Returning to school after a concussion is often a gradual process.
Research has shown that returning to school after a couple of days rest is helpful in an adolescent’s recovery from concussion.
When comparing students recommended to return to school after 2 days rest versus students recommended to return to school after 5 days of rest, the students returning to school after 2 days of rest experienced concussion symptoms with a lesser severity through their recovery and their recovery was of a shorter duration than the other group.
But this does not mean immediately returning to full time school with a full workload.
Returning to school typically incorporates 3 things:
Avoidance of another concussion.
Temporary academic adjustments.
Temporary adjustments of the physical environment.
1. Protection from another concussion:
Excused from sport participation.
Excused from gym class to prevent another hit or jolt to the head. But going for a walk with a friend is encouraged, although sometimes supervision rules create some barriers to implementation.
Excused from recess to avoid another hit or jolt to the head. Falling, being pushed strongly, or being hit in the head with a ball can all lead to another concussion especially during the first 10 days of recovery.
Excused from field trips.
2. Temporary academic adjustments for concussion:
Half days of school may be the starting point.
Excused from exams.
Excused from homework.
Excused from assignments.
Realize that subjects like math may be more difficult due to the working memory requirements like keeping one number in mind while doing another calculation. Subjects like social studies or science may be difficult due to the memory requirements. Subjects like art are better tolerated.
Focus on limiting learning to essential material in the beginning. Later, progress to semi-essential, and finally non-essential material.
3. Temporary adjustments of the physical environment to minimize provoking increased concussion symptoms:
The specific adjustments will depend on what type of sensitivities a person is experiencing. Generally, as the sensitivities improve, less and less precautions are used.
Some examples of adjusting for the sensitivities created by concussion:
Limit noise exposure:
Later start in the morning.
Early dismissal from each class to go to a quieter space.
A quiet work space if the classroom is noisy. Working with a friend can be helpful – we don’t want to promote social isolation.
Quiet place for lunch with a friend(s).
Limit bright lights:
Dimmed lights in classroom.
Allowed to wear a brimmed hat.
Allowed to wear sunglasses sometimes if needed.
Limit visual motion environments:
Avoid being in a crowd of people between classes or during lunch or dismissal.
Limit use of computer screens.
Final notes:
The process of returning to full time school after a concussion can be a bumpy road.
Many times students unintentionally irritate symptoms.
But don’t worry.
Use these times as a learning tool to help better manage the next day or week.
The only concern is if a person pushes strongly through symptoms repeatedly, basically ignoring the symptoms. Research has demonstrated that ignoring symptoms completely over a long period of time tends to prolong the recovery. Intuitively this probably makes sense to people – ignore a painful, stiff, and swollen ankle and just running 5 km each day probably won’t lead to the speediest recovery. The same can be understood with concussion.
To learn more about recovering from a concussion, please browse more of our posts and check out the concussion page.