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Updated: Apr 11, 2026

Multimodal Protocol for Assessing Metacognition and Self-Regulation in Adults with Learning Difficulties

Multimodal Protocol for Assessing Metacognition and Self-Regulation in Adults with Learning Difficulties

Published on: September 27, 2020

Defining return-to-learn through an evidence-based systematic review.

Zachary W Bevilacqua¹, Joseph Fetta², Emily Vierno¹

¹SUNY Brockport, Department of Kinesiology, Sport Studies & Physical Education, Brockport, NY, United States.

Frontiers in Neurology

|April 10, 2026

Summary

This study proposes evidence-based definitions for return-to-learn (RTL) to standardize academic recovery after concussion. New definitions address gaps in current literature for university and K-12 students.

Keywords:

RTL RTLU concussion definition return to class return to learn return to school

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Area of Science:

Neuroscience
Education
Rehabilitation

Background:

Concussion recovery definitions vary, leading to inconsistent data.
Existing return-to-learn (RTL) criteria lack transparency and a holistic approach.
Current definitions may not account for logistical factors in academic settings.

Purpose of the Study:

To identify and analyze operational definitions of academic recovery (RTL, return-to-school, etc.) in scientific literature.
To propose evidence-based, standardized definitions for RTL in university and K-12 students.
To improve the reproducibility and application of academic recovery data post-concussion.

Main Methods:

Systematic literature search of PubMed and ScienceDirect (2010-2023).
Inclusion of peer-reviewed English articles with full text available, focusing on student samples and clear RTL criteria.
Independent extraction and unanimous agreement on definitions and outcome measures by three researchers.

Main Results:

24 studies met inclusion criteria from 456 articles reviewed.
Five common recovery criteria identified: guided protocols, clinician clearance, school attendance, full academic workload, and full-time without accommodations.
Proposed evidence-based RTL definitions for university and K-12 settings, incorporating symptom resolution, academic participation, and cognitive stability.

Conclusions:

Varied definitions of academic recovery hinder data reproducibility.
Proposed RTL definitions offer a standardized, evidence-based framework for university and K-12 students.
These definitions aim to provide a more holistic and individualized approach to academic recovery after concussion.