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Book Evaluating the Need for Return to learn Concussion Protocols in High School Student athletes

Download or read book Evaluating the Need for Return to learn Concussion Protocols in High School Student athletes written by William D. Midgette and published by . This book was released on 2023 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over a million high school students are estimated to sustain at least one sports-related concussion annually. Unfortunately, over a third of these student-athletes suffer from post-concussion syndrome, which leads to the question of whether student-athletes are allowed proper time to heal after a concussion or if more can be done to optimize concussion recovery. Proper and optimal recovery post-concussion encompasses both physical and cognitive rest. While concussion management has traditionally focused on the physical aspects of recovery, emphasis has shifted to the cognitive impacts of concussions. There is literature to support that cognitive rest is vitally important, if not equally important, as physical rest after a concussion. Cognitive rest is essential for healing the brain and speeding up recovery post-concussion, while increased cognitive activity post-concussion is associated with longer recovery. Return-to-learn protocols and methodical reintroductions of students into the academic setting are equally vital to allow the brain to recover from sports-related concussions as physical rest and return-to-play protocols. This review’s key focus and purpose is to assess the literature to support suggestions for practice change that involves a mandatory, structured return-to-learn concussion protocol.

Book Sports Related Concussions in Youth

Download or read book Sports Related Concussions in Youth written by National Research Council and published by National Academies Press. This book was released on 2014-02-04 with total page 215 pages. Available in PDF, EPUB and Kindle. Book excerpt: In the past decade, few subjects at the intersection of medicine and sports have generated as much public interest as sports-related concussions - especially among youth. Despite growing awareness of sports-related concussions and campaigns to educate athletes, coaches, physicians, and parents of young athletes about concussion recognition and management, confusion and controversy persist in many areas. Currently, diagnosis is based primarily on the symptoms reported by the individual rather than on objective diagnostic markers, and there is little empirical evidence for the optimal degree and duration of physical rest needed to promote recovery or the best timing and approach for returning to full physical activity. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture reviews the science of sports-related concussions in youth from elementary school through young adulthood, as well as in military personnel and their dependents. This report recommends actions that can be taken by a range of audiences - including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, as well as youth who participate in sports and their parents - to improve what is known about concussions and to reduce their occurrence. Sports-Related Concussions in Youth finds that while some studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions; and the short- and long-term consequences of concussions as well as repetitive head impacts that do not result in concussion symptoms. The culture of sports negatively influences athletes' self-reporting of concussion symptoms and their adherence to return-to-play guidance. Athletes, their teammates, and, in some cases, coaches and parents may not fully appreciate the health threats posed by concussions. Similarly, military recruits are immersed in a culture that includes devotion to duty and service before self, and the critical nature of concussions may often go unheeded. According to Sports-Related Concussions in Youth, if the youth sports community can adopt the belief that concussions are serious injuries and emphasize care for players with concussions until they are fully recovered, then the culture in which these athletes perform and compete will become much safer. Improving understanding of the extent, causes, effects, and prevention of sports-related concussions is vitally important for the health and well-being of youth athletes. The findings and recommendations in this report set a direction for research to reach this goal.

Book Policy Recommendations for Concussion Recovery

Download or read book Policy Recommendations for Concussion Recovery written by Maya Vanderhorst and published by . This book was released on 2022 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The return of concussed students and student-athletes to the classroom is commonly referred to as return-to-learn (RTL). RTL, however, is often overshadowed by returning a student-athlete back to athletic competition (return-to-play), with few recommendations and studies evaluating the effect of improper management of recovery from a concussion in an academic setting. Therefore, the research proposed here aims to track how symptom severity, student behaviors, and oculomotor performance formulate our ability to prognosticate how a student will respond to academic stimuli post-injury. This will be achieved by longitudinally tracking student-athletes as they recover from concussion, using a repeated measures design to sample data. The data was analyzed using an analysis of variance mixed effects model to understand the relationship between daily behaviors and symptom prevalence. The study identified overall time, caffeine intake, alcohol consumption, screen time, music listened to, physical activity, sleep duration, step count, and gender as significant factors associated with concussion symptom recovery and classroom management. Linear regression was utilized to correlate RTL recovery time to oculomotor scores, to preliminarily show how these scores can inform medical personnel when a student can return, unrestricted, to the classroom, and the types of accommodations to suggest for use in the classroom during recovery. Additionally, the Rochester Institute of Technology was used as a case analysis of current RTL procedures (athletic and academic management) to find areas of inefficiencies in providing timely and sufficient support to concussed students. The data collected and presented in this study was utilized to develop preliminary, evidence-based RTL guidelines to provide clinicians, athletic training staff, and university stakeholders with policies and practices to better ensure proper care is taken among students recovering from a concussion."--Abstract.

Book A Case Study Examing Student athletes Returning to the Classroom After Suffering a Concussion mild Traumatic Brain Injury

Download or read book A Case Study Examing Student athletes Returning to the Classroom After Suffering a Concussion mild Traumatic Brain Injury written by Sheila Jackson Benton and published by . This book was released on 2019 with total page 198 pages. Available in PDF, EPUB and Kindle. Book excerpt: The purpose of this qualitative case study was to explore how a student-athlete suffering a concussion/mild traumatic brain injury copes academically in a high school environment. This case study sought to answer the question of how these student-athletes cope with their return to the classroom and are affected academically, physically, socially, and emotionally from multiple perspectives. Guiding this instrumental case study was an analytic generalization of the theory of planned behavior, social norm theory, Bandura’s social learning cognition theory, and the theory of mind. This bounded case study included one participant who had suffered a concussion and was returning to a high school educational environment in South Carolina. In addition to the case study participant, data were collected from teachers, family, friends, coach, school nurse, and others who were involved during the student’s concussion recovery. This data were collected through interviews, documentation, journaling, and focus groups. Data analysis includes coding for themes and triangulation of data to establish trustworthiness through credibility, dependability, confirmability, and transferability. The results of this case study revealed how the student was affected by her concussion in all areas researched: physical, academic, social, and emotional. The findings demonstrate the need for support as concussed student-athletes return to the classroom through better communication with all involved in the return to learn process, homebound instruction, and continuous reassessment of concussion protocols. Additionally, cognitive assessments should be developed to assist in determining timing for concussed students to return to the learning environment.

Book Concussion Protocol 101

    Book Details:
  • Author : ImPACT Applications
  • Publisher : ImPACT Applications
  • Release : 2021-12-03
  • ISBN :
  • Pages : pages

Download or read book Concussion Protocol 101 written by ImPACT Applications and published by ImPACT Applications. This book was released on 2021-12-03 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: What happens when someone on your team has a suspected concussion? As a person responsible for a group of athletes, students, or employees, you need to have a concussion protocol in place. When a concussion happens in your organization, make sure you and everyone involved knows exactly what they need to do. This brief guide will help you identify the key team members, get tools, and develop policies you need to confidently handle concussions when they happen. You'll learn how to check for concussion and signs of a concussion, how to facilitate concussion treatment, and return to play protocols for athletes.

Book Cram Session in Evaluation of Sports Concussion

Download or read book Cram Session in Evaluation of Sports Concussion written by Tamerah Hunt and published by Taylor & Francis. This book was released on 2024-06-01 with total page 142 pages. Available in PDF, EPUB and Kindle. Book excerpt: When you need a fundamental and clinical understanding of sports concussions, supplemented by current research and management techniques, look to Cram Session in Evaluation of Sports Concussion: A Handbook for Students & Clinicians for quick and at-your-fingertips facts. Cram Session in Evaluation of Sports Concussion: A Handbook for Students & Clinicians by Dr. Tamerah N. Hunt is a succinct and descriptive quick reference that provides the health care professional with a simple step-by-step approach to various sports concussion assessment and management techniques. Cram Session in Evaluation of Sports Concussion: A Handbook for Students & Clinicians is designed to bridge the gap between research and clinical practice to improve assessment and management of sports-related concussion and return-to-play decisions. What is in your “Cram Session”: Concept maps Red flags for differential diagnoses Return to participation guidelines Detailed algorithms for evaluation, testing, and working with other health care professionals Model protocols and management strategies that can be implemented with minimal resources and support staff Cram Session in Evaluation of Sports Concussion: A Handbook for Students & Clinicians is an informative, well-organized handbook for all students and clinicians in athletic training, physical therapy, and allied health professionals who evaluate and manage concussions.

Book Sports Neuropsychology

    Book Details:
  • Author : Ruben J. Echemend?a
  • Publisher : Guilford Press
  • Release : 2006-02-06
  • ISBN : 1572300787
  • Pages : 337 pages

Download or read book Sports Neuropsychology written by Ruben J. Echemend?a and published by Guilford Press. This book was released on 2006-02-06 with total page 337 pages. Available in PDF, EPUB and Kindle. Book excerpt: In actual therapy sesions, the video shows Dr. Linehan teaching patients the use of such skills as mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation in order to manage extreme beliefs and behaviors. Viewers observe how Dr. Linehan and a team of therapists work through the range of problems and frustrations that arise in treatment.

Book Concussions in Athletics

Download or read book Concussions in Athletics written by Eric E. Hall and published by . This book was released on 2017 with total page 320 pages. Available in PDF, EPUB and Kindle. Book excerpt: Eric E. Hall, PhD has expertise in the area of exercise psychology focusing on how physical activity affects mental health (e.g., affect and cognition) and the underlying neuroscientific mechanisms. Dr. Hall has been forming collaborations around concussion work since 2009 and has been co-principal investigator on two grants from American Medical Society for Sports Medicine. He has served on the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports and is currently on the NCAA Concussion Protocol Committee. He is also on the editorial board for the journals: Psychology of Sport and Exercise as well as Sports. His excellence in research and mentorship has been recognized at Elon. Caroline J. Ketcham, PhD has expertise in the area of motor control and focuses on how movements are controlled, organized and coordinated. Her work includes assessing movement and developing therapeutic interventions for neurodiverse populations to improve coordination and integration. Caroline''s expertise in balance assessment and sensorimotor integration were incorporated into Elon''s concussion work 4 years ago and she has continued to lead on investigations between neurocognitive and motor function in brain injury and recovery. Together Drs. Hall and Ketcham established and Co-Direct Elon BrainCARE Research Institute with a mission to 1) help create a supportive environment for students and student-athletes to become educated concerning the potential impact of concussions through evidence based practices and research; and 2) to create health promoting environments that support resilience and positive mental wellness. Since 2012, Elon BrainCARE has resulted in over 40 presentations at regional, national and international conferences, published over 10 papers and mentored or co-mentored over 25 undergraduate students engaged in Elon BrainCARE research. In addition, Hall and Ketcham have organized and hosted annual symposia for 4 years inviting the Elon and surrounding community. The goal is to provide concussions education for parents and youth sport leaders in the area along with Elon and surrounding university concussion researchers and practitioners. Some of the seminal work from Elon BrainCARE includes an evidence informed return to learn protocol for collegiate student-athletes and understanding modifiers that affect baseline performance and recovery from a concussive injury in neurocognition, balance, gait and symptom reporting. Elon BrainCARE Research Institute not only serves as a service to sports medicine and student health staff at Elon, but also a model of co-mentored undergraduate research training for students headed into both academic and clinical health profession fields. Book Description: Sports related concussions and the implications of short-and long-term outcomes is a concern to athletes, parents, coaches, academics, and health care professionals. Leading clinicians and scientists across a variety of fields have come together to collaborate around topics related to concussion education, assessment, management and treatment of head injuries that occur in sports. Athletes of all levels not only have to perform on the field, but may also have to perform in the classroom where symptoms of a concussion can have profound impacts. As health care professionals work to implement the best practices around concussive injuries, scientists assess outcomes, implications and emerging topics related to management and recovery. This book aims to gather leaders in the field of concussion assessment and management to highlight the state of evidence-based practice. In addition, authors explore emerging issues around the care of athletes in returning to play as well as returning to academic settings. Concussion assessment and management is not a one-size-fits-all concept, and topics around pre-existing factors like cultural, ethnic and sex differences are essential to consider as we attempt to change reporting behaviors and positively impact recovery and outcomes from injury. As new information continues to emerge, the education, assessment, management and treatment of concussion evolves with the health and safety of athletes taking a front seat. This book is a timely snapshot of concussion assessment and management, and it is also a leader in emerging issues in the ever-changing science and evidence-based practice of sport-related concussion research. Target Audience: This book is targeted for a wide audience including scientists and health professionals doing concussion work as well as students, parents, and newcomers to concussion education and research.

Book League of Denial

Download or read book League of Denial written by Mark Fainaru-Wada and published by Crown. This book was released on 2014-08-26 with total page 457 pages. Available in PDF, EPUB and Kindle. Book excerpt: NEW YORK TIMES BESTSELLER • The story of how the NFL, over a period of nearly two decades, denied and sought to cover up mounting evidence of the connection between football and brain damage “League of Denial may turn out to be the most influential sports-related book of our time.”—The Boston Globe “Professional football players do not sustain frequent repetitive blows to the brain on a regular basis.” So concluded the National Football League in a December 2005 scientific paper on concussions in America’s most popular sport. That judgment, implausible even to a casual fan, also contradicted the opinion of a growing cadre of neuroscientists who worked in vain to convince the NFL that it was facing a deadly new scourge: a chronic brain disease that was driving an alarming number of players—including some of the all-time greats—to madness. In League of Denial, award-winning ESPN investigative reporters Mark Fainaru-Wada and Steve Fainaru tell the story of a public health crisis that emerged from the playing fields of our twenty-first-century pastime. Everyone knows that football is violent and dangerous. But what the players who built the NFL into a $10 billion industry didn’t know—and what the league sought to shield from them—is that no amount of padding could protect the human brain from the force generated by modern football, that the very essence of the game could be exposing these players to brain damage. In a fast-paced narrative that moves between the NFL trenches, America’s research labs, and the boardrooms where the NFL went to war against science, League of Denial examines how the league used its power and resources to attack independent scientists and elevate its own flawed research—a campaign with echoes of Big Tobacco’s fight to deny the connection between smoking and lung cancer. It chronicles the tragic fates of players like Hall of Fame Pittsburgh Steelers center Mike Webster, who was so disturbed at the time of his death he fantasized about shooting NFL executives, and former San Diego Chargers great Junior Seau, whose diseased brain became the target of an unseemly scientific battle between researchers and the NFL. Based on exclusive interviews, previously undisclosed documents, and private emails, this is the story of what the NFL knew and when it knew it—questions at the heart of a crisis that threatens football, from the highest levels all the way down to Pop Warner.

Book Evaluation of Concussion Education  Prevention and Management Policies in School Districts of a Rural State

Download or read book Evaluation of Concussion Education Prevention and Management Policies in School Districts of a Rural State written by Cole Andrew Whitmoyer and published by . This book was released on 2016 with total page 87 pages. Available in PDF, EPUB and Kindle. Book excerpt: Concussions have become a national issue in organized youth and adult sports. Estimates indicate there are upwards of 3 million concussions yearly. Concussions are unique in the fact that they can cause serious long-term effects and even death if not managed properly. All 50 states have passed laws mandating school districts implement policies and procedures to educate stakeholders about the nature and risks of concussions and subsequently statutes on the proper management of concussed athletes. Montana passed the Dylan Steiger's Protection of Youth Athletes Act in 2013. It is the purpose of this paper to analyze data from interviews and appraisal of school district concussion policies and procedures in the state of Montana; ultimately describing the current state of implementation. Subsequently, recommendations for policy change, school and clinic practice will be made. School district superintendents were interviewed from 12 counties in Montana. A tool was created to specifically inquire about superintendent knowledge regarding the current policies and procedures in their respective districts as they pertain to the statutes set forth by the DSPYAA (2013). Subsequently, the policies and procedures in these schools were critically analyzed against the statutes of the DSPYAA (2013). Superintendents had general knowledge of each districts policies and procedures, though many were unsure or unaware of multiple key aspects that are mandated by the law. Critical analysis of district policies and procedures also showed deficiencies when compared to the mandates of the law. Also many districts denied having adequate health care resources. Recommendations include amendment of the DSPYAA (2013) by restructuring definitions within the law to provide clarity. Amendment should also include multidisciplinary concussion management teams, preferably including superintendents and licensed health care providers, which conduct concussed student-athletes through a gradual return-to-learn process. Superintendents play an important role in ensuring policies and procedures are appropriately implemented and abide by the DSPYAA. It is also recommended that school staff, officials, and local LHCPs be educated on the most current management recommendations. These recommendations may be facilitated by the nurse practitioner considering they have competency in leadership, quality, policy, and health care delivery systems.

Book Sports Neurology

    Book Details:
  • Author :
  • Publisher : Elsevier
  • Release : 2018-12-19
  • ISBN : 9780444639547
  • Pages : 0 pages

Download or read book Sports Neurology written by and published by Elsevier. This book was released on 2018-12-19 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Sports Neurology is designed to be a comprehensive overview of neurology within the context of sports medicine. This definitive text addresses the history of sports neurology, including its unique role within sports medicine, and provides a detailed assessment of central and peripheral nervous system injuries and illnesses in athletes. Sports Neurology is a critical companion for all sports medicine clinicians and for neurologists who manage athletes.

Book The Development and Implementation of a Concussion Education Program for High School Student athletes

Download or read book The Development and Implementation of a Concussion Education Program for High School Student athletes written by Jeffrey Caron and published by . This book was released on 2016 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: "Concussions are the most frequently occurring brain injury in sports (Carroll & Rosner, 2012), and the injury can be particularly problematic for adolescent athletes because of their developing brains (Carman et al., 2015). As a result, experts have highlighted the importance of improving athletes' knowledge of concussions to improve their health and safety (McCrory et al., 2013). Despite this, there is no consensus regarding the most effective way to disseminate concussion knowledge (Mrazik et al., 2015). The purpose of this dissertation was to develop and implement a concussion education program for high school student-athletes in Eastern Canada. This was accomplished through a cohesive series of four original manuscripts. The first manuscript was a review paper that investigated literature on concussion education programs. Results revealed there have been three types of concussion education programs to date: interactive oral presentations, educational videos, and computer-based learning programs. However, these interventions have been limited by the dissemination of knowledge at one time-point only and by minimally implementing qualitative methods. The second manuscript was a qualitative study that explored high school coaches' insights and perceptions of concussions. The coaches said they taught athletes skills during practices and games to improve their safety and well-being, which they said they valued more than winning championships. Coaches also mentioned that some of their athletes were occasionally disingenuous when reporting concussion symptoms. The third manuscript was a qualitative study that gathered high school athletes' insights on concussions, including the mediums through which they acquired information about the injury. Results revealed the high school athletes primarily acquired information about concussions through interactions with peers and family members, media reports involving professional athletes, and school projects. Additionally, the athletes noted they attempted to deceive coaches and health professionals about concussions, a finding that was related to the coaches' perceptions in study two. Results from the first three manuscripts were used to create a concussion education program for high school athletes. Thus, the fourth manuscript investigated a concussion education program for high school athletes, which consisted of four interactive oral presentations that were evaluated using a mixed method design. The results revealed improvements in participants' knowledge of concussions after exposure to the concussion education program. Participants also indicated the concussion education program might influence their future in-game behaviors, such as avoiding dangerous collisions. Furthermore, the athletes said they enjoyed the interactive nature of the presentations and the use of case study examples. In sum, this dissertation contributes to the research and practice of concussion education in many ways. To our knowledge, it is the first program of research to systematically develop and implement a concussion education program for high school athletes. Results from this dissertation indicated that interactive oral presentations were an effective strategy to disseminate concussion information to high school athletes, and provides recommendations for future research in this still underdeveloped domain." --

Book The Impact of Concussions on High School Athletes

Download or read book The Impact of Concussions on High School Athletes written by United States. Congress. House. Committee on Education and Labor and published by . This book was released on 2010 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Book Mild Traumatic Brain Injury in Children and Adolescents

Download or read book Mild Traumatic Brain Injury in Children and Adolescents written by Michael Kirkwood and published by Guilford Press. This book was released on 2012-05-22 with total page 420 pages. Available in PDF, EPUB and Kindle. Book excerpt: A cutting-edge synthesis of science and practice, this book covers everything from sports-related concussions to less common types of mild traumatic brain injury (mTBI) and related complications. Preeminent authorities review what is known about mTBI in childhood and adolescence—including its biomechanics, pathophysiology, and neurological and neurobehavioral outcomes—and showcase evidence-based clinical evaluation tools and management strategies. Challenging areas such as evaluating complicated mTBI and treating persistent problems after injury are discussed in detail. Also addressed are forensic issues, injury in very early childhood, and other special-interest topics.

Book Identifying College Athletes Who Would Benefit from a Dual Return to Learn and Return to Play Protcol Post Concussion

Download or read book Identifying College Athletes Who Would Benefit from a Dual Return to Learn and Return to Play Protcol Post Concussion written by Alyssa Laura Vaniman and published by . This book was released on 2020 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: A sport-related concussion is classified as a mild traumatic brain injury caused by outside mechanical forces causing a blow to the head, neck, face, or body. Concussion diagnosis is an assessment based on the field and clinical testing that assess neurocognitive behaviors subjective symptoms, physical signs, and behavioral symptoms. Concussions are a heterogeneous injury for which there is no diagnostic gold standard or established uniform healing phases. Student-athletes who sustain a concussion are not only asked to return to the playing field but also the classroom. There has been an emphasis placed on developing and implementing return to play guidelines but the same emphasis has not been made for return to learn guidelines. The purpose of this study is to highlight a gap in research regarding return to learn testing and guidelines. Also, to create a sample test form that can possibly be used to help identify student-athletes struggling to return to academics post-concussion.

Book Back in the Game

    Book Details:
  • Author : Jeffrey S. Kutcher
  • Publisher : Oxford University Press
  • Release : 2017
  • ISBN : 0190226609
  • Pages : 273 pages

Download or read book Back in the Game written by Jeffrey S. Kutcher and published by Oxford University Press. This book was released on 2017 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: The word concussion was unheard of in youth sports a decade ago. The injury was indeed occurring, but youth athletes were often told to "shake it off" after "getting their bell rung". Science and increased awareness about concussion and brain health have transformed the way youth parents, coaches, and players pursue athletics. Fear of incurring concussions, as well as incomplete or incorrect information, is leading some parents to keep their children out of contact sports, such as football and soccer, where concussion is more prevalent. Back in the Game: Why Concussion Doesn't Have to End Your Athletic Career does not dwell on perpetuating fears but, rather, provides the most up-to-date understanding of the condition. This is a real-world discussion of what science and medicine know, what parents and coaches need to understand about concussion, evaluation and treatment, and what possible post-concussive issues exist. The expertise and experiences of noted sports neurologist Jeffrey S. Kutcher, MD, along with reporting and interviews by award-winning sports journalist Joanne C. Gerstner, make this book a timely, relevant, and real discussion about concussions in youth sports. Athletes and professional coaches who have participated in the formation of this book include two-time Olympic gold medalist soccer player Kate Markgraf, former NHL/Team Canada head coach Andy Murray, champion X-Games snowboarder Ellery Hollingsworth, along with an array of youth parents, coaches, and athletes from across the country.

Book Concussion  Learning  Academics  and Student Success

Download or read book Concussion Learning Academics and Student Success written by Rebecca James Posey and published by . This book was released on 2019 with total page 142 pages. Available in PDF, EPUB and Kindle. Book excerpt: Concussions are common injuries for high school student-athletes. However, academic re-entry following a concussion is lacking research, which creates significant variation in student experiences as they Return to Learn (RTL). The purpose of this study was to explore the perspectives of high school students about their RTL experiences after a concussion. High school students with concussion completed a survey about their injury and RTL experience. Results from 58 students revealed diverse student experiences with RTL, specifically regarding medical care, school processes, academic adjustments, and support. Initial and persisting academic problems following concussion were endorsed by students. Students reported returning to school soon after injury, experiencing extended recovery times, and carrying the burden for managing communication among professionals involved in their recovery. Student recommendations for RTL included improved professional education, increased information about and planning for RTL, usage of self-advocacy during recovery, and greater trust and understanding between students and others.