New ‘Return-to-Learn’ program helps students succeed in the classroom post-concussion

HERRIMAN, Utah — Utah follows strict protocols to help student athletes who suffer a concussion “return-to-play.” But what about helping injured students keep up in the classroom?

The Alpine School District is first in the state to partner with Intermountain Healthcare on a new program called “Return-to-Learn.”

Nathan Bos, 19, suffered three major concussions three years in a row.

In seventh grade, he was riding a bike when he hit a parked car, which required major face and nose surgery.

“It started snowing and I slipped and I actually went through the back windshield of a car,” he described. “It was bad, but I recovered and I was able to go on my daily life.”

The summer after eighth grade, he was injured in a Lake Powell incident while tubing.

“The top of his head hit me right here and it broke my jaw and also gave me a very, very bad concussion,” he said. “I had my mouth wired shut for about two months.”

That’s when the migraines, severe short term memory loss, and emotional challenges began. Those symptoms were only compounded by the third and worst injury in ninth grade when Nathan hit his head in a rugby tackle.

“I went for a tackle and got kneed right in the forehead right there,” Bos described. “That one was definitely the worst out of the three.”

He doesn’t have any memory of that day in particular.

Sadly, his memory loss started affecting him on a daily basis.

“I couldn’t even remember what I ate for breakfast in the morning by first period,” he said.

Remembering assignments and math formulas became impossible.

“I went from a straight A student to almost failing my classes,” Bos said. “I couldn’t focus. I couldn’t learn. I couldn’t retain any information.”

His teachers gave him extra time on homework and tests, but Bos says he couldn’t even remember the subjects to begin with. He said he needed one-on-one time with the teachers.

“We were moving so fast and I couldn’t even comprehend what was happening,” he said.

Bos’ mental health also plummeted.

“My depression, my self-esteem, my irritability, my anger just all erupted… [it] even came to the point where I had severe suicidal thoughts,” he said. “Just a totally different person than what I was before.”

“My parents didn’t know how to help. My teachers didn’t know how to help,” Bos said.

Intermountain Healthcare’s Dr. Darren Campbell, a sports medicine physician at the Utah Valley Concussion Clinic, said a concussion is a mild traumatic brain injury and can affect basic brain function.

Campbell said concussion symptoms go beyond just having a headache.

“It can be balanced symptoms, visual symptoms, cognitive processing symptoms, emotional symptoms, some of the things we don’t think about,” he explained. “If we have areas that are affected, such as our visual system, it can be really difficult to pay attention in class, to receive the message.”

“So for that short period of time, it’s truly like a learning disability,” Campbell said. “Students can fall behind significantly in their classes…. The deficit that they have to make up can be significant and can affect a whole semester.”

Campbell believes teachers are key to helping students recover by making simple accommodations.

“Our teachers are dealing with students and watching them interact every day,” he said.

“If someone’s having trouble seeing the board in a classroom, they can have them listen to that lecture or that class on audio,” he explained. “[Or] simply letting them out of class five minutes early, so they don’t have to walk through a hall full of students. Getting them to their next class can really help them make it through a day of school.”

Bos’ mom, Mickelle Bos, who is also the assistant principal with Mountain View High School, recently helped the Alpine School District develop a post-concussion protocol and symptom scale to help educators.

The protocol requires injured students to fill out a daily report, rating their symptoms on a scale of one to six. If a student has a score of four or higher, they may need to take a break from what they are doing.

“This helps them communicate with their teacher, their parent, with anybody, so this needs to be in hand every single day,” she explained.

Nathan hopes this program will benefit others in the future.

“It’s not just about getting your student back into sports, it’s about actually reintegrating them into school,” Bos said.

“Find someone to help you through because it is so hard to do it on your own,” he urged.

With the right help and hard work, Bos ended up graduating in the top five percent of his class and spoke at his high school graduation.

“I was diagnosed with a severe concussion,” he said in his speech. “I emerged victorious, just like all of us at this moment right now.”

Campbell said the first step is not ignoring the injury.

“The most important thing to do is identify it, put in the right restrictions, just for that short term, get the right treatment and heal from it, and if we’re able to heal completely from that, right now, we’re not seeing significant long term effects,” he said.

He said the majority of concussion injuries he sees are not sport-related, but occurred as a result of normal life activities, like taking a fall, playing with kids, or being involved in a car crash.

Campbell said this new program will help not just athletes, but all injured students better succeed in school.