University of Dayton: Concussion Awareness

Susan C. Davies, Ed.D., NCSP, is a School Psychology Professor in the Department of Counselor Education and Human Services at University of Dayton. Having authored Managing Concussions in Schools: A Guide to Recognition, Response, and Leadership, Davies is an established scholar in this field.

She also developed multiple resources for the Ohio Department of Health, a training series entitled “Return to Learn: A Concussion Team Model.”

Seeing Beyond Concussions Sustained in Athletics

While awareness of concussions has recently grown as it relates to athletics, Davies believes there is not enough public information about the impact concussions can have on students who may have sustained concussions that are affecting their academic performance months after the inciting event: from K-12 children and even students in higher education.

Every state has “return to play” laws based on three tenets—educating parents and coaches, guidelines for removing athletes from play, and gradually returning to play—but Davies wants that information to be as readily accessible to all students, all parents, and all teachers. In short, though coaches and parents of student-athletes may be more cognizant of the potential for brain injuries and alert to the symptoms to watch for, any parents should be trained to recognize these symptoms because a traumatic brain injury (TBI) can be sustained through accidents—even those that may occur in typical everyday play.

More frightening still is that younger students who are injured on a playground may not have the vocabulary to express the symptoms in a way the parents would recognize as a potential danger. They may say something as simple as, “I don’t feel good,” or they could mention they have a headache or feel queasy. In short, she is focused on “raising awareness across the board.”

Recognizing Brain Injuries at All Levels

Her objective is to help parents, teachers, counselors, and coaches all learn “how to recognize and respond to brain injuries at all levels.” She is also focused on the best approach to helping students readjust to academic life while still symptomatic. She often uses the analogy of a broken leg to illustrate the point. A student with a broken bone will have an obvious injury and a cast. However, a concussion is “invisible”: there is no cast to draw attention to the injury, and the path to full recovery is far less clear.

Just as putting too much pressure on a broken bone before it has fully healed can trigger a physical setback, there is a similar danger to applying too much pressure to a brain that is in the process of healing; even “heavy cognitive exercises” can set a student back in his or her progress toward full recovery. In other words, an overtasked brain during the healing process can make symptoms flare again. At times, however, instructions for concussion care go too far in the direction of recommending total rest for an injury, rather than a gradual return to schoolwork.

To return to the broken leg analogy, Davies explains that an injured student would not be instructed to stay off the leg indefinitely; as soon as deemed reasonable, the student would begin walking with assistance and working the muscles—ultimately regaining full use of the leg. In addition to the physical damage caused by not gradually returning to a normal state, Davies explains, the lack of activities and peer interaction can lead to prolonged problems, adding “social and emotional difficulties.”

Realizing Every Concussion is Different

Because every case is unique, Davies recommends that teachers gradually reintroduce students to a range of academic activities, but these decisions cannot be made in a vacuum.  There is a call for “a lot of progress monitoring,” she explains, where school psychologists can play a key role, but they are only part of a team—from family members to counselors, athletic directors, and school nurses—who will work together to chart a course for each student.

This group would have a Concussion Team Manager to determine what accommodations are needed, from using sunglasses to minimize light sensitivity to special testing accommodations; the Concussion Team Manager would most likely be a counselor, school psychologist, or nurse. “Every concussion is different,” Davies adds, and while students may be asymptomatic after a few days to a few weeks, there are others who could have “persistent symptoms for months.”

She mentions that one of the worst things a student with a concussion could do is take a “long, taxing, high-stakes test” during the time the brain should be healing. Of course, skeptics may be imagining that younger students could abuse these privileges, but an important consideration is that the Concussion Team involves the parents. If the student needs special accommodations at school, he or she requires restrictions at home, which would include exposure to technology: using cellphones, playing video games or loud music, or watching television. Within these confines, malingering is unlikely.

Training Others to Recognize Symptoms

Several graduate students have worked with Davies on various projects, from training RAs and Recreation Center Staff in recognizing concussion symptoms to assisting in recognizing social isolation or depression as symptomatic of an earlier TBI. Lisa Lopez is a former graduate assistant who credits Davies with making an “invaluable contribution” to her life as a student, researcher, and school psychologist.

Lopez was drawn in by Davies on her first day of graduate school, inspired by her passion for teaching and ability to deliver content that was both meaningful and practical. Lopez shares, “She incorporated real-life examples from her own work as a school psychologist to help me connect theory to practice. She guided me through the ins and outs of assessment, intervention, counseling, and consultation, and, by doing so, made me a well-rounded graduate student.”

Also crediting Davies for facilitating her interest in research, Lopez sees firsthand how Davies’s contributions to this field of scholarship brought about systematic changes in the way personnel at all levels of education are trained to work with students who have sustained concussions. Lopez adds that watching Davies strive for excellence in her work helped her to realize the power of remaining “humble and patient” while reaching for excellence in her own career. Now as a school psychologist in her second year of service, Lopez appreciates even more deeply the impact Davies had on her life. While acknowledging that she uses the content knowledge from the texts, of course, what Lopez has most appreciated is the way Davies “modeled what it truly means to stand up for best practices” and to do whatever it takes to “advocate for the child’s best interest.”

Providing Social and Emotional Support

Julie Finan is a current graduate assistant helping Davies with a special project, the result of a grant proposal that was recently funded by Ohio EMS for Social and Emotional Support for Students with Concussions. Finan shares that Davies reached out to her during the first week of her graduate program and has fostered her interest in research into concussion awareness while giving her more opportunities than she ever imagined were possible in a graduate program. In her work on “Social and Emotional Support for Students with Persistent Concussion Symptoms,” Finan is conducting interviews with participants after intensive training in the process by Davies. Finan notes that her mentor creates a powerful balance between academics and real-life application while encouraging her students to pursue their own goals and passions.

Davies is not only inspiring her students. University of Dayton colleague Dr. Elana R. Bernstein shares that Davies has had a “notable impact” on her own career as a researcher and a school psychology trainer. She states that Davies “has tremendous passion for her work, both as a teacher and a scholar,” devoting time and energy to supervising students in graduate work while also developing “innovative, cutting-edge scholarship” that improves the lives of children with traumatic brain injuries—an achievement that is a direct result of all that Davies has accomplished in training “hundreds of school psychology practitioners to provide ethical, culturally responsive, and evidence-based services to countless children and families.”

Improving Countless Lives

In addition to her teaching, service, and scholarship at University of Dayton, Davies has been working closely with Sara Timms, Ed.S., a school psychologist in Columbus who has collaborated often with Davies for presentations and publications, in her own role with the TBI Project, a School-Based Concussion-Management Program at Devonshire Elementary.

Timms has implemented a highly successful Concussion Management Program in Ohio’s largest urban district, Columbus City Schools, and often uses Davies’s “Return to Learn” tools. Timms believes Davies is one of the most influential leaders on the topic of TBI and Concussion not only in Ohio but nationally. She adds, “Her research, projects, and knowledge on this topic have brought it to the forefront in training school psychologists as well as educators across Ohio and the nation. She has also successfully bridged the gap between schools and the medical field on this topic.”

Stressing how proud she has been to collaborate with Davies over the years, Timms adds how thankful she continues to be for the impact Davies’s efforts have had on the lives of students whose lives were altered by traumatic brain injuries. Timms shares, “The students at the University of Dayton should feel very privileged to have Susan Davies as their professor. She, and her colleagues at UD, have done an excellent job in preparing their students for a successful career in school psychology.”

About the Author
Rachel James Clevenger earned her B.A. and M.Ed. degrees from Mississippi College. After finishing her PhD in Composition and Rhetoric, she taught and served as the University Writing Center Director for Birmingham Southern College and University of Alabama at Birmingham. Most recently, she taught Business Communications at Samford University.