course tests, assignments, and assessments, or consider aegrotat standing if appropriate (see Academic Calendar regulation 10.9.10)
· Preferential seating in the classroom
· individuals experiencing attention problems should be seated in an area that decreases the number of distractions (e.g. front of the room, away from open doors)
· Provide written documents with assignment requirements (e.g. length, format, due date, etc.); this helps students who have attention or memory problems following a concussion. Hard/paper copies are ideal, but details that can be accessed via another source (e.g. Moodle) are preferable to verbal instructions
· Consider allowing the student to use memory aids such as formulae sheets or other resources to decrease memory load (if appropriate)
· Encourage student to find a note-taker (the Meighan Centre can help with this), record classes, or give the student copies of lecture materials (e.g. slides, visual materials presented during class)
· Reduced distractions while writing tests or assignments (the Meighan Centre can provide this accommodation); allow individual to work in a quiet, distraction-free environment
· If required (and only if possible), transform course materials or testing materials to accommodate cognitive symptoms:
· Allow for extra time to complete assignments and/or tests
· Reduce computer tasks (as computer work may exacerbate concussion symptoms)
· Can a computer-based task be made into a pencil-and-paper task?
· Make smaller tasks to accommodate attention deficits
· Can an assignment be broken down into several smaller assignments?
· Although it is not recommended that a student still experiencing symptoms write tests, if it is necessary, is it possible to break a test into two smaller tests (e.g. the first 20 items completed on Monday and the next 20 items completed on Friday)?
· Bigger font for assignments/handouts, fewer questions per page, layout that makes the items perceptually distinct for students with perceptual or attention symptoms
· Font size (and letter spacing) making written words more perceptible seems to be more important than font type, therefore, for individuals experiencing symptoms it is recommended that you increase the font size for printed materials
· Increased contrast between the background colour and font colour is also recommended. Black letters on a white background is highly recommended for printed text. High contrast is also recommended for electronic information (e.g. powerpoint slides or webpages).
 Please note, these are recommendations only. None of these accommodations are mandated and the suggested accommodations will not be appropriate or practical for all situations. Determining the level and nature of the accommodations is left up to each instructor.