Episode 2 - Return to Learn: Understanding What Is Best For Your Brain Throughout Recovery
Episode 2 - Synopsis
Moderator: Penny Welch-West
Episode Description: Penny Welch-West, a Speech-Language Pathologist with Parkwood Institute, guides a group of current students and graduates through a discussion about their experiences transitioning back to school following a concussion/TBI. Group members talk about challenges, accommodations and strategies they implemented to support their return.
How to listen
MAIN POINTS, TIMESTAMPS, THEMES & RESOURCES
Post injury problems and barriers to learning - 5:29
Common issues in the Return-to-Learn process: attention, memory, communication expression issues, reading or having to re-read, information processing issues (not understanding what is read or lectured about), issues with written expression, problem-solving skills affected, (temperament) issues in social communication situations exaggerated or frustrated, executive functioning (ability to make plans).
Challenges following the injury – 15:49
A variety of symptoms made recovery challenging, symptoms include nausea, vestibular issues, headaches, sensitivities to light and noise, anxiety, insomnia, concentration and brain fog
Having to re-read and go over schoolwork multiple times before being able to fully grasp the content made returning to learn more difficult.
As recovery progressed, returning to the classroom was one of the more challenging experiences. Longer processing times made it harder to keep up with lectures or classroom discussions.
Movement in the peripheral vision could be distracting, leading students to lose their focus on lecture. In recovery it can be very unsettling when you lose track in class because it is harder to regain focus. The feeling of being stuck can lead to anxiety or other emotional symptoms that can lead students down a negative spiral.
Some found it helpful to chunk lectures and to 10-minute pieces.
Fatigue and the stigma surrounding cognitive fatigue played a role in the return to learn process.
Example: people who have no experience with concussion making comments such as “well, I feel tired too”.
Knowing what type of help you need in recovery can be hard to understand.
Limited access to specialized help or practices can make it hard to get the right care when returning to learn.
Time disorientation affects how a student plans breaks or pacing in recovery (being unaware of how much time has passed or how long they have spent doing a task).
Cost can become a factor when considering different types of care, especially when symptoms change or are not progressing after seeing multiple practitioners.
Recognizing that cognitive efforts can create headaches or the development of other symptoms.
Accommodation needs can change as recovery progresses.
It can be a challenge to navigate the extensive paper trail needed to return to learn, especially when acquiring accommodations.
Students can lack the knowledge needed to understand what they are going through, what to ask for as an accommodation, what could be asked for and what they need during recovery.
What types of accommodations were received – 38:57
Some students were allowed to have reference sheets and no tests or assignments unless requested.
Breaks between tests or test sections can help reduce the onset of symptoms.
Some students had additional time to take tests in an effort to help manage the various symptoms that can present themselves under stress.
Note taker and/or recorder can help students navigating the return to learn process. Note taking and listening to lecture at the same time can be hard to process, especially in a crowded space (lecture hall or classroom) and a time sensitive environment.
Private study or test rooms allow students to read out loud and process information in a different way. Additionally, students only have to worry about a few other people in their environment opposed to 15-250 people in traditional learning environments.
New technology that can help with note taking is changing the way people re-integrate back into the school environment (see Live Scribe Pen in the resources below).
Who helped with accommodations – 48:58
The guidance department can be a positive resource for some students seeking accommodations or help in the return to learn process.
Teachers play a vital role helping students feel comfortable in the classroom environment.
Academic advisors help varies; some students were left to reach out to professors themselves. The response from professors also varied. Some accepted and accommodated, others perceived the injury as fake or unjustifiable for accommodations.
Other people who have had experience with TBI help advocate for each other.
Timeline for return to learn – 55:54
Taking full time studies off the table can help with confidence erosion.
Not all courses and programs are created equal – taking time off certain classes that are more demanding can help with re-integration. Each person has their own strengths to consider (one class may be okay for one person but not for another).
It is good to take your time in the return to learn process so you can figure out how your brain learns after a concussion or TBI.
There is a common misconception that one day you will wake up and everything will be “normal” again. It is more about finding right accommodations as recovery progresses, constantly evaluating how the accommodations are helping.
Sometimes the return to learn process can help you understand more about how you learn, even if the process is long and arduous. Staying consistent and internalizing the new strategies is an integral part of compensating for the additional complexities brought forth by brain injury.
It is important to build efficient and well-planned days.
Remote learning can be too much time on a screen – leading to further cognitive fatigue. The in-person practice is an important part of social re-integration.
Remote learning can help with pacing if there are flexible course schedules. Playback of lectures can help with an adapted learning process.
Most important recommendations - 1:14:24
Ask for more accommodations than you think you need. This way you will have more than enough support in the early stages of your recovery. If you do not need all of them, you do not have to use them.
Have patience, it takes time to re-learn how you learn and don’t expect to perform at your “normal” level or do things in the “normal way”.
Look for grants – you may qualify for more than you expect. Check for OSAP grants (link in the resources).
Find someone you can be open with and who can express to others how you are feeling.
Educate your friends, family and peers about the realities of the injury and your own experience with it.
Plan and pace your way through recovery. Use a timer to help manage your pacing.
Be mindful of the narrative that we tell ourselves, be kind to yourself.
Use resources on campus and ask for resources available to you.
Try to work within your symptoms without pushing through.
Resources
Check out the great work conducted at the Parkwood institute https://www.sjhc.london.on.ca/search?keywords=abi
Here is a link where you can find grants that are not often publicly talked about. https://osap.gov.on.ca/OSAPPortal/en/A-ZListofAid/PRDR019233.html
Live Scribe Pen https://www.staples.ca/collections/livescribe-smartpens-7267