Dodge City Community College Athletics

 
The following return to learn (RTL) protocol will be individualized to each student-athlete by a Dodge City Community College athletic trainer. Return to learn and return to play are complimentary and will follow a stepwise progression. Some athletes may require academic accommodations initially due to their symptoms. The majority of concussed student-athletes, however, may not need a detailed RTL program because full recovery from concussion tends to occurs over a 7 to 10-day period.  RTL can become more difficult when symptoms persist for longer than two weeks or if symptoms are severe following a concussion.  These student-athletes may require extensive academic accommodations over a longer period of time.
 
Return to Learn Concepts

• Return to learn will be managed in a stepwise progression that meets the needs of the individual student-athlete.
• RTL guidelines assume that physical and cognitive activities require the brain to function at or close to normal levels. It is also assumed that brain injuries require time and energy to heal, just like other injuries. Thus, energy is not readily available for physical or cognitive exertion following a sport-related concussion (SRC).
• RTL recommendations are based on consensus statements. Consensus statements are produced with correlating evidence-based data.  
• It is difficult to provide recommendations for return to learn because the student-athlete may appear normal, but may not be able to perform at their pre-injury physical and cognitive levels due to SRC symptoms and effects. 

Return to learn administrative procedures. The following is a step-by-step procedure for enacting and using the RTL protocol. The RTL protocol will be activated by the athletic training staff following the diagnosis of a concussion and the determination that cognitive accommodations are necessary. This protocol will be individualized to each concussed student-athlete by the athletic training staff. 

1. Following the diagnosis of a concussion the athletic trainer will determine the athlete’s level of disability based on reported symptoms and cognitive and functional evaluation.
   1. It is important to remember that each concussion is different and individuals will respond to a brain injury differently. This variability requires that the return to learn protocol be specific to the individual.
   2. The return to learn protocol is designed to be fluid. The concussed individual may not need to start at the beginning and progress all the way through the protocol.  Stages may be skipped, individuals may move backwards, some individuals may skip return to learn entirely. This determination will be made by the Athletic Trainer based on physical and cognitive evaluations.
2. Following the diagnosis of a concussion the athletic trainer will inform the athletic administrative staff and college counselors as well as sending a competed concussion accommodations checklist form. The counselors will notify the appropriate person(s) of the student-athlete’s status depending on their program of study.  Contacts could include, but are not limited to, the program director and instructors of the student-athlete’s classes.
   1. The purpose of the letter of is to inform the appropriate academics personnel of the student-athlete’s status following SRC. This accommodation form will include date of concussion and any accommodations requested for the student-athlete. This will also include any revision dates as well as a full RTL date.   
3. Upon receiving this the counselors will work with the student-athlete’s professors/instructors on implementing these accommodations.
4. The appropriate staff members will be notified of any updates or further accommodations the student-athlete may need.     
5. Professors should communicate with the athletic training staff if any further problems or questions may arise. 
   1.  Two-way communication will ensure that the athletic trainer has the best information possible to make decisions on the individual’s status and improve the care of the concussed individual and progress them appropriately through the protocol.
6. In the event that the concussed individual’s symptoms remain elevated or no signs of improvement are shown the athletic trainer may refer to the team physician and potentially specialists. 

Duties. The following section is to ensure that each person involved in the return to learn process for a student-athlete knows their role. These duties must be completed to ensure that the student-athlete receives the best possible care following a sport related concussion.

1. Athletic trainer:  diagnose, treat, and manage return to play and return to learn for concussions. Communicate new entrants into the return to learn protocol. Communicate changes to an individual’s status in the return to learn protocol. Receive communication from academic personnel after each interaction. 
2. Athletic administrative staff/counselors:  serve as a communications liaison between academics and athletics. Receive communications from athletic trainers and forward to appropriate academic personnel. Receive copies of communication between academic personnel and the athletic trainer. 
3. Academic personnel:  receive communication from the athletic administrative staff and counselors about individuals in the return to learn protocol. Work with the individual to provide accommodations. Communicate with counselors and the athletic trainer any observations made during each interaction with the concussed individual.

 
Concussion Return to Learn Stages and Accommodations
 

Stage	Description	Academic Strategy	Characterization
1	Cognitive Rest; Symptomatic at rest	No academic activities  All academic personnel will be made aware of student-athlete’s status	The student has sustained a concussion and is resting physically and cognitively to avoid symptom exacerbation.   The student will be building up to the cognitive requirements in stage 2. When the student returns to the classroom they will need to work with the instructor to catch up in a graduated way.
2	Cognitive activities at one-hour intervals	Academic work from home is permitted; no class attendance	The student is permitted to perform cognitive activities in one-hour increments. They may work on assignments and other school work, but must take frequent breaks of 10 minutes every hour to avoid symptom exacerbation. The student may require more frequent breaks depending on when or if symptoms increase.  The student will begin building up to the cognitive requirements of stage 3.  Please communicate with the student about creating and maintaining a schedule for completing missed activities.  The student is under continued daily monitoring by the athletic training staff.  No physical activity at this time.
3	Half day of class	Class attendance and academic work permitted; participation as tolerated; potential rest period or break from class if becomes symptomatic	The student is permitted back in the classroom. They may need classroom accommodations to limit symptom exacerbation. The student may begin building up to the cognitive requirements of stage 4.   Please communicate with the student regarding a schedule for completing missed activities.   The student is under continued daily monitoring by the athletic training staff.  “Active recovery” activity may begin.
4	Full day of class	Full class attendance and participation as tolerated	The student is permitted to attend and participate fully in classes. Continue schedule to make up missed activities with increasing amounts of work.   The student is under continued daily monitoring by the athletic training staff.  Return to play may begin.
5	Return to all academic activities	Classroom attendance by student-athlete is required as clearance has been granted Student communicates with appropriate people if symptoms return	Full academic participation without accommodations. Continue to work with the student to make up missed activities, assignments, quizzes/exams. The student is under continued daily monitoring by the athletic training staff.  Return to play continues.

 
 

Potential Accommodations and Interventions Based on Concussive Symptoms
Headache	Frequent breaks Avoid triggers for headaches  Can take Tylenol as directed  Nutritional supplements as directed Diaphragmatic breathing Therapeutic modalities as necessary
Sensitivity to Light	Wear sunglasses Move to an area with low lighting Sit out of direct sunlight from windows or outside Avoid or minimize computer screens, projector light, TV, video games, dim screens (avoid bright blue lighting from screens)
Sensitivity to Noise	Sit in quiet settings  Provide quiet settings to study, complete assignments, quizzes, exams No physical activity around loud areas  Do not use headphones or earbuds; limit music listening
Other Vision Problems (blurred/double vision, eye tracking problems, etc.)	Limit screen and phone time; dim screen if necessary Shorten, reduce, or extend reading assignments Record lectures or use lecture handouts; provide a note-taker Refrain from texting, watching TV, and video games  Eye exercises as prescribed by athletic trainer
Concentration or Memory Problems	Place focus on content or concept Postpone/reschedule tests Allow extensions for assignments and other class activities  Reduce assignments
Sleep Difficulty	Frequent breaks  Allow students to attend a later section of the class if possible

                                                                                                                                       
               Revised June 2022