After a Concussion: Returning to School and Play by Colleen Kraft, M.D.
After a concussion, it is common for many parents and coaches ask when their child/athlete can return to their sport or to recreational activities. However, it is also important to for parents to remember that children are “students” first and “athletes” second.
The American Academy of Pediatrics (AAP) has developed the following guidance on when children with a concussion should return to school and learning.
How Concussions Affect Learning
A concussion is an injury that (usually only) temporarily disrupts the normal function the brain. A concussio
n will usually disrupt a child’s ability to:
- Be efficient at processing and learning new school material
When to Return to School?
The first few days following a concussion, when the brain is still healing, a child may be too symptomatic to attend school. Brain cells repair themselves daily, so the effects of the concussion should lessen and become more tolerab
le and manageable with time. When this happens, a child is encouraged to go back to school.
Following a concussion, it can be very difficult for a healthcare provider to know exactly when a child is ready to return to school. For example, if a healthcare provider sees a child on a Thursday she/he may or may not be ready to return to school on Monday morning. Therefore, it is important for parents and healthcare providers to watch a child’s symptoms to determine when to return to school.
When concussion symptoms have lessened and are tolerable for up to 30 to 45 minutes, a child should return to school. This will usually happen within a few days/within the first week of the concussion.
Check with your child’s school to see if your district or school has a policy in place to help students recovering from a concussion succeed when they return to school. If not, consider working with your child’s school administration to develop such a policy.
Policy statements can include:
Returning to School Does Not Mean Returning to Play!
In order to reduce the risk of another brain injury, a child must be removed from the following upon returning to school:
In addition, teachers should modify homework as needed for students. Children need an average of 3+ weeks recovery time after a concussion to perform at their pre-concussion state.
Team Effort to Adjust and Heal
Supporting a child recovering from a concussion requires a collaborative, team approach among school professionals, health care professionals, parents, and students.
It is encouraged that the family team (student, parents, guardians, grandparents, siblings, peers, family friends) help to facilitate feedback and information to, from and between the school teams and the medical teams (physician, concussion specialist, neurologist, psychologist, school/team physician).
It is important that the school have two teams:
- Academic Team (teacher, counselor, speech-language pathologist, school mental health, school nurse, administrator)
- Physical Team (certified athletic trainers, school nurse, coach, PE teacher, playground supervisor)
Before a child can even consider returning to the field or to recreational activities, he must successfully adjust back into the social and academic demands of school.