The Centers for Disease Control (CDC) encourages schools to form a support team around students following concussion. Return to Learn Guidelines are just as important as Return to Play Guidelines but can be overlooked by school professionals. This is possibly because of the “invisibility” of the injury and of the damage from returning to learn too early.
A concussion affects each student differently, so follow-up and monitoring afterwards, regardless of early symptoms, is critical. Only a physician can decide when a student is ready to return to the classroom. The physician may wish to consult trained allied health care professionals when the issue of returning a student to the classroom arises. Parents and teachers should also look to the physician for guidance on what activities are appropriate for the brain to manage at each level.
Ask for a physician note prescribing the appropriate levels of activity (for example gradual return to school such as 1-3 hours per day to start, only one test a day, no more than 2-3 hours of reading or computer time, etc.) and more time to complete tests and assignments. The physician should participate in a clear return-to-school protocol, written down, so that all participants (teachers, parents, school administrators) will be on the same page to help the student to heal completely. In general, the principal of the school is in charge of the communication required for a successful, individualized Return to Learn process.
Once in school, teachers should monitor and, with proper permission, share these guidelines and observations with others in the students care team (parents, physicians, school professionals). Guidance counselors, public health nurses and physical education teachers may be especially helpful during the Return to Learn process.
What to look out for after a concussion:*
- Increased problems paying attention or concentrating
- Increased problems remembering or learning new information
- Longer time needed to complete tasks or assignments
- Difficulty organizing tasks or shifting between tasks
- Inappropriate or impulsive behavior during class
- Greater irritability
- Less ability to cope with stress
- More emotional than usual
- Difficulties handling a stimulating school environment (lights, noise, etc.)
- Physical symptoms (headache, nausea, dizziness)
*Adapted from: Returning to School After a Concussion: A Fact Sheet for School Professionals. Available at http://www.cdc.gov/concussion/HeadsUp/schools.html