TOOL DEVELOPMENT PROCESS AND INFORMATION
Who is this tool for?
This tool can be used by:
School Boards:
- Directors
- Trustees
- Superintendents
- Administrators
- Psychological Services Team
- Social Work Services
- Consultants
School Partners:
- Office Staff
- School Nurses/
Public Health Nurses - Athletic Trainers
- Child and Youth Workers
- Educational Assistants
- Lunch Assistants
- Specialty Operators
School Administrators:
- Principals
- Vice Principals
Teachers
Coaches
Students
Families
School Volunteers
Healthcare Professionals
Note:
This tool directs you to a range of concussion information and supporting resources. The information and resources shared have been created by various groups, and so you may see different recommendations, messages and language (e.g. return-to-learn vs. return-to-school). The field of pediatric concussion is young, growing and not yet standardized. It is important that from the information and support resources provided in this tool, that you use what works best for you in your school and education system context.
SCHOOLFirst development
The SCHOOLFirst tool was developed by an interdisciplinary team and in consultation with key stakeholders with experience in
supporting students to reintegrate and return-to-school after a concussion. The development process involved the following steps:
Qualitative research study
A qualitative research study of school staff, students, families and healthcare professionals who have engaged in a postconcussion return-to-school process was conducted.
Semi-structured interviews with teachers, students, family members and healthcare professionals were completed to gain insight into individual experiences with the return-to-school process.
Interview data were synthesized and analyzed to generate themes.
These themes acted as principles for which the content and design of this tool were based.
Information
Evidence in pediatric concussion and on concussion management, specifically how to optimize the return-to-school process, is evolving.
To build this tool, we:
- reviewed evidence in the form of consensus statements and clinical practice guidelines
- leveraged the expert opinion and collective experiences of healthcare professionals,
knowledge translation experts, and teachers with experience in concussion and the return-to-school process
Stakeholder review
Feedback from targeted stakeholders with expertise in concussion and return-to-school was obtained to ensure that different perspectives were captured and that the tool would meet user needs.
An integrated knowledge translation approach was taken to develop the SCHOOLFirst tool. This involved engaging multiple stakeholders throughout the different phases of the work to ensure that the user’s (education community) needs were being met. The stakeholders helped to inform the content, organization and build of this tool, resulting in a multimodal (i.e. video, text, images, links to resources, case studies, tools) product that is truly user-driven and user-focused.
SCHOOLFirst development team
Team
Nick Reed, PhD, MScOT, OT Reg. (Ont.)
Associate Professor, Department of Occupational Science and Occupational Therapy
Member, Rehabilitation Sciences Institute
University of Toronto
Adjunct Scientist, Bloorview Research Institute
Holland Bloorview Kids Rehabilitation Hospital
James Carson MD, Dip.
Sport Med, CCFP(SEM), FCFP, Associate Professor, Faculty of Medicine, University of Toronto
Alexandra Cogliano, MScOT, OT Reg. (Ont).
Research Assistant, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital
Stephanie Cowle, BA
Manager, Knowledge Translation
Parachute
Barbara Csenge BA, BEd, MSc
Educational Consultant, Barbara Csenge Consulting
Pamela Fuselli, MSc
President & CEO
Parachute
Becky Green, BPHE, BEd, MEd
Superintendent of Education, Student Achievement and School Operations, York Region District School Board
Dayna Greenspoon, MScOT, OT Reg. (Ont).
Research Coordinator, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital
Allia Karim, MA, President
Reserca
Pauline King-Taylor, BPHE, BEd
Former Head of Guidance and Career Education, Bill Crothers Secondary School, York Region District School Board
Christine Provvidenza, MSc, R.Kin
Knowledge Translation Specialist, Holland Bloorview Kids Rehabilitation Hospital
SCHOOLFirst contributors
The SCHOOLFirst tool was jointly produced by researchers, healthcare professionals, knowledge translation experts, school administrators and staff, family members and youth. The team would like to thank and acknowledge the York Region District School Board for their collaboration. The team would like to recognize the following individuals for their contributions to the co-creation of this tool: Laura Thompson (Occupational Therapist, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON), Sarah Keenan (Life Skills Coach, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON), Kasandra Tinoco (student), Dr. Sari Kraft (Sport Medicine Physician, Sports Medicine Specialists, Toronto, ON), Maddy Hearne (Holland Bloorview Ambassador, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON).
SCHOOLFirst information
Conflict of interest declaration
Members of the SCHOOLFirst development team (NR, CP, BC) have authored some of the resources that are linked out to in this document. These resources are available to the public at no cost. The other contributors have no conflict of interest to declare.
Funding
The SCHOOLFirst tool was funded by the Public Health Agency of Canada.
How to cite this document
Provvidenza, C., Greenspoon, D., Carson, J., Csenge, B., Karim, A., King-Taylor, P., Cogliano, A., Cowle, S., Fuselli, P. and Reed, N. (2019). SCHOOLFirst: Enabling successful return-to-school for Canadian youth following a concussion. Holland Bloorview Kids Rehabilitation Hospital. Toronto: ON.
Copyright
© 2019 Holland Bloorview Kids Rehabilitation Hospital
User consideration
SCHOOLFirst is a compilation of information and resources to assist the education community in supporting students with the reintegration and return-to-school after a concussion. This tool was developed to assist the education community with ‘how’ to support students with concussion when returning to school. While great effort has been made to ensure the accuracy and currency of the content of the SCHOOLFirst tool at the time of its publication, the completeness or accuracy of the information cannot be guaranteed. Many of the resources and research reach different conclusions; in particular, the stages of recovery differ across authors and groups who have published in this field. The reader may see different recommendations used because the field of pediatric concussion is young, growing and not yet standardized. As such, the education community are required to exercise their own judgment in using and applying the information in the SCHOOLFirst tool, and must consider the individual student’s needs, relevant circumstances and local school context when using the information.
The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.
Contact information
Nick Reed, PhD, MScOT, OT Reg (Ont)
Associate Professor, Department of Occupational Science and Occupational Therapy
Member, Rehabilitation Sciences Institute
University of Toronto
Adjunct Scientist, Bloorview Research Institute
Holland Bloorview Kids Rehabilitation Hospital
Rehabilitation Sciences Building, University of Toronto
160-500 University Avenue, Rm. 936
Toronto, Ontario, M5G 1V7
nick.reed@utoronto.ca
Follow @DrNickReed
Parachute
Parachute is Canada’s national charity dedicated to reducing the devastating impact of preventable injuries. Unintentional injury is the No. 1 killer of Canadians aged 1 – 34, where one child dies every nine hours. The financial toll is staggering, with injury costing the Canadian economy $27 billion a year. Through education and advocacy, Parachute is working to save lives and create a Canada free of serious injuries.
Bloorview Research Institute
The Bloorview Research Institute is dedicated to improving the lives of children with disabilities through client and family-centred rehabilitation research. Located onsite at the Holland Bloorview Kids Rehabilitation Hospital, the Bloorview Research Institute is recognized in Canada and around the world for its unique client population and leadership in the field of childhood disability. The Research Institute brings together a multi-disciplinary team of scientists who work collaboratively with clinical staff, clients, and families to generate clinically-linked and applied pediatric rehabilitation research.
Public Health Agency of Canada
The Public Health Agency of Canada empowers Canadians to improve their health. In partnership with others, its activities focus on preventing disease and injuries, promoting good physical and mental health, and providing information to support informed decision making. It values scientific excellence and provides national leadership in response to public health threats.
References
1. Lax ID, Paniccia M, Agnihotri S, Reed N, Garmaise E, Azadbakhsh M, et al. Developmental and gender influences on executive function following concussion in youth hockey players. Brain Inj. 2015;29(12):1409-19.
2. Halstead ME, McAvoy K, Devore CD, Carl R, Lee M, Logan K. Returning to learning following a concussion. Pediatrics. 2013;132(5):948-57.
3. McGrath N. Supporting the student-athlete’s return to the classroom after a sport-related concussion. J Athl Train. 2010;45(5):492-98.
4. McCrory P, Meeuwisse WH, Dvorák J, Aubry M, Bailes J, Broglio S, et al. Consensus Statement on Concussion in Sport-The 5th International Conference on Concussion in Sport Held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838-47.
5. Provvidenza C & Reed N. Concussion & You: A handbook developed for parents and kids. Toronto: ON, Holland Bloorview Kids Rehabilitation Hospital, 2015.
6. Zemek R, Barrowman N, Freedman SB, Gravel J, Gagnon I, McGahem C, et al. Clinical risk score for persistent postconcussion symptoms among children with acute concussion in the ED. JAMA 2016;315:1014-25.
7. Gan C & Ballantyne M. Brain injury family intervention for adolescents: A solution-focused approach. Developmental Neurorehabilitation. 2016;38(3):231-41.
8. Baldwin P, King G, Evans J, McDougall S, Tucker MA, Servais M. Solution-focused coaching in pediatric rehabilitation: An integrated model for practice. Phys Occup Ther Pediatr. 2013;33(4):467-83.
9. Andrews D, Fong G, Hackam D, Li L, Lynam MJ, Matthews M, et al. Guide to knowledge translation planning at CIHR: Integrated and end-of-grant approaches. Ottawa, ON: Canadian Institutes of Health Research, 2012.