Caregiver and Student Perspectives on School Services for Students With TBI During the COVID-19 Pandemic

Objectives

The objective of the School Transition After Traumatic Brain Injury (STATBI) project is to rigorously evaluate the impact of BrainSTEPS, a formal return-to-school (RTS) program, on academic, social, and health outcomes for students in grades K-12 who have experienced TBI of any severity, compared to students who have no formal RTS programming. In 2020, the study shifted to examine the effects of COVID-related educational changes on students who experienced a traumatic brain injury (TBI) prior to the pandemic.

Methods

STATBI uses a mixed-methods, cohort-controlled research design. The institutional review board–approved protocol includes electronic survey administration and virtual interviews with parents and children. The data included in this presentation are cross-sectional, although the full STATBI protocol is longitudinal. Measures include standardized assessments of executive function, participation, social, and cognitive abilities, in addition to semistructured interviews with parents, students, teachers, and BrainSTEPS team members. This presentation focuses on themes identified from interviews with caregivers whose child experienced a TBI prior to the COVID-19 pandemic, with interviews taking place between spring 2020 and 2021.

Results

Of the 46 families that completed majority of the protocol, the average student age was 14.2 years (SD = 3.3). The sample included students with mild ( n  = 19), moderate ( n  = 12), and severe ( n  = 13) TBI. The average age at injury was 11.8 years (SD = 4.3) and average time since injury was 2.7 years (SD = 2.1). A total of 41 caregivers completed interviews. Caregivers discussed the impact of COVID-19–related school changes on their child with TBI. Most families reported that their students were attending school in either a hybrid model (40.9%,  n  = 18) or fully remote (45.5%,  n  = 20). Families reported the following areas of accommodation were needed: physical accommodations (25%,  n  = 11), learning/thinking (36.4%,  n  = 16), and behavioral/social (22.7%,  n  = 10). Interviews with caregivers and students are currently being analyzed using reflective thematic analysis to reflect the themes expressed by these key stakeholders. Overall, themes focused on 3 primary areas: the impact of COVID-19 on their child's health, school performance and/or services, and socialization with peers.

Conclusions

The STATBI project is unique in its focus on RTS for youth with TBI, and these data are particularly pertinent as they highlight the impact of COVID-19–related school changes on students who experienced a TBI prior to the beginning of the pandemic. Our sample included many students who reported having mild injuries but who continued to have academic needs that warranted a referral to the BrainSTEPS program. A majority of the enrolled participants were engaged in school via hybrid or remote options, with a consistent minority requiring academic supports. Implications of COVID-19–related school changes on students with TBI based on data collected during the first—unique and challenging—year of a longitudinal study will be discussed.