School absence, academic accommodation and health-related quality of life in adolescents with sport-related concussion

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Determine school absence and accommodation frequency, accommodation type, and relationship to health-related quality of life (HRQOL), following concussion.


Repeated measures.


Secondary schools.

Patients or Other Participants

Athletes with diagnosed concussion (n=149; males=130, females=19, age=15.7±1.1, grade=10.0±1.0).


Sport-Concussion Assessment Tool-2 (SCAT2), a general survey, paediatric Quality of Life Inventory (PedsQL), Multidimensional Fatigue Scale, and Headache Impact Test (HIT-6) were administered on date of injury (DOI), and days 3(D3), 10(D10), and 30(D30) post-injury. The general survey captured academic absence and accommodation occurrences and accommodation type.

Main Outcome Measures

Dependent variables: school absence; academic accommodation; and, type of accommodation received. Descriptive and Mann-Whitney U analyses were employed.


Of 143 patients: 28% (n=40) missed school, 16.1% (n=23) received academic accommodations, and 7.7% (n=11) experienced both. The most frequent accommodation was shorter school day (n=9 (39%)). Those requiring accommodations: missed more school, had lower D3 physical, psychosocial, and school functioning, and PedsQL total score; and had higher D30 HIT6 score (all p<0.05). Those with school absences had: more problems with DOI balance, slowness, fatigue, confusion, drowsiness, sleep, irritability, symptom severity and endorsement (all p<0.05); lower (all p<0.05) DOI SCAT2 total score D3 physical, psychosocial, and school functioning, PedsQL total score and sleep fatigue and higher D10 HIT6 total.


Results suggest that SRC-induced school absence and accommodations are related to declines in DOI and D3 HRQOL and increased symptom severity. Further research should explore the predictive value of these measures to future academic disruption.


This study was funded by a grant from the National Operating Committee for Standards on Athletic Equipment (NOCSAE).

Competing interests


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