Traumatic brain injuries (TBIs), including concussions, occur with relative frequency among youth (National Electronic Injury Surveillance System, 2016). TBI symptoms vary by severity but are generally categorized as emotional, cognitive, sleep, or physical difficulties. Common emotional symptoms reported by students include feelings of emotionality (i.e., being more emotional than usual), irritability, sadness, and nervousness (CDC, 2010). Cognitive difficulties often manifest in the learning environment, and may appear as difficulty focusing attention, thinking clearly, feeling slowed down, or an overall sense of sluggishness. The academic setting presents unique challenges to students in the process of recovery from a TBI. Schools are highly structured environments that place demands on students' cognitive and emotional resources. Applying a multitiered system of support (MTSS) framework to TBI can help educators understand how and when to apply more intensive school-based support. The tiered-model approach allows schools to be sensitive to the needs of individual students and, by conceptualizing students in a "pyramid within a pyramid" model, ensures that the provision of support is proactive and appropriate.