Returning to School After a Brain Injury

Returning to school after a brain injury is an important part of your child’s recovery

Most children can and should return to school or academic activities after a brain injury. Participating in school and other academic activities helps them:

• Stay connected and make friends
• Build or re-learn skills
• Keep a routine
• Do physical activities
• Prepare for adulthood

Brain injury symptoms may make it harder for some children to attend school or do their schoolwork. It is important to set up a plan to help lessen or prevent symptoms from getting worse at school. Schools can provide support and make academic adjustments that are designed for specific brain injury symptoms and help your child ease back into schoolwork. School supports and academic adjustments are provided primarily to assist with learning and achievement rather than to restore a child’s school performance to what it was before the brain injury.

It is important to notify the school about your child’s brain injury

You should notify the school right away about your child’s brain injury. Ask your child’s medical professional for written information to share with school professionals about your child’s injury, symptoms, medical needs, and when they should return to school. To get information on your child’s brain injury sent to the school from their medical professional, you may need to sign a medical release form. Another option is to make copies of your child’s medical records and share them directly with the school. Be sure to request that information about your child’s brain injury be placed in their comprehensive educational file and student health record.

Ask your child’s school to create a plan

If a child attends a public school (or charter school), getting a return-to-school plan in place often starts when a parent or guardian writes an email to the school’s principal, vice principal, nurse, teacher, and/or counselor that shares information about the child’s injury and asks for an evaluation for special education services under the Individuals with Disabilities Education Act (IDEA). When a child’s health condition is reported to the school, school professionals are required to evaluate and create a plan for managing the health condition while the child is in school. This process does not automatically enroll a child into the special education program. Instead, it serves as a pathway to access additional supports or academic adjustments that can be approved and put in place.

In general, a plan should:

• Identify a case manager who will serve as the primary point of contact for everyone (including school professionals, medical professionals, and parents).
• Outline who is responsible for monitoring your child while they are at school.
• Consider your child’s age, symptoms, level of understanding, and emotional status.
• Include the type and length of activities your child can handle.
• Address any schoolwork they may have missed.
• Be made available to any of the school professionals who interact with your child at school.
• Include feedback from you and your child (if appropriate for their age and ability).

Schools can set up an Individualized Health Plan (IHP) or Individualized Health Care Plan (IHCP).

IHP and IHCPs are formal documents created by the school nurse (or whoever oversees medical/health-related issues at school). These documents vary by state, but in general, they outline a child’s health conditions and how to manage them while the child is at school. As an example, a child’s IHP or IHCP may include how and when they should take medications for seizures and headaches during the school day. If your child’s school sets up an IHP or IHCP, be sure that it includes input from you and your child, as well as from their school nurse, medical professional, and other school professionals your child interacts with during the school day.

Federal law requires that public schools provide support to children identified as having short- or long-term disabilities due to a brain injury.

The type of formal support will differ depending on the specific needs of each child. You can request a meeting with school professionals to discuss what types of school supports and academic adjustments are best for your child. You can also request that your child be evaluated by the school if you have concerns about your child’s learning due to ongoing symptoms of brain injury.

The following are summaries of common educational supports available through schools. Importantly, these services may vary by state and school district. Many states offer special education services to people until age 22, but some states have extended eligibility through to age 25.

Informal academic adjustments: If your child’s brain injury symptoms are expected to get better and not affect them for more than a couple of weeks, their school may recommend informal academic adjustments. Informal academic adjustments are designed to help a child re-enter and succeed in school, but there are no changes to academic standards, school content, or requirements.

Multi-Tier System of Support (MTSS) or Response to Intervention Protocol (RTI): An MTSS or RTI may be used for students who need academic adjustments for an extended period and/or need to increase the level of a particular intervention. An RTI allows for a multi-step, targeted approach that school professionals can use to monitor a student’s progress through increasing levels of intervention. At each intervention level, a school professional assesses the students to determine whether additional instruction or support is needed.

504 Plan: Students with long-term or persistent symptoms and who require assistance to be able to participate fully in school may be candidates for a 504 plan. A 504 plan removes barriers and provides support that allows a student with disabilities to learn alongside their peers in the classroom. For example, a 504 plan for a child with brain injury might include environmental adaptations, behavioral strategies, or learning supports such as extra time for classwork and testing in a separate room. However, the curriculum cannot be modified under a 504 plan. A 504 Plan is a legally binding document. To qualify, the school generally collects data and evaluates the child to determine if he/ she has a physical or mental problem that substantially affects a major life function (such as learning, thinking, reading, or sleeping), and requires medical documentation of a brain injury from a medical professional.

Individualized Education Program (IEP): Children with brain injury who require significant help to participate in the school curriculum, which cannot be managed by a 504 plan alone, may be eligible for an IEP. An IEP is part of special education, and it details the special education and related services that a school will provide to meet the unique needs of a student with a disability. An IEP may include adjusting the student’s curriculum, adjusting methods or pace of instruction, or allowing the student to work in a smaller classroom environment other than an inclusive classroom. To qualify for an IEP, a school will evaluate the child through a psycho-educational evaluation.

Special education services are available for infants, toddlers, and preschool-age children

If your child is under age five, you can request that your local Early Intervention Program evaluate your child. Public schools are required to provide qualifying services to infants and toddlers who demonstrate developmental challenges through an Individual Family Service Plan. Once a child reaches age three, and if they qualify for an IEP, they can get services from their local school district as part of the early childhood education program.

There are special considerations for private school students

If your child attends a private school, be sure to check with the school to see if they offer special education services. School districts may set up a private school service plan. However, the services may be more limited than what’s offered in a public school.

Compassionate answers. Real support. Every step of the way.

Contact the National Brain Injury Information Center at 1-800-444-6443 to speak to a specialist about:

• Help with care needs
• Legal and financial resources
• Services in your community