In this episode of The Sharing Experiences With Concussions/TBI podcast, Ryan Sutton sits down with Stephanie McFarland, an Occupational Therapist at Holland Bloorview Concussion Clinic, to talk about how to effectively accommodate concussions in the classroom. As one of the leading experts in the field of pediatric concussion, Stephanie works with students every day to build strategies for their recovery.
We asked teachers and educators across Ontario to submit their questions and experiences regarding concussion support in the classroom. Listen in as Stephanie answers these questions while busting myths and highlighting her best tips and advice for educators on creating accommodations in the classroom.
In this episode of The Sharing Experiences With Concussions/TBI podcast, Ryan Sutton sits down with Stephanie McFarland, an Occupational Therapist at Holland Bloorview Concussion Clinic, to talk about how to effectively accommodate concussions in the classroom. As one of the leading experts in the field of pediatric concussion, Stephanie works with students every day to build strategies for their recovery.
We asked teachers and educators across Ontario to submit their questions and experiences regarding concussion support in the classroom. Listen in as Stephanie answers these questions while busting myths and highlighting her best tips and advice for educators on creating accommodations in the classroom.
Narrator (00:00:01):
What is a brain injury? The answer to this question is more complicated than it may seem.
Speaker 2 (00:00:07):
I didn't realize the scope and the challenges until I started to struggle.
Stephanie (00:00:13):
Concussion will change very quickly and rapidly week by week. And we need to adjust very quickly that
Ryan C (00:00:18):
Pretty hard to self-identify. When you have a brain injury,
Catherine (00:00:21):
Approximately 80% of adults in the justice system who are incarcerated, have a history of brain injury.
Narrator (00:00:30):
Our brains are intricate, comprised of billions of neurons, responsible for how we think feel, communicate, and experience life. The significant role our brains play in our everyday life is what makes experiencing an injury to it. Traumatic.
Stacey (00:00:47):
And I got a call from one of Jake's friends saying that he'd been in an accident
Vijaya (00:00:52):
Most of the time it's been ignored. So they feel very isolated.
Ryan C (00:00:57):
I didn't tell anyone. I just mean you just keep going, right?
Blair (00:01:01):
Light, sensitivity, sensitivity to noise. The irritability, the fact that like things are making you dizzy when they're passing by like all these small signs are things that nobody really understands
Narrator (00:01:14):
Approximately 165,000 TBIs occur annually in Canada, equaling out to 456 people every day. And one person, every three minutes as the leading cause of death and disability, worldwide brain injury is 15 times more common than spinal cord injury. 30 times more common than breast cancer and 400 times more common than HIV aids. What this also means is that by the time this intro finishes, someone will have experienced a TBI. It is because of the severity of this injury, that two leading organizations in the sector have come together to create a sharing experiences with a concussion or traumatic brain injury podcast, the Ontario brain injury association, and the heads up concussion advocacy network are proud to present yet. Another season of this multimedia series, as we continue our mission to create a deeper understanding towards a varying impacts of this injury, and now a message from the executive directors responsible for creating this series.
Ruth (00:02:22):
Hi everyone. My name is Ruth Wilcock and I'm the executive director of the Ontario brain injury association.
Ryan S (00:02:28):
And I'm Ryan Sutton the executive director of the heads up concussion advocacy network.
Ruth (00:02:34):
I want to welcome you to our multimedia podcast series. The mission of OBIA is to enhance the lives of Arians living with the effects of acquired brain injury, through education awareness and support. We are so excited to have partnered with headsup concussion advocacy network to publish this multimedia podcast series. And Ryan is going to tell you a little bit more about our partnership and the series.
Ryan S (00:03:00):
We are thrilled to be sharing a second season of the series with all of you this season aims to broaden the conversation around concussions and traumatic brain injury by highlighting different perspectives in topic areas that lack representation building off the success of last season. We found new ways to facilitate discussions between people directly impacted by the injury while gaining up to date insights from industry experts. We are very proud to present the second season of this podcast series and hope you enjoyed this episode.
Narrator (00:03:34):
Thanks to Ruth and Ryan's commitment to education. This podcast will run throughout brain injury awareness month with episodes releasing weekly. During this season, we will explore a wide range of topics by highlighting group discussions that incorporate elements of lived experience and professional expertise in our collective effort to provide a diverse understanding towards a varying experiences of a brain injury. This series has been broken down into five parts, brain injury and justice, concussion, and TBI within the veteran community impact of brain injury on family members, recovery at home and accommodating a concussion in the classroom today's episode was brought to you by our sponsor Thompson Rogers lawyers and features a one-on-one discussion that focuses on accommodating a concussion in the classroom. This episode was facilitated by Ryan Sutton, the executive director of the heads up concussion advocacy network and a passionate leader in the concussion space. Ryan has devoted his time to understanding people's lived experience with the injury after sustaining multiple concussions himself. He advises on different committees related to concussions and is an active advocate for the community. For this episode, we ask teachers across Ontario to share their most pressing questions about how to support a student with a concussion in their classroom. To answer the questions provided by the teachers, Ryan interviews, pediatric concussion specialist, Stephanie McFarland, an occupational therapist at holland bloorivew concussion center, who has extensive experience in the holistic management of concussion in children, youth, and families. We would like to thank our amazing episode sponsor Thompson Rogers lawyers for making this podcast possible.
HeadsupCAN (00:05:31):
The following podcast may contain sensitive material that could be potentially distressing or triggering to some people. If you require support, please call the Obi helpline at 1-800-263-FIVE 4 0 4. The helpline offers confidential and emotional support for those who need a caring, compassionate, and non-judgmental listening ear.
Narrator (00:05:56):
And now please enjoy the conversation.
Ryan S (00:05:59):
Welcome to the final episode of our second season of the sharing experiences with concussion and traumatic brain entry podcast. On this episode, we'll be exploring the topic of accommodating a concussion in the classroom. My name is Ryan Sutton and I'm the executive director of the heads up concussion advocacy network, a nonprofit organization, whose mission is to build collaborative networks in an effort to innovate and inspire concussion, education awareness and research. I'm very excited today to facilitate a one-on-one podcast episode that will be answering the most pressing questions for teachers supporting students with a concussion for teachers and students alike navigating through these circumstances can be quite difficult for many different reasons, often individualized to each situation today. I'll be speaking with one of the leading experts in the field of pediatric concussion, who works with students every day to build strategies for their recovery. I'm pleased to welcome our expert guest, Stephanie McFarland from the holland bloorivew concussion center. Welcome Stephanie.
Stephanie (00:07:05):
Hey Ryan. Thanks for having me.
Ryan S (00:07:07):
Yeah, we really appreciate having you here. If you could just briefly introduce yourself the work you do and yeah. Just let people know kinda your background.
Stephanie (00:07:17):
Sure. Sounds good. Well you obviously already did a great introduction, but I guess some pieces I'll add is I'm a clinician by background. I'm an occupational therapist. Who's been working in concussion center at home, whatever they wanna say for, I guess, seven years now working clinic, as you said, with kids in their recovery, but then also have sort of a leadership role and project management role where I work at a broader skill outside the hospital. So working with broader communities, whether it's the medical community, the sports community, the school community, parents, kids, just on understanding the ever changing best practices that are happening in concussion. And what we'll talk about at length today is that over the past three to five years, there's been a ton of change in what we do in pediatric concussion. And I think it's really important to get that message out. So outside of doing that within our four walls at home bla view, we wanna make sure that that's understood across the broader community. So looking forward to talking more about that today, and maybe what we used to do, we don't do anymore. And why is that? So yeah, looking forward to diving into that more,
Ryan S (00:08:26):
Yeah. I'm really excited to explore that with you as well. And yeah, I think you're the perfect person for this podcast and really excited to get into those conversations on some of the more finer details of the situation. But before we get into the discussion, I'd like to provide some context for this episode that may be helpful for the viewers, basically when we're putting this podcast together. We reached out to teachers across Ontario to see if they had any questions or experiences with navigating through accommodating a student with a concussion that they'd like to share with us. So I'd like to extend a big thank you to all the teachers who submitted questions and shared their experiences. Your submissions were well received and will provide the foundation that this podcast was built upon. So you'll see some questions throughout that were, were actually created in collaboration with these questions that were proposed by the teachers, and we'll be sharing some direct questions and some direct experiences from those teachers as well.
Ryan S (00:09:26):
And one last thing before we jump into the discussion, I think it's important for our listeners to understand that this podcast series is only gonna be focusing on the concussion experience. The insight shared throughout this episode should not be taken into consideration when dealing with students or a person with moderate to severe brain injury. And I think with that, Stephanie, I think we'll get right into it with our first question here. So before we get into the more detailed areas, I'd like to kind of get an overview of what the general return to school standards are. If you could please provide that, that would be amazing.
Stephanie (00:10:02):
Yeah. I think this will be a good time to highlight. Maybe some of the things have changed or what we've learned over the past few years is what we should be doing with return to school moving forward. And the first one is honestly, just a more active approach with return to activities that are low risk in nature. And what we mean by low risk is activities that don't pose risk of sustaining another concussion, or are highly unlikely to do so. So when we think about cognitive activities, social activities, light aerobic exercise, it's more individual in nature. These are the things we want kids doing sooner rather than later, and not always doing it on a very rigid symptom, free expectation. So what I mean by that is it's okay for kids when they're starting to do some cognitive activity when they're starting to do red aerobic exercise, engaging in social activities to have some symptoms when they start.
Stephanie (00:10:58):
And what's important is to sort of gauge how much within that tolerance we should work with until we take a break and how much is okay to continue with, because what we're learning is engagement and stimulation of the brain helps it recover. And if we continually rest every single time, we may actually be creating more problems and prolonging recovery by doing that. So there's been a ton of really good research out there where it's pretty much the gold standard now, and everyone agrees that exercises medicine when it comes to concussions. So the sooner you're exercising, whether it's a stationary bike walking, going for a light dog, likely the better you will do. And there's many reasons for that it's gonna help with your symptoms, but it's also gonna help with some of those secondary factors like help your sleep, help your mood help your overall wellbeing.
Stephanie (00:11:52):
So exercise is really important. What starting to evolve in the research a bit more is we can also kind of apply that to cognitive activities. So the sooner we stimulate the brain, obviously not over burning it with too much stress and workload, which we'll talk about further in the podcast, but doing something the better you're gonna do. So I still feel like that's not completely understood, or we still expect kids, for example, to be completely symptom free before they return to school or completely symptom free with cognitive activities at home before they would start something more, or they need to be completely symptom free before they write a test and we'll get into the details today. I'm sure, but you know, those are some myths that we're trying to get out there to say, that's not true. Let's participate, accommodate and prioritize. Like that's sort of the three main things that we tend to, to focus on to get kids back.
Stephanie (00:12:42):
So in light of that, I guess one more thing I'll add in terms of what's changing over the past bit is we're starting to think of return to school a little bit more of a guideline rather than a very rigid protocol. Rigid protocols are important when we're doing more risky activities. So like return to sport or return to competition because those are the things that might create risk for another concussion. Therefore, we do wanna make sure people have fully recovered before they engage in those, but school is such an individualized experience and everyone has their pre-injury challenges. Everyone has different learning needs and everyone's in a different situation. Like we can't apply a kid who's in grade two to be having similar school situation to someone who's in grade 12 and about to go to university. There is more at stake for missing a lot of school and workload and not doing tests.
Stephanie (00:13:36):
So I guess the other piece is we're really starting to learn that schools and teachers, they know individualized learning really well <laugh> and they do it amazingly well. And sometimes when we throw really strict protocols that then we kind of take away their skills to do that. So how can we sort of rethink what we do with return to school and just think, you know, these steps and stages are guideline, but at the end of the day, we should really be looking at the kid, their needs, their circumstances prior to injury there's circumstances now, and just think what's gonna work for this kid. So that's, I think probably the two things just active approaches and rethinking just back to individualization is really what's changing and we'll dive into more of the details as we go.
Ryan S (00:14:19):
Absolutely. No, I really appreciate all that information. And you highlighted something just like the, the individualized approach and, and when teachers are navigating through that, what are different ways that when they're looking at the guidelines, the protocols, how they can support the student going through it, when it hasn't necessarily those guidelines haven't caught up to the protocols, you kind of touched upon it, but if you can just, I guess, dive into that a bit more. That would be amazing.
Stephanie (00:14:47):
Yeah. The reality, the way the concussion world works, or I guess any world that's changing in evidence very quickly is I think, I think the statistic is correct, but you might wanna fact check me after this podcast, but I think on average, it takes about seven years for evidence to be implemented in best practice. And perhaps at times it's longer than that. Think at minimum, the problem with concussion is that things have changed so quickly over the past three to five years, a lot of guidelines and protocols within the schools that were created three to five years ago, no longer align with actually what we would recommend as best practices or what's gonna help someone recover. And I think what further complicated that is obviously COVID like schools, concussion was not a priority for the past, like two to three years, schools are completely overwhelmed with other needs.
Stephanie (00:15:38):
Now we have schools with a lot more behavioral and mental health challenges. So it's really, really tough for schools and best practice guidelines for many reasons, funding time resources to continually keep up as quickly as they would need to. So I think what we need to do is understand that some of the protocols that are in place across school boards or within schools lack some of that language that I just spoke to. So maybe their language is a little bit more rigid in nature, and we wanna look at it and maybe loosen it a bit in our minds. So do you need to be symptom free reading for a specific amount of time before you go back and engage in school? No. Think of it kind of as a guideline in general, that would be ideal, but if it's not working for that kid, what we're learning is a kid should really be back in school within a week from recovery.
Stephanie (00:16:26):
And that doesn't mean fully back. It means exposed to the school environment in some capacity, if we wait for everything to be fine or better or perfect until we get back to school, we may prolong the problem. A lot of kids get really anxious when they are outta school for a long time. They think about how much work they're missing and the longer that occurs, the bigger of a hill, it feels like they need to climb to go back. So yes, we could sit and do cognitive activities at home as long as we want. But at some point we do need to try some exposures to the school environment. And that's just kind of an example of though it may say something in your protocol, kind of look at the kid and understand their circumstance. How, how much stress is that causing keeping this kid at home?
Stephanie (00:17:12):
Does this kid have a good home circumstance? Should we be considering maybe sort of bringing them back sooner than, rather than later, even though they still have symptoms and just accommodate and manage their symptoms within the school environment instead, there's really good resource. And I'm actually part of the expert panel it's called the peds concussion living guidelines. I'm sure you can link to it in the podcast notes afterwards, but that really is where best practice stands. There's really good resources there for teachers to pick up. So I know it's kind of annoying to have one thing protocol that may say one thing, but then the guidelines say something else. I think we just need to look at and say in general, this is what we want things to look like, but we don't need to follow it like a rule book anymore when it comes to return to learn.
Stephanie (00:17:54):
And I guess the last thing I would say is as a lot of, I think heightened rigidity because of Rowan's law. So a lot of people feel that legislation applies to return to learn, but that's actually not true. Legislation currently applies to return to sport and physical activity within a school environment, which should have a more rigid piece in nature because of what we spoke to earlier, those are the things that could create risk for another injury. It's not legislated that you need to follow each stage of a return to learn or return to school protocol. That's kind of left up to, you know, best judgment of all of those involved with the kid and what they think would work best for them. Every kid has a right to be accommodated for their concussion. I think that that is one thing we all wanna commit to and that those accommodations should be fast acting in nature and supported, but those accommodations shouldn't be restrictions or avoidance of activities.
Stephanie (00:18:49):
They should always lean towards how in some way, can this kid participate? I think if we think of it as a general rule of thumb, maybe we can start to make sense of our, our protocols, but it's confusing. It's the reality of where it is. But I think teachers have a lot more skill set here than I think we like teachers know how to do this. That's really well <laugh>. And so I think when we take away some of that rigid at rigid focus, kids actually do better. They know these kids way better than the medical community knows them. So I guess that'll be my final piece on those inconsistencies.
Ryan S (00:19:25):
That's great. And I think, yeah, the having the teachers kind of utilize their skill set. That's something that I know we've talked about a lot. Yeah. And it it's so important because they are trained. They, they know the students, they know kind of how they're interacting, they know their circumstances. So being able to help them kind of weed through the guidelines, the protocols is, could be very advantageous for a student's recovery. And you may have mentioned at least one of these, but I'd love if you could just kind of debunk some concussion myths relevant to the return to learn process.
Stephanie (00:19:57):
Let's just dive into those myths. Yeah. I feel like I've touched on a few, but it's helpful just to like list them and have a view them mm-hmm <affirmative> so I think the first one is having symptom free expectations for low risk physical or cognitive or social activities. We want to start doing things more as tolerated. So I kind of use a bit of a, a color scale with kids and maybe I'll explain it so it can give people some context. Cuz sometimes when we say, as tolerated people say, well, what on earth does that mean? So for kids, I tend to use a color scale of like sentence being green, yellow, or red. And what I do for kids is sort of relate it back to how well they're functioning in something is based on the color that they would choose. So let's use headaches for an example because headaches are probably one of the most common symptoms after injury and recurring the school environmental for a lot.
Stephanie (00:20:51):
So what I'll say to a kid is let's say you're in the classroom and you have a headache, but it's not impacting your ability to do anything in that moment. You can still do math class just as well. You're following along with the teacher quite well. You can do your work. It's basically annoying or a nuisance that you have a headache at the same time, those ones we call green. And then we say those ones we can continue with. So it's okay. Continue with what you're doing and just sort of monitor, but there's no need to change up the plan you're performing just as well as you would normally would. And you're comfortable where you are. Yellow symptoms. We say, I am in the classroom, I'm in math class. I have a headache, but it's definitely impacting my ability to do things so I can stay in this classroom.
Stephanie (00:21:38):
That's okay. But I I'm getting a little lost on what the teacher is saying. It's taking me longer than usual to do my work. I feel distracted. I feel irritable. Yellow are the ones that we say, we gotta change up what we're doing in some way. So maybe you need to have a paper handout instead of looking at the smartboard, for example, maybe what you're doing. You need to take more breaks. You've been doing it for too long. So sort of revisit what you're doing and change it up. Doesn't necessarily mean take a break from the environment, but some way you need to be accommodated to help you perform in that activity a bit better. And then we say red symptoms are the ones that are so bad. We have to leave the environment. And those are the ones that we encourage kids to have quiet spaces or places within the school to accommodate their symptoms.
Stephanie (00:22:22):
So it's kind of teaching kids and everyone around them that we can't leave an activity or stop an activity. Every time we're in the green, it'll be really hard to progress over time and improve our recovery. So that's kind of what we mean by not having a symptom free expectation or treating all symptoms is the same, how much your symptoms impact your performance should then relate to how much we accommodate for them in that moment. So that's what we like to think of for return to school. And that can apply to everything like test writing homework afterwards, how much we need to accommodate what's okay. And when we need to break. So that's what we wanna move more towards. The other thing too, that is a common myth I see in schools often is that kids need to completely fully return to all aspects of school before they do any physical activity.
Stephanie (00:23:15):
It is true that kids should be fully back to school schedule and workload before they're back in competition or game or the final stages of return to sport. I have a lot of kids that need to burn off some steam at recess, or need to do something to move their body, to focus better, or to be able to tolerate the classroom a little bit more because we know exercise is gonna help their recovery. So we encourage schools and we also encourage the clients and families we work with to find what is that safe amount of physical activity within the school environment you're comfortable with? And usually it means some type of engagement in exercise at recess with their friends, maybe not participating in that full soccer game with their friends at recess, but finding something for them that at least gets them out and being a bit active, being as active as they can outside of this school.
Stephanie (00:24:05):
And then phys ed is always one of those things. It kind of depends on what the kid is doing. So sometimes fied is actually fitness based activities at the time and it'd be very appropriate for a kid to be doing those types of things. But then obviously it's not appropriate for a kid still in recovery to be doing like Dodge ball basketball or volleyball or something like that. So we always just sort of decide what is it that you're doing within school? And what's the right amount of physical activity for you because when we limit all aspects of physical activity or what I often see too, is keep a kid indoors for recess. We might be creating more problems by doing that. And when we have increased irritability sadness from that isolation just a lack of ability to be active. It's hard to know where the symptoms are coming from anymore as, as that goes on.
Stephanie (00:24:52):
So I think that's one of the other myths we really, really wanna get out there. A few others that are common as well is I constantly see the way we accommodate concussion tends to focus on the environment in the school, which you know is good in nature. So a quiet space, for example, maybe the kid would wear sunglasses or noise, canceling headphones or paper handouts. Those are helpful. But honestly, what I find more helpful for kids is accommodating the workload and I find the workload often gets missed or is completely delayed until they feel better. The number one thing I see that can help kids recover from a concussion faster and just do better in the long term is if we put fast acting accommodations in place, which eliminates the non-essential workload, they missed. So if they missed a week or two of school or they had missed a couple tests, they're not expected to get caught up on every single one.
Stephanie (00:25:49):
That is, I think the number one thing that keeps kids from progressing and increases a ton of stress in kids when it's not clearly communicated that they don't have to get caught up on all those things. And then if we just say, don't worry, none of those things matter until you feel better. Well, now the kid is seeing this massive pile of work that they don't think they ever wanna get back to. Yeah. Because it's too overwhelming to even think about mm-hmm <affirmative> so we tend to more say, let's cut the non-essential workload and how do we prioritize? What's important. That's this? I usually recommend, it's gotta be something that's knowledge building in nature. So if you don't learn this material, it's gonna be really hard to learn future content. And there's certain subjects that just build more and then other subjects. So usually what's most helpful is to have a contact person at school or someone who's gonna look at all your workload, make those decisions and communicate with all your teachers, cuz it can be really hard to decide what is the priority in a high school kids' workload.
Stephanie (00:26:51):
And it's kind of unfair to expect a 14 year old to advocate for themselves on what that should be. Yeah. Yeah. So I think that's one of the more commonness. And then the last one I'll just say is a lot of protocols in return to learn right now still have a lot of yes or no rules, which encourage avoidance of certain activities, which if you kind of remember what I said from the beginning around not having symptom free expectations, we kind of wanna move away from that. So screens, for example, is screens aren't bothering a kid or they stay within the green, sometimes yellow level with their symptoms. We don't need to completely avoid them. We need to gradually start exposures with those tests. We don't wanna have no rules around tests because again, if we delay all tests on a certain stage, we're gonna prolong the recovery.
Stephanie (00:27:38):
So what can they start to pick up and work on? The strong, no rule we do need to follow is again, feel like I'm repeating myself, but I'll say it again, is the stuff that puts you at risk for another concussion. Those are the things that are a strong, no rule. So like fied sport participation until a child is fully recovered. Everything else should be a little bit looser in terms of individualized based on what the kid is coping with. Well and what isn't otherwise we might create rules for no reason and actually perpetuate more avoidance and activities that would actually help the kid recover in time. So I think just to reiterate it's that symptom for expectation quicker engagement of physical activity actually accommodating the workload, not just the environment and moving away from these strict, no rules are the commonness or I guess things that have really good intentions that actually create longer recovering kids. We see very often still in schools.
Ryan S (00:28:34):
Okay. Yeah. That's, that's a lot of great information right there. Thank you so much kind of building off your last point. I just wanna ask you if there's a way for teachers to kinda identify what a student can and can't do academically, while they're going through that process and understanding it's an individualized kind of process for the student and the teacher, how would you respond to
Stephanie (00:28:57):
That? Yeah, it's, it's hard. I can give some ideas, but it really does depend on the student. I would really lean towards understanding the kids' circumstance of what the most important work that needs to get done is we always encourage attendance first. So getting a kid back to the school environment is important before we start to put some workload on them, but we shouldn't wait for a complete full school return before doing any workload either. Like we slowly have to build kids self-efficacy and self-confidence like checking things off their to-do list to make them feel like they're progressing. That's really important for improving recovery as well. So usually what we tend to say is like, what is, what does this kid need to accomplish within the, within the next one to two months for school? What are the biggest priorities? That's where we should focus and do whatever we can to get that work done.
Stephanie (00:29:49):
So even if the kids, so I'll give some examples the kids attending school well, but is having a lot of issues with workload. So it's not really the environment, that's an issue they're just really stuck in the work. Some really helpful accommodations might be. So what actually helps someone learn the content, not necessarily memorize it, if someone's having issues with retention or just can't tolerate long work periods. It's, it's diff school's enough, let alone dumping two to three hours of homework after school in order for them to perform the next day. So we tend to say, you know, just do whatever we can that helps this kid learn the concepts. In the meantime, some of the other things too, to look for and I feel this would resonate with teachers is there are a lot of kids right now that are very stress about performing really well in school.
Stephanie (00:30:36):
And I actually find those are the ones that tend to struggle a little bit with concussion recovery and there's very high expectations they have on themselves and starting something when they don't feel at their best can kind of create this fear of failure. So if you have a kid who, you know, places of really strong sense of identity in their grades, it might be helpful to remove some of the grading expectations initially to allow them to slowly jump in. So we just want you to slowly learn this content, but throw it in the recycling after you're done. I'm not gonna look at it. So there's sort of this when they first try, there's not this fear of that. Others will think that they're dumb. I think this is a very common fear that a lot of people have because they don't feel at their best.
Stephanie (00:31:21):
So if I'm not a hundred percent, I don't wanna try, but we wanna encourage, you know, trying when not at your best, but not fear of repercussions for that as the confidence builds, how can we slowly put some grading expectations in with kids and have a plan B I think a lot of kids benefit from, if this test comes out completely on side of your usual self will give you opportunities for a makeup. Like even that relief in itself can help kids build their confidence to jump in. So those are just a few examples of like things you can look for in the type of individual a kid is and how you would accommodate some kids are gonna need a little bit more of a scaling back approach. So you're doing a lot, you're sort of trying to do everything. You need more strategies on how to prioritize and like permission to use their accommodations. And some kids are gonna need more of like an engaging approach. Like I just said, like exposures to things and encouraging them to try and just deciding what approach would work better for the kid that you know, is likely to help their recovery. So I think those are just a few things that people can look for, but it's so what you said, it's highly individualized, but those are a few examples.
Ryan S (00:32:33):
I think those are really great points and definitely the emphasis on learning opposed to the outputs I think is really, really helpful. And I hope some teachers can understand the value in that for sure. I, I know they would,
Speaker 13 (00:32:49):
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Ryan S (00:33:25):
So I guess kind of still talking about the same kind of area within this experience, but how would you address the concern of a student not being able to complete the minimum requirements needed to pass a concussion? So kind of touch upon some ways that teachers can kind of work with a student, but what if it gets to that point where they actually may not meet the minimum requirements or minimum achievement necessary to kind of pass that course? How does that work? Yeah,
Stephanie (00:33:53):
We get a lot of questions about this and I wanna start off by saying when we take more active approaches initially and we accommodate kids quickly, we encourage them to be back in the school environment. As soon as possible. We focus on learning rather than outputs. And we put some accommodations in place that allow kids to complete work to allow them to be graded. We actually shouldn't see this problem happen too often, where kids are really behind in a course and have not completed the necessary requirements. And we don't know where to go from there, to be honest, I find it's strict, rigid. You need to be symptom free before you do anything that kind of creates this issue. So if we're a little bit more proactive with some of the stuff we've all talked about, we might prevent some of these occurrences from happening in the first place.
Stephanie (00:34:44):
But that being said, we can do all of these things in every now and then these things will still happen. I think a few examples I can think of is I've worked with quite a few kids who before their concussion, they were behind for whatever reason. So this was just, you know, just one more thing in this kid's life that sort of set things back. And really at this point you would be accommodating. However, you've done it for any other issue where a kid is really behind and you would problem solve what would work for that kid. So are we at a point where dropping this course and doing it this summer is better for this kid's wellbeing are, is this course even a kid's priority for their future goals that they want to do. I often find that's a big piece is it's like, I'm just, just doing this credit.
Stephanie (00:35:31):
It actually isn't that important. So it's an easier decision for the ones that are a priority. I just encourage it to do, to be used exactly the same way it is whenever there's large absences or missed work for any other issue, the same strategy applies to concussion as it would for someone who missed a lot for another injury or illness or maybe a family issue, or maybe mental health reasons. It's the same type of strategies on what does this kid want to be able to accomplish and how can we get them to their goals in the best way possible. And, and what are all our options? One thing I just wanna touch on because it's been something I've been seeing a little bit since the pandemic is from a concussion perspective, it actually, isn't a good idea to encourage virtual school for a catch up plan or doing that instead of an in person, we learned a lot over the pandemic and the in person piece I think is extremely beneficial for concussion recovery.
Stephanie (00:36:25):
So I just wanted to put that out there that that's not something we would do to maybe support a kid in completing a course. But if it's the only means then which it's offered, of course whatever's gonna work to get the kid what they need and the credit. But I think I just wanna say is we shouldn't be seeing these circumstances too often, but the last thing I'll say is right now, it's also really unique. Like there are kids right now who between the pandemic strikes four years ago, literally never had a regular year of school and some kids just aren't ready for the next step as maybe some kids were previously because they lost key developmental, like milestones and rights of passage that they should have had throughout their like older elementary or high school experiences. So maybe meant now more than ever, some people might be taking a few extra courses or taking an extra year before going off to post-secondary and that's okay.
Stephanie (00:37:24):
And we need to sort of communicate that that's okay. I think we're in a bit of a unique circumstance, which we'll, I know we're gonna get into a bit more where a lot of kids aren't doing well before concussion and then this happens and things get more complicated. So I think just for us all, to realize that this has been a very challenging few years for kids and if they need ex, if they need to delay a course or do it at another time concussion or not, that's okay. And there's nothing wrong with taking that approach.
Ryan S (00:37:56):
So kinda like taking a step back, being able to assess the situation as a whole would be quite beneficial is kinda what I'm hearing from you is understanding the mental health components too. Like that's, that's a big thing, especially with what we've been going through in the pandemic and everything.
Stephanie (00:38:13):
I guess what I'll just say is from my experience, I haven't seen too often kids needing to drop out of a course or delay a course for solely concussion reasons. There's usually more at play that the concussion has complicated. So it's important to take a step back and not sort of, you know, say the concussion has resulted in all of this. It's not usually the case when I've seen those, I guess more uncommon examples where those decisions need to be made. There's a lot going on outside of that. So it's really important to take a step back and look at that kid's life and just see where we go from there, with their goals and what they wanna do in the future, what they're learning in school.
Ryan S (00:38:51):
Yeah. I really like that. And just making sure teachers are there to support opposed to being there to be like, oh, we gotta get this done. We gotta get this done is it's kind of another theme I'm starting to notice is being there to ensure the kids are able to progress. And I know all teachers would want that from their students as well. So just making sure that we're always remembering that in the back of everything.
Stephanie (00:39:14):
Yeah. I think a lot of teachers I've talked to over the past few years have really had to step up to be teachers of life mm-hmm <affirmative> rather than teachers of content and like hats off teachers who yeah. Have taken on this role because very challenging and it's kind of shifted of what we even think of what schools do. And I think over the past few years, they've more been a system of care for kids than they have been a Institute of teaching concepts. And it's important to recognize that role and that applies here as well in everything we're talking about.
Ryan S (00:39:53):
Yeah. So I guess just kind of say like on the same topic here and you, we talked about the transition with COVID to kind of virtual learning how it's not necessarily conducive to a student who's sustained a concussion and maybe navigating through that, what factors impact teachers like when they're trying to navigate a student who has a concussion in a virtual learning session and what complexities should they be considering? I know we've touched upon the mental health and everything, but how can they be navigating those, the virtual environment and everything with COVID a little more
Stephanie (00:40:29):
Specific. Yeah, I think over COVID a lot of things were from a concussion perspective were made easier for kids from a who had concussions, but a lot of things were made a lot harder. So there was kind of winds and losses. I know a lot of schools are sort of moving away from the virtual environment, but the virtual environment still exists for many reasons or hybrid models. I know post-secondary education would probably be like that much more often moving forward than maybe high school and elementary school. I mean the, the pros of a virtual environment, if again, I'm just gonna say, I always support an in person environment for concussion recovery, but if virtual is the only option, these are some things that might work. So the nice thing about virtual is there is easier opportunity for breaks that are slightly less awkward for kids. It's quite awkward to get up and leave your classroom. Just to acknowledge that.
Ryan S (00:41:22):
Yeah, it really is. I
Stephanie (00:41:23):
Still wanna do that. Like it's awkward. Yeah. And it makes people uncomfortable. It's easier to do that in a virtual environment. You know, you turn your camera off and there's permission to do that or take a quick break, keep your headphones in those mini breaks, I guess, have less social awkwardness, which is nice and helps. I do find obviously tons of screen time can be some challenging for a lot of people, but we give a lot of strategies for that around like there's like this 20, 20, 20 rule for eye breaks using things that would actually support the right use of natural light with their screen in the room and also where they can have paper handouts and just listen whenever possible. It's, it's pretty similar. But again, it's important to engage in some type of screen time and then just find the chunks or the opportunities that can be paper based and what absolutely has to be on the computer, because it can be really it's.
Stephanie (00:42:13):
Some things are just impossible to do on paper. Like there's a lot of coding classes these days. Mm-Hmm <affirmative> so you have to pick which ones have the opportunities to not be on screens to give those kids a bit of a break. And I think we stick with those, but it's okay for the ones that have to be. We just give them the tools to tolerate it better in time. But the reality is for the virtual environment, especially for kids who had focused issues prior to injury can be a lot more challenging to learn content, stay focused. And I often feel in a virtual environment, sometimes there's a higher expectation of self-directed learning, which is really challenging to do when you're not feeling at your best. So the other thing I would say is sometimes in a virtual environment, kids might need more opportunities for like one-on-one learning and actually teaching to engage a bit, rather than here's the general idea of the concept.
Stephanie (00:43:05):
Now go take it and learn it on your own for one to two hours. So I sometimes try and like, obviously self-directed learning is very important and we should all have a skillset, but in concussion recovery, it's a little bit harder to do. And sometimes you need someone to sort of sit through you and actually teach you the concepts in a more detailed way that the virtual environment doesn't always provide, because there's that less opportunity for drop in, or just talking to someone that you don't understand something on your way in or outta class. So if teachers can kind of make sure that they're available or there's a clear process that isn't completely on the kid initiating that they need help. Cuz a lot of kids don't initiate it's it's, it's hard to initiate. It's challenging. And we can say, oh, I'll advocate be more independent, but you know, when you're younger, it's just really hard to do that. So we might need to create those opportunities to allow those conversations to come up that actually initiate from the adult and then give the, the child or student the opportunity to bring it forward. So those are just some things from the virtual environment I've been seeing. We may need to up a little bit more yeah. For working with kids in recovery.
Ryan S (00:44:11):
No, I think that actually leads perfectly into my next question here is what can students be doing to accelerate their recovery process and where can teachers help with this process? So you touched upon the virtual, the in person. Yeah. I'd love to hear your thoughts on this.
Stephanie (00:44:29):
Yeah. You know, it's interesting. One of the things I find, what I work on for the kids to do are the clients on themselves is a little bit more of an understanding about how mood impacts their cognitive functioning. I often feel it's the stress, it's the uncertainty, it's the lack of confidence, the decrease self-efficacy, which is complicating, the focus, the memory, the, the cognitive issues that we we see. So I tend to work with kids on strategies, on understanding the connection between mood, stress, wellbeing, and how well they can perform at the things they want to do. Cognitively mm-hmm <affirmative> there's like stress behaviors, for example, that a lot of kids do that they might heighten concussion recovery. So a lot of kids might have a higher tendency to avoid activities that are stressing them out. So we'll go through what I call like a fear hierarchy.
Stephanie (00:45:30):
So we don't wanna start with a task that's nine out of 10, stressful for us to start, cuz it's just gonna bring up all these feelings about what we don't know, but we gotta get there eventually. So what on the hierarchy can we start with, but then teachers need to support and sort of prioritizing. So they're not wasting their time on work. That's just not relevant or important and using their cognitive efforts, not strategically. So it's like teachers tell us what's important, create a minimum list and then we'll work to sort of understand how stress and mood is connected with, with going through those asks. So that's just like one example. I also find a lot of kids do a lot of other types of stress behaviors when they're in recovery, which may take a little bit longer for their work. So a lot of kids start to check their work way more often than they would normally would.
Stephanie (00:46:18):
And I think it's because they're uncertain and therefore it's taking them a really long time. Like I have some kids who would check work maybe 12 to 13 times after they do it really, or they seek a lot more reassurance from people like, am I doing this right? Is this due date right? And are most sort of leaning on their own understanding and strengths and relying on other people to really, to relieve their worries. So these are sort of few themes of some things that I work with kids and other. And then other times it's just creating a schedule for cognitive participation success. So some kids benefit a lot from doing a little bit of exercise before they do cognitive activities. Some kids need a whole like reawakening of their sleep hygiene. Like that's really impacting their ability to perform well in school.
Stephanie (00:47:08):
You know, there's a lot of focus just used, but I'm like your sleep schedule is all over the map. So it's kind of to be expected. Or we have some kids who are just trying to cram everything into their schedule still and haven't really picked the priorities that they need to do. So I think the other thing I work on with kids is what time of day is calling of activity gonna be very successful for you? What else is going on in your life? That's complicating the picture and making sure their demands and resources match, cuz sometimes they're way more demands than they're currently able to do with the time. So it's not avoiding things necessarily, cuz I never want to fall into a theme of completely avoiding things, but it's just, what's important to you in your life right now and what can maybe go or what can we maybe hand off for someone else to do at this time?
Stephanie (00:47:57):
A lot of kids I work with too are part of like 15 committees and like a lot of like different extracurricular activities and they still wanna do all of it and they will, we'll get back back to all of it. But for a time period, sometimes it can create a lot of noise in our minds and it's, it's hard to focus because we, we are so overwhelmed by all the things we do that that's actually creating a bit of distraction in our ability to focus on our school efforts. So maybe that gives you a few examples of what we work on at a individual level with the kids and sort of like what they take on to support their recovery. But it's only as helpful as the accommodations that they have and the priorities that are helped set for them in their workload. Otherwise they're taking on a part-time job talking to each teacher asking who the priorities are and gets more complicated. So
Ryan S (00:48:46):
Mm-Hmm <affirmative> yeah, no, I'm, I'm starting to see even more similarities between like just setting priorities, whether it be from a teacher's perspective, a student's perspective. Yeah. Maybe even a parent's perspective, but being able to set those priorities, understand what is most important in this recovery for you to be doing, as you mentioned, such busy schedules for students, right. They have so many things on the go yeah. And including their social lives as well. So just navigating through it can be a challenge for sure. So I guess,
Stephanie (00:49:14):
Sorry, go ahead. I'm just gonna add one thing. Go ahead. Just based on what you just said, I think it's important to highlight and it's that I think a lot of kids fall in, especially when they're behind in school and recovery, they fall into this pattern of feeling guilty whenever they're not doing school stuff. That's a really good point. Yeah. And it's, it's really important to remember that like exercise and social activity and the right amount of sleep is as important as school function and helping people understand that those things are as important in their life in recovery takes a bit of time. So sometimes when we're setting priorities, everyone's priorities are gonna be a little bit different. But I think it's really important that we all agree when it comes to kids concussion or not. They should have some type of meaning or priority outside of school.
Stephanie (00:50:00):
And if they don't, that's a problem, right? Like that's a problem. So I think that's the one thing I'm another thing I find that I have to work with is almost giving kids permission to say, it's okay to take 30 minutes for social activity. You don't need to feel guilty that you're not studying. So sort of that theme of work, smart, not hard <laugh> yeah, that makes sense. But that takes a lot of maturity and time to discover we all went through it, right? We do it in our own mm-hmm <affirmative> work days every day as adults where we revisit what we're doing and am I being productive in this time? Would I be more productive if it took a bit of time for myself and then try this thing, but kids are learning that that's, especially when they're teenage years, they're just starting to learn that skill set, but concussion can really make you completely dive into a school like tunnel focus and think nothing else matters. So I think that's just the last piece. I think it's important what you said and that we need to help realize that other things in life are just as important and you have an identity outside of being a really good student, good grades. You've more offered to the world and remind yourself of that in your strengths, in other areas of your life, by living your life in other areas.
Ryan S (00:51:11):
So, well I think what you're mentioning there really touches upon the mental health pieces as well. Right? Yeah. And how the concussion recovery is so intertwined with mental health and, and just how you're navigating through that. And most often like doing proper, like mental health practices can actually help a student see progress in a concussion recovery as well.
Stephanie (00:51:31):
Yeah. I'll, I'll touch on that a little bit because I think both maybe now more than ever are overwhelmed with mental health needs of their students and a lot of the strategies that work for anxiety, low mood, maybe learning issues that have a strong mood connection like ADHD, these strategies can work really well for kids with concussion as well. Like schools have the tools to do this. It's obviously a bit different in nature because you're dealing with a sudden change in someone that happens with an event rather than something that maybe has been diagnosed and more prolonged and existed before. So we just have to be more rapid in nature in how we react to it and be open-minded to the fact that unlike diagnosis that would carry through someone for years or lifetime concussion will change very quickly and rapidly week by week.
Stephanie (00:52:23):
And we need to adjust very quickly to that. So kids progress and we should continue to make sure those accommodations make sense with their progression and not be fast acting in nature. So one thing that we're really learning that I don't think a lot of people understand is yes, yes, there's mental health challenges after concussion. And there's lots of different theories as to why that might be. But what we're really learning now is that you're pre-injury mental health, coping stress, all the things that happen before injury kind of where is sort of setting the stage, which might determine how likely you are to perhaps struggle with concussion. Should you sustain one? So I like to explain it to the clients that we work with that mental health is your brain's immune system. It needs to be in a good state mentally in wellbeing, coping stress.
Stephanie (00:53:17):
And if we add anything to it, like a concussion, maybe a stressful social situation, maybe complex family dynamics, we're not in a very good state to recover from those things that are suddenly added to the previous pressures that we already had. So sometimes what happens is we see that the mental health issues that were pre-injury are now just more complicated in nature as a result of the concussion and the concussion experience itself, not just the injury, but the actual experience can sort of create a lot more of these mood issues. And that's a massive mind body connection. I don't, I think a lot of people understand, yes, mental health can affect your emotions, but it can affect you physically and cognitively as well. It can completely affect your focus. Your ability to remember poor mental health can give you more headaches, greater sensitivity to lighter noise.
Stephanie (00:54:07):
And these are all that crossover a lot with concussions. So I guess my general rule of thumb here and why we need to take or reconsider our strict approaches that we take with concussions sometimes is if we're making accommodations or rules from a concussion perspective that are likely to decrease, someone's mental health. We're not supporting their recovery. So strict isolation, bedroom, jail, avoiding school. These are things that we know in time will make mental health worse, which therefore can make their concussion recover. So I think that's what we need to think of when we're working with kids, is will this also help their concussion and their wellbeing and their mental health? If we're only depending it for the sake of concussion, we might wanna ask ourselves questions because it might with really good intentions, do the opposite of what we wanted. So,
Ryan S (00:54:56):
Yeah, I really, really, really like all of that. That's so important to understand, and I think the way you even put it, where like, if you're prescribing certain things as a teacher, to a student that is almost gonna go against their mental health, it is just not gonna be positive for their recovery. So just that simple thing to keep in mind can really go a long way for both a student and a teacher when supporting someone through this experience. So, but yeah, to change pace a little bit, as I mentioned in the intro of the podcast, we did hear from teachers and get their experience with working with children who have sustained a concussion and, and navigating it. So I do want to read out a passage that we actually we're able to get from one of those teachers. And then I'd love to get your thoughts on it afterwards, Stephanie, if that's okay.
Ryan S (00:55:45):
Yeah. Yeah. So this is again from a teacher, I work with children who have brain injuries and in, bracket's not a concussion, so this isn't specific to a concussion, but I think there's some great learning points in here. My practice is to identify the different learning levels of the child through academic testing and task analysis. Once a cognitive level of a student has been identified, I will create an IEP to guide my teaching throughout the year. This document is ever changing and allows for adjustment depending on success rates. These children are often accommodated in the classroom with various teaching testing and environmental accommodations. I'd love to get your thoughts on that kind of treatment for a student.
Stephanie (00:56:26):
Yeah, I think it's a really nice statement because I love how right now there's not really a focus so much on symptoms, but just what can this student do? How can we support their learning? How can we make sure that our teaching supports their type of learning testing and our mental accommodations? I like it cuz it takes a step back. And I think that this is what we need to do with concussion. A little bit more is just look at the situation and decide what needs to be done. I do wanna acknowledge that this situation is quite different. So it's obviously a lot easier when we have formal IEPs in place and formal IEPs are not typically done for concussion. Think of concussion as more of like a temporary IEP that wouldn't formally go on a student's record and follow them through their school years.
Stephanie (00:57:17):
There's just temporary accommodations we put in place. So I think sometimes when there is a diagnosis where we can expect it to be more long term in nature, like a on severe brain injury or ADHD or a learning disability, it's, it's a bit easier because there's very formal processes in place with an IEP that sort of support teachers and sort of, and they're not as quickly changing in nature. So just to appreciate that the, the situations can be very different in terms of the tools that teachers have available to them. What I like about the statement though, is just how, you know, I just work with the students strengths. I work with what the student is struggling with. I sort of juggle all the strategies that I know might be available or have works with people in the past or might work with this type of kid.
Stephanie (00:58:03):
And I base my testing and environmental and teaching accommodations around that. It's just it's a great approach. And I think it's something we, we should be doing more instead of are you stage three or schedule four, these are activities that you should be doing and not be doing, cuz it just works better. We know it works better. So I think, but I just do wanna acknowledge that, you know, teachers don't have many, as many supports when it doesn't fall under a formal IEP. They're sort of juggling a little bit there and it's gonna change quickly. So just when you get Comy information, you're gonna have to change it. So outside of teachers, this is why we need learning sports specialists. Maybe it's a guidance counselor. Maybe it's a nurse within the school. I'm not sure who vice principals. There's a lot of people who sort of step into this role, but someone needs to be that I guess, main contact person who coordinates with all the teachers and sort of supports them because it's challenging to do this just from a teacher perspective, there has to be some other support within the school system to support the level of individualization that I'm talking about and how quickly it would change.
Stephanie (00:59:07):
It's just teachers have how many students to take care of with who, how many have like there's so many IEPs now people are under resourced. It's, it's very challenging. So there has to be some other support within the school system to meet the approach that you just discussed from a concussion
Ryan S (00:59:23):
Standpoint. Yeah. And another question, a direct question from one of the teachers which builds off this actually quite well is when working with children with special needs. I create an IEP that informs my teaching. As we, we just saw there, is there a framework to follow for teachers who have a child with a concussion?
Stephanie (00:59:43):
I think the best frameworks we have these protocols, which may or may not align with some of those individual needs. I guess what I would say is a lot of the frameworks that we use for anxiety, ADHD, those types of accommodations that help kids progressively become more active within their schooling and make reasonable like workload modifications are your frameworks and tools which already exist, which are likely to support really well. We just have to be more rapid access in how we put them in place. You're gonna get less direction from the medical community on them because there isn't sort of as much formality to it and we have to be willing and flexible to change them week by week, the frameworks are there. And they exist. And I think a lot of concussion protocols can support this as long as you're just sort of look at your protocol and say, is there a lot of no words in my protocol, is there symptom free expectations? Those are the ones we wanna loosen about and more lean towards the ideas of the accommodations of the protocols present.
Ryan S (01:00:49):
Thank you so much for answering that question. I do think it is very helpful and it is a, a kind of a pressing question, the framework of course, for them to follow as we've touched upon it at many points in this podcast. And I guess one thing the question I do have for you as we know, teachers are like amazing at helping students learn and progress in their lives, how can they leverage their existing understanding of their students needs and the skillset they already have to just kind of help students through this process and in the accommodations that they can provide.
Stephanie (01:01:23):
Yeah. I think it's a really good question. And I think it's touches on a few things we've talked about already, but I truly believe teachers know kids pre-injury functioning that are learning a style. What makes them tick better than anybody? When I meet someone mental community, I'm only meeting them in a short period of time. I gather a lot of clinical history, the best that I can as well as a functional history, but truly teachers know these kids best and they're kind of experts in these kids. So yes, there's expertise in concussion. What often gets forget, or what's so important when we're talking about brains and people is who is the expert in this person, obviously the client themselves, their parents, and the people around them who have been heavily involved, which is teachers. And sometimes even coaches, depending on how often you would be working with that kid.
Stephanie (01:02:15):
So I think it's really getting back to just, what does this kid need? What works for them and what sets them on a plan that reaches their goals. And if we start to focus more in that way and be a little bit more solution focused in that approach rather than problem and symptom focused, we will be doing so much better in terms of getting kids on the right path quicker and better after a concussion injury. The other thing that I often see is when we become problem focused. So did you get symptoms? Did you not? What are your issues? It's, it's slowly taking away that kid's confidence and nobody is better sometimes than a teacher or a school environment to build that confidence back again. So I think just in summary, it's, you're, you have a lot of expertise in these kids just think of what you would do to help this kid in their wellbeing and you know, what works them and what's gonna motivate them. What do they actually, what are their goals in their learning? Like what do they need to accomplish this year? What, what do they need to head towards? And that can sort of guide your priorities and be a little bit more solution focused or I guess also acknowledging progress in, in kids rather than problems or what they still have left to do. I think those are just some final statements on what we can rethink with this population and what I find actually helps kids get better.
Ryan S (01:03:45):
Yeah. I think those are some really great closing points there. And just being able to leverage their existing skill set, their existing knowledge of the student is so important and, and it can be forgotten. That's, that's kind of the weird thing with concussion. So just a gentle reminder that teachers, you are amazing. Just use your skillset and just keep doing what you can to support the students with that. I would love to just open it up to you. If you have anything you'd like to share Stephanie before we close things out here.
Stephanie (01:04:14):
Yeah, no, this has been great. I think my final statement is just to acknowledge again, the past two years that we've been through <laugh> in schools and with kids and why now more than ever, it's so important to change our approach with kids with concussion. I think we did a not so great international experiment where we saw what happened when kids were out of school for long periods of time, didn't have sport, didn't have social interaction. It's pretty much like a bedroom jail approach to concussion that we used to do. And look how many net new pro problems were created. I mean, obviously all these things were necessary at the time. This is what we've had to do. It was a global pandemic, but we also learned a lot about what it meant for kids wellbeing and how important things like school and meaningful daily activities are to kids' wellbeing.
Stephanie (01:05:11):
And when we take those things away, we don't help kids. And I think that's just a really good lesson to take forward on why we need, because we need to change our approach now more than ever. We're, we're really understanding that what we did in the past probably didn't help so much. And the last piece is that we do have a lot of kids who aren't doing as well pre-injury and therefore we can expect them to maybe need a little bit more support after an injury, because there's more going on. That's complicating the picture and taking a step back and appreciating that this is not just a kid with a concussion. This is a kid who got a concussion and maybe also B, C and D like in addition. So therefore are we, we have to make sure we're supporting those other things because the mind and the brain and your emotions, it's all in one place.
Stephanie (01:06:04):
And if we don't support just helping people feel good about life, having meaning to get up in the morning, having things that they feel good at in our skilled, at have things to participate in. It's no wonder that they're, they continue to have symptoms, cuz they start to have different sources in where they're created outside of the injury, which are those non-injury factors, which is I don't have anywhere to go. I don't exercise. I don't have a purpose when I go to school, I don't have expectations those types of things. So I think it's just a really good time to do a bit of a reset and, and what we know about kids and take a whole different approach and really understanding schools are about getting kids back to life. And that is, or sorry, getting kids through life. And that's what concussion should be too, is getting kids back to life and participating whatever they possibly can. And when we do that, we can expect really good outcomes for kids with concussion. So it's kind of a nice, I guess, positive note it's when we take these more active approaches, we won't be seeing as much of the prolonged issues that we have seen in concussion in the past. So it's, it's actually hopeful for the future as well.
Ryan S (01:07:15):
Well, thank you Stephanie so much. We really appreciate this. And you taking the time outta your day to kind of inform us on these amazing topics and, and the conversation you were able to provide was just yeah. Exceptional and yeah, lots of passion too. I love your passion for the topic and thank you. And just being able to actually have so many actionable things that teachers can do in order to of course accommodate a concussion in the classroom. So I know any parent teacher school administrators, even students can actually listen to this podcast and take so much valuable information from it. So I really appreciate you being able to help us facilitate this. Thank you so much.
Stephanie (01:07:56):
Yeah. Glad it was helpful. And thank you so much for having me.
HeadsupCAN (01:07:59):
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