Evaluating a Post-Concussion Return to School Group Program for Secondary and Post-Secondary Students in Southwestern Ontario, Canada
Bibliographic record
Abstract
Background: Mild traumatic brain injury (mTBI) is a steadily growing public health concern. Young adults with mTBI find themselves having to navigate not only the physical, cognitive, and somatic aspects of their recovery, but also self-advocate for accommodations and services when they return to school. The skills required to be an effective student upon returning post-injury are paramount to continued success in returning to life. However, there is a gap in the literature in terms of evidence-based return to school (RTS) programs for those with mTBI.Objective: The aim of the current study is to examine effectiveness of an outpatient RTS intervention on studentsu2019 executive function and post-concussive symptoms.Methods: In this pre-post-trial, an RTS program was delivered to students attending post-secondary institutions with a diagnosis of a concussion. The group based RTS program consisted of 2 hour sessions delivered over 7 weeks. The program included sessions consistent with the Practice Standard Guidelines for Cognitive-Communication put forward by the College of Audiologists and Speech-Language Pathologists of Ontario. Participants were asked to complete questionnaires related to demographic factors and a formal battery of cognitive-communication assessments. Participants who completed the RTS Program were also sent a survey link, with questions about their injury and school status. Primary outcome measures included: Attention Processing Training (APT), Woodcock-Johnson III Test of Cognitive Abilities (WJ-III), and Rivermead Post-Concussion Symptoms Questionnaire (RPQ) at baseline and post-treatment. Pre and post assessment scores were compared using paired samples t-tests.Results: 38 students participated in the study. According to survey results, the number of students who continued/enrolled in academic studies increased from 24 to 33 after attending the RTS program. Additionally, the number of students using learning supports increased from 17 (post injury-pre RTS program) to 29 (post RTS program). Overall satisfaction with the RTS program was high with 37 out of 38 participants stating they would recommend it to others looking to return to learning. Significant improvements were seen in attention including complex sustained attention (p<.001), selective attention (p<.001) and alternating attention (p=.004) on the APT. Significant improvements were also found on decision speed (p<.001), pair cancellation (p=.027), rapid picture naming (p<.001), and reading fluency (p=.029) from the WJ-III. No significant improvement in the RPQ was reported.Conclusions: Results from the study suggest improvement in the management of skills beyond simply academic performance and into improved cognitive symptoms in general. Future research should examine if improvements in cognitive-communication symptoms result in a significant change in learning strategies, information uptake, and academic achievement. Studies incorporating multidisciplinary management for learners including rehabilitation professionals and academic centers are warranted.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.003 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".