Return-to-learn after concussion in Washington state public high schools during the COVID-19 pandemic

To understand academic support structures for Washington state public high school students with concussion during the COVID-19 pandemic. Prospective, repeated cross-sectional study of 21 schools in 2020 and 2021. About 28% of schools reported not providing any return-to-learn (RTL) accommodations for students with concussion throughout the COVID-19 pandemic. RTL accommodation provision was associated with larger student body size ( = 0.002) and higher graduation rate ( = 0.261) but was not associated with presence of RTL school policy. About 38.1% of schools received no guidance on how to provide RTL accommodations during the COVID-19 pandemic, and many reported that students with concussion struggled more. Schools struggled to provide RTL accommodations for students with concussion during the COVID-19 pandemic, highlighting the need for evidence-based guidance and resource allocation to vulnerable schools. This prospective, repeated cross-sectional study demonstrates that schools are struggling to provide academic support for students with concussion during the COVID-19 pandemic, highlighting the need for evidence-based guidance and resource allocation to vulnerable schools.