With no state guidelines, students struggle in classrooms after concussion

Students are back in class - and back in the game - as school sports get underway.

KIRO7 has learned thousands of Washington students get concussions every year and Washington state is falling behind in making sure students injured on or off the field get the help they need.

“I had a concussion, it was about a couple of weeks into the season,” said Andrew Johnsen, a junior and football player at Lake Washington High School in Kirkland.

His concussion was freshman year. He knows the risks of the game first hand, as well as the challenges after a concussion.

“It was a little hard concentrating, that's also why I had to take some breaks. When you have a concussion it's kind of hard to still be a full time student, deal with a concussion, and try to get better at the same time,” Johnsen said.

But it's not just sports. The CDC says about half of brain injuries among kids are from falls.

Charlie Yanny, a Seattle student, suddenly fell one day while standing in the driveway waiting for a ride to school.

“Bleeding on my brain, a fracture on my skull from here to here,” he said gesturing to the spot on his head.

All concussions are considered a form of mild traumatic brain injury. Charlie’s wasn’t so mild.

After a month and a half at home, he finally went back to class but found his high school didn't quite know what to do with him.

“Anxious as all get out. I was like how am I supposed to get this stuff done? How am I supposed to be able to read when I can only read for 10 minutes and put myself in an excruciating headache?” Charlie said.

He said the nurse’s office was often full of kids when he went to take breaks.

“I didn't know what to do so I was just taking breaks in the hallway, really embarrassingly,” he said.

Charlie said even his teachers were also at a loss

“That was a massive challenge,” he said. “A lot of the teachers and nurses were looking to me for guidance. And I was like, I am so confused right now because I'm in so much pain and this has been so wild for me. And I had to explain a lot of times to the teacher what was working and why I needed to take these breaks,” Charlie said.

Washington state has some protections in place for students - specifically student athletes -- who've suffered concussions.

In 2009, the state passed the Zackery Lystedt Law.

He got a concussion during a game in 2006 as a 13 year old and was put back in after a few plays.

That led to a brain hemorrhage, leaving him permanently disabled.

What happened to Zackery led Washinington to pass a law that requires any student athlete showing signs of concussion to be examined and cleared by a licensed health-care professional before being allowed to "Return to Play" -- making Washington the first state in the country to pass such a law.

Since then, every state in the country has followed suit.

But the state does not have guidelines for when, or how to re-integrate a hurt student back into the classroom -- something called "Return to Learn."

At least a dozen states have policies requiring protocols for transitioning kids back to school after a concussion.

Doctor Monica Vavilala is with UW Medicine and director of Harborview Medical Center’s injury and research center.

“Ten years later, other states have moved forward to create more comprehensive laws. Washington has not. Would you say our state is falling behind?” KIRO7’s Deedee Sun asked her.

“We are a bit behind on return to learn,” Vavilala said.

She said part of the problem is that there’s no standard way to track concussions in schools.

KIRO7 filed public disclosure requests for 15 Western Washington school districts, asking for the number of reported sports-related concussions over the past five years.

For example, the Seattle School District reported 1,039 sports-related concussions over the last five years.

But between the different districts, KIRO7 found some numbers are from athletic trainers on staff, some are contracted out to trainers at hospitals, others are from coaches, or "support staff" - who cannot diagnose a concussion.

Everett School District said the athletic trainer at Everett High School left the country and took the data with him

“Nobody tracks it, and it's hard to track,” said Jennifer Carrol, the Washington Athletic Trainer’s Association president.

“We don't have a database. We don't have a central database in Washington where all concussions are tracked. So we don't report our numbers to anybody,” Carrol said.

It means there are big gaps in even basic information on concussions.

“Washington state is struggling from a lack of understanding of how often concussions are actually occurring. And therefore, not able to provide a comprehensive plan for kids for kids who returns to school,” Vavilala said.

Right now, how a student is re-integrated back into the classroom varies from district to district, and even school to school. Lake Washington High School, where Andrew goes, has its own return to learn guidelines. But Charlie’s school does not.

“How detrimental can it be for a student when the support services aren't there?” Sun asked.

“It can be pretty detrimental. Because if you're academically falling behind, then obviously that affects your SAT, studying, college applications. This is a serious issue because high school is an important period of time in one's academic career,” Vavilala said.

Dr. Vavilala is part of the team working to fix that problem.

So far, they’ve studied 118 Seattle students across five high schools and created a pilot program.

“The novelty of this program is it doesn't rely on the presence of an athletic trainer or school nurse. It’s anybody who's a TBI (traumatic brain injury) champion can go through the check list we've developed, identify the symptoms, and map those symptoms to accommodations and make those recommendations to the teacher. It's really that simple,” Vavilala said.

“Is it working?” Sun asked.

“We’re finding the schools that participated really like it. They find it provides them with some support and structure for taking care of these kids,” she said.

And their program is about to expand.

The team at Harborview and UW medicine just got a grant from the CDC ($570,000) to roll this out at 24 public high schools across the state.

“We don't want students to fall behind academic and underachieve, because they're not receiving the right accommodations in a timely manner,” she said.

For Charlie, high school completely changed after his injury

“School became much more of a nightmare, than this fun place that it was before,” he said. “I felt like my life was robbed from me,” he said.

He ended up leaving his high school and finished credit requirements at North Seattle Community College.

He said a plan would've made a big difference

"100%! If there was a plan in place so people could understand and know what to do," he said. 
"Having teachers understand so people like me who have injuries don't have to argue and fight for the accommodations that they need. I see could be incredibly beneficial," Charlie said.

The team at Harborview and UW is currently recruiting high schools to participate in their return to learn program. They hope to make a policy recommendation to lawmakers in a couple of years and get return to learn guidelines in all schools across Washington.