Zachary A. Marowitz, Psy.D.
Neuropsychologist
Neuropsychology Services – Suite 4A&B
3300 Main Street, Springfield, MA 01199-0001
(413) 794-1039
Patient Name: DOB:
The above student has suffered a concussion and is currently under the care of this clinic. He/She is not permitted to participate in any sport related activities until formally cleared by this clinic.
Academic Accommodations:
The following academic accommodations may help in reducing the cognitive (thinking) load, thereby minimizing post-concussion symptoms and allowing the student to better participate in the academic process during the injury period. The student and parent are encouraged to discuss and establish accommodations with the school on a class-by-class basis. It is recommended that the school consider formalizing accommodations through a 504 plan.
Testing: ___ extra time to complete tests; ___ testing in a quiet environment ___allow testing across multiple sessions; ___ reduce length of tests; ___reformat from free response to multiple choice, or provide cueing (e.g. use of a notecard for useful formulas); ___No tests/quizzes. Students with concussion can have increased memory and attention problems. They will not be able to learn as effectively or quickly as before. Furthermore, highly demanding activities, like testing, can significantly increase symptoms and slow recovery. Tests should only be given if the student has had adequate instruction and time to prepare, particularly for those who have missed multiple classes.
Note Taking: ___ Allow student to obtain class notes or outlines ahead of time to aid organization and reduce multi-tasking demands. ___ Provide notes from any class time missed by the student. Note taking may be difficult due to impaired multitasking abilities and visual disturbances (e.g. convergence).
Workload reduction/alteration: ___reduce (modify) overall amount of ___ make-up work, ___ class work, ___homework (we typically recommend 50 to 75% reduction, though may vary by class); ___shorten tests and projects; ___ Books on tape/cd/ipod __ Allow dictation of written work. It takes a concussed student much longer to complete assignments due to increased memory problems and decreased speed of learning. Recovery can be delayed when a student “pushes through” symptoms. Therefore, it is recommended that “thinking” or cognitive load be reduced, just as physical exertion is reduced. Examples to consider: reducing the length of essays, requiring every other homework item to be completed, or highlight key concepts to be tested, and eliminating less critical topics from exams.
Breaks: ___ Take breaks, as needed, to control symptom levels. For worse symptoms, he/she may need to leave class, find somewhere quiet and rest (e.g Nurse’s office). If he/she feels better after a break, he/she can return to class. __ Allow to leave class ~2 minutes early to avoid crowded/over-stimulating hallways.
Extra Time: ___ Allow student to turn in assignments late for full credit. Students may experience severe symptoms some days/nights and not others. With increased symptoms, students are advised to rest, and therefore, may need to turn assignments in late.
Attendance & Restrictions: ___ Full days, as tolerated; ___ Partial days, as tolerated:______Initiate/Continue homebound educ (Tutor ) ___ No School
___ No Standardized Testing (e.g. .MCAS/SAT) ___ No / Modified Phys. Ed ___ No Music/Band Class ___ Lunch in quiet setting ___ No Driving/Driving Lessons ___ No job-related activities
***Full or partial days missed, and assignments not completed on time due to concussion syndrome should be medically excused, with ample time given to make up missed work/exams before grades are finalized.***
Follow-up evaluation and revision of recommendations to occur______
Signature: ______date______
Zachary Marowitz, Psy.D., Neuropsychologist
Clinic phone: (413) 794-1039 Clinic fax: (413) 794-1741 email: