Sustaining a brain injury due to a concussion can keep a student-athlete off the playing field or court for a while. It can also affect him or her where it counts the most: in the classroom.

When a student is found to have a concussion, the schools have a list of "pre-determined accommodations" that are immediately enacted, according to Sisters High School (SHS) Nurse Trish Roy. Students are not to take any tests, homework is put on hold, and the school works to "balance activity and rest."

No more are students sent home to stay in a dark room for several days. Athletic Director Tim Roth said that, in consultation with The Center Foundation, the school district has altered its protocol.

"You don't isolate the kid," he said. "You don't want the kid to be in a dark room for two weeks. You need to get them back in the swing of things."

Both Roy and Roth say that teenagers who are isolated can develop depression and anxiety over missing out on school and activities, which impedes recovery.

Getting a concussion identified quickly is important, according to Mark Stewart, the SHS administrator tasked with administering accommodation programs for special needs of all kinds. A concussion that occurs in a school sport is readily noted - but when it happens off the field, recognizing the effects can be delayed.

"Those are tricky," Stewart said. "Hopefully the student went to the doctor so we've got a little bit of a diagnosis ... it really helps to have that diagnosis from a physician."

Roy notes that a parent should act if they think something may be wrong.

"Listen to your gut instinct," she said. "If it's telling you something is wrong, there's probably something wrong... We've got to have information. We have to know that a kid is not normal."

If staff is unaware of a concussion, they sometimes have to identify the situation working back from academic or behavioral symptoms.

"Sometimes it's just problem-solving and we find out, oh, gee, they've had an accident and we have to step back a little bit and move forward from there."

For most concussions, there is a two-to-three-week window of healing. In some cases, though, symptoms linger for longer periods of time (see related story, page 21). When that is the case, more structured and individualized accommodations may be required. According to Stewart, that's when the Student Effectiveness Team steps in.

A student who requires accommodations lasting more than 60 days is placed on a federally mandated "504 plan." That plan is supposed to get teachers, students and parents on the same page. Effectiveness requires communication between all parties - and monitoring the program to make sure it's being implemented across the board.

Cort Horner's son Ty was on a 504 plan to accommodate issues stemming from concussion. Accommodations included breaking up four-part tests into individual days, because Ty had a hard time switching focus between different aspects of a subject. Extra breaks are also common requirements.

"That's one of the accommodations that you can have in a 504 plan," Cort told The Nugget.

Stewart says that common accommodations include extra time; organizational support; and help with time management. All of those functions are commonly affected by concussion and post-concussion problems. Horner singled out math teacher Kristy Rawls as having done a particularly good job in staying on top of Ty's 504 plan.

"Kristy Rawls was fantastic in spending the extra time with him and finding where he was struggling out of the classroom," he said.

He was not as satisfied with the across-the board implementation. Some teachers, he felt, were not fully dialed-in on what the 504 required.

"I would hope attention is brought to how we assure that teachers are adequately trained in 504 plans," he said.

Currently, Ty is at a school in West Linn, because the family did not feel his needs were being fully met. They are now.

Horner is not casting blame.

"The district resources are limited; their resources to accommodate anomalies to the norm are limited," he said. "I understand that."

However, he says, there is "room for changes to the process or improvements in the process."

Horner believes that success requires "a good plan; administrative understanding; and teacher implementation." Without all three clicking together, a student's needs may not be completely met.

Stewart believes that the district did everything possible to accommodate Horner. Still, he acknowledges that the district can improve its understanding and accommodation of brain injuries.

"The problem with the 504s is the monitoring," he acknowledged. "There can be gaps. I think we're getting better," he said. "I think as we learn more about them and their impact in the classroom, we'll get better and better."

Horner, Stewart and Roy are in agreement on one requirement: Students need to express their needs and let teachers and parents know when they're not being met.

"The student needs to be able to advocate for themselves as part of a 504 plan," Horner said.

Successfully navigating a student through the classroom impacts of concussion requires a high degree of cooperation between and among staff, parents and the affected student. Each case is individual and complex, and it's all part of an evolving understanding of the nature of concussion-related brain injury. For everyone, education and training continue to be the best tools to deal with a potentially life-changing issue.