Sports-related Concussion: When medicine and sport meet head on
The Community Factor How Brain Usage and Rest Affect Recovery
Brain

The brain can use its energy to heal and to think, but not at the same time. Taxing mental activity during the healing process will cause it to suffer as a result. Even if the student stays away from school it can be hard for them to give their brain the rest it needs. To the student, activities such as driving, surfing the internet, talking on their cell phone, watching television and playing video games are not only things that are a normal part of their day, they consider them to be relaxing. But these activities do not give the brain the rest it needs to recover and can make symptoms worse and lengthen recovery time. It’s important that everyone involved in the student’s recovery understands this.

In the early days following the concussion, strict restriction on schoolwork, texting, gaming and computer use is recommended. A physician may allow this to become more acceptable as the patient begins to improve, as defined by their symptoms.

Managing concussion symptoms at school:*
(To be shared with entire care team with the school principal as the captain of the team, and the physician as a member)

Mental

  • Focus on flexible thinking and organization, over academic content.
  • Start with what they do well and expand to challenging content as symptoms subside
  • Adjust daily schedule to avoid fatigue: shorten day, challenging classes when most alert, breaks, reduced course load
  • Reduce distractions and/or protect from irritations (bright lights and loud noises)
  • If experiencing reading comprehension problems: use self-paced, computer-assisted or audio learning systems
  • Allow extra time for test/in-class assignment completion
  • Encourage task lists and/or daily organizer
  • Suggest that a peer take notes for the student
  • Record classes
  • Increase repetition to reinforce learning
  • Break assignments down into smaller chunks
  • School should provide alternative learning methods (multiple-choice or oral exams over long essays)

Behavioural/Social/Emotional

  • Redirect frustrations or failure in one area to other elements associated with success
  • Use positive reinforcement for behaviour as well asand academic achievements
  • Acknowledge and empathize with the student’s sense of frustration, anger or emotions
  • Provide structure and consistency across the care team
  • Remove the student from problem situations, but avoid framing it as punishment and keep it as brief as possible
  • Engage the student and involve them in any decisions (schedule changes or priority setting)
  • Involve the family in any behaviour management plan
  • Set reasonable expectations
  • Arrange thoughtful seating (away from the bright windows or talkative peers, and closer to the teacher)

*Adapted from: Returning to School After a Concussion: A Fact Sheet for School Professionals. Available at http://www.cdc.gov/concussion/HeadsUp/schools.html