Date Approved


Degree Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department or School

Leadership and Counseling

Committee Member

Ronald Williamson, EdD

Committee Member

Jaclynn C. Tracy, PhD

Committee Member

Theresa Saunders, EdD

Committee Member

David C. Winters, PhD


Over half million children with traumatic brain injuries (TBI) pass through United States emergency departments each year. While there is Return-to-Play legislation in all 50 states, in response to sports-related concussion, there are very few Return-to-Learn protocols in place in the nation’s public schools. Concussion is a mild form of TBI; the vast spectrum of TBI makes it a complex disability, which may involve intensive physical rehabilitation and cognitive therapy. The primary purpose of this qualitative case study was to examine the collaboration between educational and medical providers at one high school in Michigan to illuminate the process of school reintegration for students with concussion. The analysis was organized around Duffy’s nested theories of action to understand the communication strategies, decision-making processes, and culture influence on the collaboration between the hospital and school. Data were collected through cognitive interviewing methodology with medical providers, educational personnel, and a TBI teacher consultant from a district agency. Findings reveal there is one directional communication from the medical professionals to the educators via the student, and educators defer to the doctors on how to accommodate the student, implementing recommended environmental accommodations without an educational lens for needed academic supports. Additionally, confused terminology does not provide educators a clear understanding of concussion as a mild traumatic brain injury, the unique healing process, and a new way of learning for each student post injury. This study illustrates the need for a new model of “short-term disability” to activate educational accommodations within the framework of multi-tiered systems of support, shifting the perspective of educational leaders and the current mindset of concussion.