Systematic Review: Returning to School After Traumatic Brain Injury

Objective(s): To complete a systematic review of research regarding returning to school after Traumatic Brain Injury (TBI) to 1) determine recommendations for a successful return to school following a TBI according to the implications of children returning to school after sustaining a TBI, and 2) determine the impact of the lasting effects of TBI on children’s success in an academic environment when returning to school.

Data Sources: PubMed, ProQuest, Sage Journals, NIH, ResearchGate, Europe PMC, JAMA, Lippincott Williams & Wilkins, Frontiers with time restrictions between 1980-2023

Study Selection: Using the PRISMA guidelines and a three-phase review process, the principal investigator completed the initial records search, yielding nine databases. The second phase included an article search and records review by two investigators with inclusion criteria pulling articles for signs and symptoms of mild traumatic brain injury in school-aged children from 1980 to 2021, yielding 24 articles narrowed down to 4 that met the criteria for a full review. The third phase of the review searched ‘return to school’ or ‘re-entry to school’ or ‘return to learn’ and ‘TBI’ or ‘traumatic brain injury’ or ‘brain injury’ or ‘head injury’ and ‘in school-age children’ by a single investigator with a follow-up review by the principal investigator. This yielded 168 articles from 1980-2021, narrowed down to 45 articles that met the criteria for a full review completed by both investigators.

Data Extraction: The records review was completed initially on 10/29/2020, and the final review was completed on 7/31/2023, yielding 49 articles from 36 journals reviewed to include years from 1993-2021.

Data Synthesis: Research found that many professionals and caregivers often did not know how to support children as they returned to school, thus requiring more training and education. Increased preparation and interdisciplinary support were associated with better academic and social outcomes.

Conclusions: General recommendations have been summarized; further research is recommended to establish procedures to reintegrate children into the school environment with proper modifications, accommodations, and other necessary supports based on current symptomology and encourage advocacy for services.

Author(s) Disclosures: Dr. Bratcher serves on the New Mexico Brain Injury Advisory Council as appointed by the Governor and teaches Neurogenic Language Disorders at Eastern New Mexico University.
Ms. Montes is a Graduate Assistant in the Communicative Disorders Program at Eastern New Mexico University.