Special Ed Connection, May 30, 2014
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gzittoun quoted in Special Ed Connection article.

A child plays basketball with his friends and dribbles right into an opposing player. He gets knocked down and hits his head on the pavement. At the doctor’s office, the physician tells the parents their child needs to refrain from any physically or mentally demanding tasks for a couple of weeks.

When the student returns to school, he gets migraines from the classroom lights, has trouble focusing on work, and gets upset at his teacher when she tells him to pay attention.

As a 504 coordinator you wonder, Should we evaluate this child for Section 504?

Concussion symptoms don’t always emerge right away, but they can temporarily affect major life activities such as learning, concentrating, and thinking, which lead many schools to consider an evaluation.

However, most students who have a concussion only need a couple weeks to recover with short-term adjustments to the educational setting, said Karen McAvoy, the director of the Center for Concussion at the Rocky Mountain Hospital for Children and author of REAP, a protocol for managing concussion.

In most cases, convening a 504 or IEP meeting to discuss an evaluation would be unnecessary and could delay the use of immediate adjustments, McAvoy said. Instead, suggest that teachers and coaches make a variety of adjustments to reduce the mental and physical demands on the student and help speed recovery, she said.

In 80-90 percent of cases, children recover in one to three weeks, McAvoy said. A small percentage of children with protracted recoveries may be eligible for Section 504, but rarely will a child with a concussion be eligible under IDEA, she said.

“For kids who are still experiencing problems in their second or third month of recovery, [the school] might need to consider 504 accommodations,” she said. “But I virtually never see a concussed student rise to the level of needing an IEP.”

Take these steps:

Implement immediate adjustments

As soon as possible, educators can take steps to speed recovery. These are academic “adjustments” for a temporary impairment that schools can implement outside of a 504 plan, McAvoy said. It’s better for a student’s recovery to offer many adjustments right when she returns to school, she said. Depending on the student, adjustments could include providing sunglasses to help reduce light sensitivity, offering a five-minute break for the student to rest his head on the desk each hour, reducing homework or the number of problems that he completes, offering a quiet room for the student to rest in, or providing copies of class notes.

“If you can make academic adjustments right off the bat, there’s a really good chance that the recovery for many [students] won’t go on past a few weeks,” McAvoy said.

Also, gather information about the student’s condition from teachers, parents, and the child’s physician, said school attorney gzittoun with Shipman & Goodwin LLP in Hartford, Conn.

“Keep communication lines with the child’s physician open during the recovery,” Zittoun said.

If after a month, the student still experiences problems, investigate what specific areas are causing the child trouble, McAvoy said. If symptoms continue to last for a few months, consider whether the child is eligible for Section 504. A 504 plan will not include all of the adjustments that originally were made for the student, but should address the specific issues that still prove a problem, she said. If the student initially is determined not to be 504-eligible, continue to follow up on the student’s condition and reconvene to determine eligibility again if the condition persists, Zittoun said.

Consider child find duties

While Section 504 can cover temporary disabilities, OCR clarified in a 2011 FAQ that a student with a temporary impairment with “an actual or expected duration of six months or less” is not “regarded as” an individual with a disability. Most students with a concussion will recover in a short period of time and not be eligible for Section 504, McAvoy said.

Use child find standards in your state to determine when you need to conduct an evaluation, Zittoun said. “If there’s any doubt, I would convene the 504 meeting to determine eligibility and give parents notice of their rights,” she said.

Sometimes a child who has a protracted recovery may have underlying issues such as ADD, neurological problems, or school avoidance issues, McAvoy said. “Be careful of these other issues. For example, if a student is out of school for a concussion, his school avoidance issues can flare up,” she said.

A concussion can also impact a student’s existing disabilities, McAvoy said. “A concussion hits you where you’re the weakest,” she said. A learning specialist may notice additional issues during weekly instruction with the student, she said.

Write 504 plan for current needs

A student’s need for accommodations can change quickly as she recovers from a concussion. Rather than develop a plan for reducing or increasing accommodations, reconvene the 504 team as the student’s needs change, Zittoun said. “We should write 504 plans for current needs because while we might think we know how the student will be in two weeks, we don’t actually know,” she said.

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