After a concussion is diagnosed, when should my child return to school?
It depends on the type and severity of your child’s symptoms, and how those symptoms respond to doing the cognitive (thinking) activities of school. If at all possible, it may be best to stay out of school the first few days after a concussion to determine what kinds of activities the child can handle. Many children miss a few days, then return to school for a partial day, and gradually increase to a full day as there symptoms can tolerate. The simple rule is that if the mental activity worsens the child’s symptoms, the activity should be avoided or reduced.
How do I explain my child’s injury to their school?
It is important to explain your child’s injury and the types of symptoms to all key school personnel. A child who returns to school with symptoms (e.g., headache, tiredness, difficulty concentrating) is not ready to participate fully in all school activities, and should not be expected to take exams or quizzes. They may need to put their head down during class or be excused to rest in the nurse’s office. The CDC School Toolkit, available on the web for free, is a great resource to help schools understand this injury.
The kind of school help will depend on the kinds of symptoms your child is experiencing. The school accommodation plan should be individualized for your child. The kinds of supports your child needs will change throughout recovery as the symptoms improve. Some common accommodations include rest breaks, shortened days, reduced homework, modified or no tests, provision of notes and outlines, and extra time for assignments and tests. Certainly, early on after the injury, it may be necessary for your child to stay home from school entirely in order to maximize rest.
Activity restrictions My doctor told my child to rest. What exactly does “rest” mean?
Rest means reduced physical and cognitive activity. The goal is to minimize brain activity to promote healing. Resting can be lying in a quiet room, reading a magazine, or watching “mindless” television. Resting does not include spending long periods of time in activities such as walking around the mall for hours, studying for long periods of time, or listening to loud music. Too much activity too early may delay recovery.
Can my child watch television, play video games, text, etc.?
The types of activities and how much they do depend on their level of symptoms, and whether the activity makes symptoms worse. Playing games, computer time, and texting may be fine, as long as they do not make symptoms worse and do not interfere with rest or return to school. Activities that risk re-injury must be avoided.
Can my child go out with their friends? Can they have sleepovers?
Children who are no longer highly symptomatic can spend limited amounts of time with friends doing low-key, supervised activities. Sleepovers are not recommended because of the tendency to stay up late and sleep in less than optimal conditions.