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Health
Illness
Should a student become ill at any time during the day, the nurse’s office is available. The office is located on the ground floor across from the lunchroom. Questions about health and diet should be directed to the School Nurse. Please have consideration for others and do not send your child to school when ill. Please do not send children to school with a fever (100° F or higher), suspected strep throat, rash of unknown origin, vomiting or diarrhea. Students are not to return to school until they are without fever, vomiting or diarrhea for at least 24 hours. Remember, if a child’s fever is even slightly elevated in the morning (99° F or higher) it may be a fever by the afternoon. Students with suspected strep throat should remain at home until the throat culture result is obtained and/or until the student has been on an antibiotic for at least 24 hours.
Illness Notification to School
Please inform our nurse of any serious illness or injury, or anything of a highly contagious nature. It is essential that the nurse have information regarding allergies to food, medication, bee stings and any chronic health conditions such as seizures, asthma or diabetes.
Medications
Whenever possible, medication should be taken at home. If medication must be taken at school, the medication must be in the original container or prescription bottle with a note from the parent specifying the dosage, time to be given, number of days to be given and reason medication is to be taken. Students are not to carry medications on their persons or to keep them in their backpacks or lockers. Students with asthma or severe life-threatening allergies are permitted to self-carry inhalers and/or epi-pens when the self-carry consent has been signed in Magnus. Additional emergency medication may also be kept in the Health Office at the discretion of the parent. No other medications may be carried by students.
Physical Health Forms
Physical exam forms and emergency cards are due from fifth, seventh, eighth and new sixth grade students by Aug. 1. Students who have not turned in their forms will not be allowed to participate in athletics (seventh and eighth) or participate in PE classes (fifth and sixth).
COVID-19 Guidance
Any possible exposures to COVID-19 should be reported to the school nurse immediately. A decision will be made on a case-by-case basis to determine exposure risk and if a quarantine period is required. Students will not be permitted on campus until they have received clearance from the School Nurse.
Students experiencing possible symptoms of COVID-19 (fever, cough, shortness of breath, sudden loss of taste and/or smell, headache, fatigue, muscle or body aches, GI upset or sore throat) will not be permitted on campus without clearance from the School Nurse. Please keep your child at home and notify the School Nurse immediately.
Students who test positive for COVID-19 should be reported to the Health Office immediately. Length of isolation for the sick child will be determined by the School Nurse on a case-by-case basis in accordance with Delaware Department of Health guidance.
While masking will remain optional at this time, masking may be required in certain circumstances of household exposures and return to school after an initial isolation period for the positive individual.
Concussion
For a student diagnosed with a concussion, the academic and extracurricular impact will be varied and unique to the situation. However, in our recent experience, the typical physician-recommended concussion protocol is very often one-size-fits-all and misaligned with the realities of the environment of Tower Hill. Concussions are both a medical and educational issue. Assessing and addressing problems with learning and school performance, as well as athletic participation, do not solely involve medical decisions, but educational ones as well. It is important to note, however, that medical recommendations, while not educationally binding, will certainly be taken into consideration as the school determines the proper plan for each student.
Our concussion protocol includes steps to help students safely return to school and athletics. Extended time away from full-time school work while battling concussion symptoms can make it very challenging not only to get caught up but also to maintain one’s pre-concussion academic standing. From the school’s perspective, we want to be reasonable and compassionate with concussed students, while remaining realistic about how much work can be modified or excused. A student’s health is the top priority, and we will do all we can to facilitate “return to learn,” but work will need to be made up, and it is possible that grades will be impacted due to missed classroom time. This is a natural and unfortunate consequence of a mild brain injury. It should not persuade a student to return to school before they are healed, but should be considered in managing expectations for recovery.
A concussion management team comprises of the School Nurse, the Class Dean, the student’s advisor and School Psychologist as needed will oversee the student’s recovery process pertaining to academics.
For students who have been concussed for more than one week, the Class Dean will meet with the advisor and teachers to determine: what the student must make up; if missed work can be supported by extra help or if outside tutoring for a short period of time would be advised; a reasonable timeline based on length of time student has been unable to do academic work; a calendar that outlines the plan to make up missed assessments and extra help times (if needed); a periodic follow-up assessment of how things are proceeding.
Return to Learn Protocol:
Tower Hill will generally implement the following protocol, borrowed from “An Educator’s Guide to Concussions in the Classroom” from Nationwide Children’s Hospital guidelines. Because symptom severity and length of recovery vary from student to student, some students may not need every one of the following phases.
Phase 1: No school
● Symptom: In this phase, the student may have a high level of symptoms that prevent them from being able to benefit from being in school. Physical symptoms tend to be the most prominent
and interfere with even basic tasks. ● Treatment: The student should rest the brain and body as much as possible. ● Interventions: • No school • No activities that exacerbate symptoms, such as television, video games, computer use, texting or loud music • Other “triggers” that worsen symptoms—noted and avoided to help promote healing • No physical activity, which includes anything that increases the heart rate, such as (but not limited to): weightlifting, sport practices and games, gym class, running, stationary biking, push-ups, sit-ups, etc.
Phase 2: Half-day attendance with accommodations
● Symptom Severity: In this phase, the student’s symptoms have decreased to manageable levels. Symptoms may be exacerbated by certain mental activities that are complex, difficult and/or have a long duration. ● Treatment: Balance rest with gradual re-introduction to school. Avoid tasks that produce, worsen or increase symptoms. Avoid symptom triggers. ● Interventions: • Part-day school attendance, with focus on the core subjects; prioritize what classes should be attended and how often • Symptoms reported by student addressed with specific accommodations • Eliminate items not essential to learning priority material, as determined by individual teachers • Emphasis in this phase on in-school learning; rest is necessary once out of school; homework reduced or eliminated • No physical activity
Phase 3: Full-day attendance with accommodations
● Symptom Severity: In this phase, the student’s symptoms have decreased in both number and severity. Symptoms may still be exacerbated by certain activities, but short time spans with known symptom triggers do not have drastic effects on symptom levels. ● Treatment: As the student improves, gradually increase demands on the brain by increasing the amount of work, length of time spent on the work and the type or difficulty of work. Gradually re-introduce known symptom triggers for short time periods. ● Interventions: • Continue to prioritize assignments, tests and projects; limit student to one test per day • Continue to prioritize in-class learning material; minimize workload and promote best effort on important tasks • Gradually increase amount of homework • Reported symptoms addressed by specific accommodations; accommodations reduced or eliminated as symptoms wane and resolve • No physical activity
Phase 4: Full-day attendance without accommodations
● Symptom Severity: In this phase, the student may not have any symptoms or may have mild symptoms that are often intermittent.
● Treatment: Accommodations are removed when student can function fully without them. ● Interventions: • Construct a plan to finish completing missed academic work and keep stress levels low. • No physical activity until released by a healthcare professional (such as physician or athletic trainer).
Phase 5: Full school and extracurricular involvement
● Symptom Severity: No symptoms are present. ● Treatment: No accommodations are needed. ● Interventions: Before returning to sports, the student must also complete the DIAA-mandated Gradual Return to Play Plan.
Other Items of Note:
If students miss any classes due to healing from a concussion, they may not be present at or take part in school-sponsored activities on those days (i.e., field trips, theater productions, athletic practices or contests, dances, etc.).
Implementation of academic accommodations is temporary and directly correlated to symptom duration. If the student’s symptoms persist after two months and/or there is a request to maintain accommodations, the concussion management team will request that the family arrange for more extensive testing (e.g., neuro-/psycho-educational evaluation) to determine the extent of impairment.
The testing results would allow us to determine the appropriateness for accommodations and additional support at school. Accommodations can be continued temporarily while the family pursues a more comprehensive evaluation. Note: Accommodations given within school are separate from those offered outside of school (College Board and ACT), which require a separate application process if requesting accommodations.
All necessary work, as determined by the school, must be completed before the start of the following school year for a student to matriculate to the next grade.
Tower Hill follows the DIAA Concussion Protocol regarding a student’s return to athletic participation after sustaining a concussion. It is important to note that, regardless of physician clearance, students will not be permitted to return to full participation until they have completed the first five stages of the DIAA Gradual Return to Play Plan, listed below. In addition, the athletic trainers incorporate the Impact Testing and Balance Testing as tools to see progress in an athlete’s healing. If a student should report no symptoms, yet cannot pass an Impact test, then we do not allow them to start the stages of the DIAA Return to Play Protocol, which include:
Stage 1:
No physical activity. If the athlete has no signs or symptoms consistent with a concussion they may progress, after 24 hours, to Stage 2, etc.
Stage 2:
Low levels of physical activity (i.e., symptoms do not come back during or after the activity). This includes walking, light jogging, light stationary bike, light weightlifting (low weight, higher reps, no bench, no squat).
Stage 3:
Moderate levels of physical activity with body/head movement. Includes moderate jogging, brief running, moderate-intensity stationary biking, moderate-intensity weightlifting (reduce time and/or weight from typical routine).
Stage 4:
Heavy non-contact physical activity. This includes sprinting/running, high intensity stationary bike, regular weightlifting routine, non-contact sport specific drills (three planes of movement).
Stage 5:
*** Must have physician clearance before beginning this stage*** Full contact in controlled practice.
Stage 6:
Full contact in game play. If signs or symptoms return after Stage 5, must see physician again for Stage 6 clearance.
It is also important to note that a return to academic program takes precedence over the student’s return to sports. Students may not return to full athletic participation unless they are meeting their full academic obligations without concussion-related accommodations or modifications.
Fifth and sixth graders will participate in a physical education course that will meet almost every day. Boys and girls are separated. The objectives of the class are: a. to help young people become/remain physically fit b. to provide physical development through outdoor and indoor games c. to introduce the team sports that the children will be asked to participate in when they become seventh and eighth graders d. to develop an understanding of good sportsmanship—the demonstration of appropriate conduct, honest rivalry and graceful acceptance of the outcome
Seventh and eighth graders will participate in athletics that take place at the end of every school day. The program emphasizes teamwork, cooperation, sportsmanship and the development of individual skills. Interscholastic competition is featured in many aspects of the program. Students are placed on teams compatible with their skill development. Participation in athletics is required. We will consider an exemption from the program for one season if a child is involved on a daily basis in a sport that we don’t offer. Proposals for exemptions should be directed to Athletic Director, Steve Cacciavillano.
The most up-to-date sports calendar for Middle School can be found on Hillerssports.com. You can click on “calendar” or scroll to the bottom of listed sports and click on Middle School, where all the sports will be listed.
