Thompson Leah L, Lyons Vivian H, McCart Melissa, Herring Stanley A, Rivara Frederick P, Vavilala Monica S
Seattle Children's Research Institute, Seattle, Washington.
Harborview Injury Prevention and Research Center, Seattle, Washington.
Pediatrics. 2016 Dec;138(6). doi: 10.1542/peds.2016-2151. Epub 2016 Nov 7.
We sought to examine the prevalence, scope, and specificity of provisions governing school reintegration in current state concussion laws.
State concussion laws as of May 2016 were independently assessed and classified by 2 trained coders. Statutes were classified as "Return-to-Learn" (RTL) laws if they contained language mandating institutional action at the state, district, or school level related to academic reintegration of youth who have sustained a concussion. All statutes classified as RTL laws were further analyzed to determine scope, required actions, and delineation of responsibility.
RTL laws were uncommon, present in only 8 states. Most (75%) of these laws held schools responsible for RTL management but mandated RTL education for school personnel was less frequent, present in only one-quarter of the laws. None of the RTL laws provided guidance on support of students with persistent postconcussive symptoms, and only 1 recommended an evidence-based standard for RTL guidelines.
Our review of state concussion laws indicates scant and vague legal guidance regarding RTL. These findings suggest an opportunity for legislative action on the issue of RTL, and reveal the need for better integration of laws and research, so that laws reflect existing best-practice recommendations and remain current as the evidence base develops.
我们试图研究当前各州脑震荡法律中关于重返校园规定的流行程度、范围和具体性。
截至2016年5月的各州脑震荡法律由两名经过培训的编码员独立评估和分类。如果法规包含要求州、地区或学校层面就脑震荡青少年的学业重返采取机构行动的措辞,则将其归类为“重返学习”(RTL)法律。所有归类为RTL法律的法规都进一步进行分析,以确定范围、所需行动和责任划分。
RTL法律并不常见,仅在8个州存在。这些法律中的大多数(75%)规定学校对RTL管理负责,但要求对学校工作人员进行RTL教育的情况较少,仅在四分之一的法律中出现。没有一部RTL法律就持续存在脑震荡后症状的学生的支持提供指导,只有一部推荐了基于证据的RTL指南标准。
我们对各州脑震荡法律的审查表明,关于RTL的法律指导很少且模糊。这些发现表明在RTL问题上有立法行动的机会,并揭示了法律与研究更好整合的必要性,以便法律反映现有的最佳实践建议,并随着证据基础的发展而与时俱进。