Health, Safety, and Support

A concussion is a bump, blow, or jolt to the body that causes bruising to the brain when it hits the skull. Any one of the following symptoms is enough to suspect a concussion:

• Headache, nausea, or vomiting.
• Balance problems, dizziness, blurry or double vision.
• Sensitivity to light or noise.
• Feeling sluggish, hazy, foggy, or groggy.
• Confusion, problems with concentration or memory.
• Does not "feel right" or "feeling down."

A concussion or MTBI (mild traumatic brain injury) is extremely serious. When a student sustains a concussion, whether through athletic endeavors, recreational activities, or accidents, McDonogh School requires that they complete a step-by-step recovery process before resuming normal academic work, physical activity, and school life. Returning to any of these activities too soon may cause concussion symptoms to return. The brain needs time to heal.

Students in the Lower School who sustain a concussion must be seen by a private physician who will be required to complete and share with the School a document called an Acute Concussion Evaluation (ACE) Form. The information on this form will be used by Lower School teachers and learning specialists to plan for any accommodations the injured student might need during the recovery period. For students in fifth and sixth grades, a medical liaison employed at the School will work with the learning specialists to manage the "return to learn" program as directed by a physician.

The recovery process for older students in Middle and Upper School is managed by McDonogh's Concussion Management Team, which consists of two groups working together. The first is the medical group that includes physicians, athletic trainers, School nurses, and consulting neuropsychologists. The second is the academic group that consists of class deans, advisors, learning specialists, teachers, and School counselors. Teachers are kept well informed about their students' progress and are notified when those students catch up academically. Because all seventh through twelfth graders are required to complete an annual Baseline Test through XLNTBrain, parents may log on to XLNTBrain to track the progress of their child's recovery using the Guardian Instructions.

In the initial stages, a student with significant concussion symptoms, full cognitive and physical rest is imperative and expected:

• No exercising the body and brain.
• No computer screens.
• No television.
• No homework.
• No reading.

As symptoms resolve, students will ease themselves back to more academic and physical activity under the guidance of our Concussion Management Team.

McDonogh's Concussion Management System (CMS) tracks injured students and serves as the primary means of communication among all constituents. The CMS provides a record of assessments, treatments, and recommendations, as well as a timeline for "return to learn" and "return to play."

• Baseline Testing: All students in grades seven through twelve are required to take a neurocognitive baseline assessment from XLNTBrain to assist the athletic training staff in evaluating concussions. If a student suffers from a concussion, the test is given again as a means of comparison and to help determine when the student can "return to learn" and "return to play."
• Post-Concussion: Once a student is symptom-free, the XLNTBrain test is administered again. Post-concussion scores must be equal to or better than baseline testing scores prior to starting McDonogh's "return to play" protocol.
• "Return To Play" Protocol: Students must be symptom-free for 48 hours prior to starting the following "return to play" protocol. If at any stage of the five-day program the student becomes symptomatic, he or she must go back to the previous stage and start from there.
  • Day 1: Sustained cardiac activity for 20–30 minutes on a bike
  • Day 2: Higher intensity cardiovascular sprint workout
  • Day 3: Run, sprint, and sport-specific activity for 30–60 minutes
  • Day 4: Full non-contact practice
  • Day 5: Full practice

A final XLNTBrain test is given on the fifth or sixth day. Post-concussion scores must be the same or better than the baseline scores in order to return to play.

If you have any questions about XLNTBrain or McDonogh School's Concussion Management Program, contact Athletic Trainer Jared Braverman at jbraverman@mcdonogh.org or 443-544-7148.

For additional information, view the video Concussion Management and Return to Learn by Dr. Mike Evans.