Healthy strategies for returning to school after a concussion
“Return-to-learn” should balance brain health, academics and emotional health.
After a concussion, your child’s brain works hard to heal. Just like an ankle sprain or broken bone, a concussed brain needs time to recover from its injury.
“Part of what we know about concussions is that there is an energy crisis in the brain after it is injured,” says Alice Ann Holland, Ph.D., ABPP, a board-certified clinical neuropsychologist and the Research Director of the Neuropsychology Service at Children’s Health℠. “The brain needs a lot of energy to repair itself after an injury, so while it’s doing that, it doesn’t have as much energy for learning and memory. As a result, the brain needs some time to get back to where it was in terms of thinking processes.”
Just like “return-to-play” protocols guide a child’s safe return to physical activity after a concussion, “return-to-learn” protocols help your child get back into school and learning in a healthy way.
It’s important to find a balance between helping a child’s brain rest and ensuring they are able to return to their normal routine quickly. Keeping a child out of school too long can have detrimental effects on their emotional health and even worsen their concussion symptoms. You can work with your child’s doctor to develop a personalized plan for recovery based on the steps below.
Follow the below steps for a physically and emotionally healthy recovery.
Step 1: Physical and cognitive rest.
This means no driving, listening to loud music, texting or using screens (e.g., TV, smartphone, computer, tablet). Talking with friends by phone or in person should be allowed, as this can help prevent emotional difficulties during this time. Your child should relax, take naps, and give his/her brain time to heal without working too hard. Since every brain and every concussion is different, this rest period can vary in length, but should last no more than three days. If your child shows no concussion symptoms for 24 hours, they can move on to reading, texting and listening to music with physician approval.
Step 2: Return to school part-time.
Within a week of the concussion, your child should be back at school, but that doesn’t necessarily mean he/she is fully learning again.
“There’s an important distinction between returning to school and returning to learning,” Dr. Holland says. “It’s important to have a kid return to school as soon as possible. You want to make things as normal as possible as quickly as possible. Returning to learning may be a little slower, depending on the severity of the concussion.”
In this phase of healing, Dr. Holland says your child shouldn’t necessarily be taking on a typical workload. Your child’s first few days back at school may be half-days, assignments may be shortened and deadlines may be extended as appropriate. However, this should not last more than a couple weeks in most cases, and many children will be able to return to full school participation much sooner than that. In fact, a child who has only experienced a very mild concussion may be able to skip Step 2 completely.
Step 3: Return to school full-time
Your child should be ready to start back at school full-time after a few days to a couple weeks, depending on the concussion severity. It is important not to rush this process, but at the same time, it is best for your child’s emotional health to get him/her back in a normal routine as soon as possible.
At school, your child and his/her teachers should watch for signs of stress or fatigue. Bright lights, noisy hallways and the mental strain of a school day can be stressful, especially while also catching up on any missed work. If your child seems tired or anxious, he/she may need a quiet break from the classroom. You can work with your child’s school to help make temporary adjustments and accommodations for your student. However, it’s important to emphasize to your child that these supports are short-term and only should be needed for a very brief period of time—a few weeks at most—since a concussion is not a lasting brain injury. This should help protect your child from developing any issues with self-confidence at school.
“You want to ease back into work,” Dr. Holland says, “But you don’t want to drag that out too long. You want them to return back to normal life.”
If your child has had a concussion, talk to a specialist at Children’s Health.
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