It is important that teachers, school nurses and school officials coordinate and monitor the treatment of injured students until recovery is complete. In some regions, concussion laws may in fact require that academic accommodations are provided to students until recovery, so be sure to know local laws and your schools’ policies related to concussion care.
- All concussions are serious, but the vast majority get better without long-term consequences.
- Most concussions occur without loss of consciousness and can include a wide variety of cognitive, physical, emotional, and sleep-related symptoms.
- Recognition and proper response to concussions when they first occur can help prevent further injury and prolonged recovery.
- When in doubt, sit them out from intense activities and contact sports.
- Proper concussion management should include individualized recommendations to address activities across the home, school, and recreation environments.
- Schools play an active part in a child’s recovery. Individualized school plans are needed to allow the child to balance cognitive activities, being in the school environment, with increased opportunities for rest breaks to manage symptoms.
- Students may not learn or perform at their normal levels initially after a concussion and while still symptomatic. There may need to be temporary adjustments to their assignments and to the expectations for what type of work they should complete. Students who are prohibited from doing any work, particularly for long periods of time, may also suffer from increased stress and anxiety around school, which can also slow down recovery. It is best to receive individualized school-related recommendations from a concussion specialist who understands kids and school systems.
Returning to School
Students who have been injured often need additional support to perform school activities during their recovery. Designate a staff member to regularly meet with the injured student to monitor symptoms, individualize supports, and differentiate curriculum based on their current symptoms and ability to tolerate work. After a concussion, teachers, nurses, counselors, school psychologists and administrators should watch for:
- Problems paying attention or concentrating
- Problems remembering or learning new information
- Longer time needed to complete tasks or assignments
- Greater irritability and less ability to cope with stress
- Increased symptoms (headache or fatigue) when doing schoolwork
The Importance of Full Recovery
Full recovery should be documented with an assessment by a healthcare professional before the student returns to a full academic schedule.
Full Recovery Definition
- No active post-concussive symptoms (physical and cognitive) at rest or with exertion
- Neurocognitive functioning and ability to keep up with academic work is back to pre-injury level
- No problems with balance or coordination
- No other associated medical or neurological complications
Incomplete Recovery Risks
Children or teens who still have symptoms and who return to school without a plan for supporting their schoolwork are at risk for delayed recovery and at risk for ongoing problems with learning and performance. Please consult with a healthcare professional about the child or teen’s readiness to return to school. To best support youth throughout their recovery, designate a team or person within each school to regularly monitor the child’s progress and symptoms, adjust supports and accommodations as needed, and communicate with the family and medical team.
What Children's National Offers
The Children’s National SCORE Concussion program partners with school officials across the DC/Maryland/Virginia region and beyond to support them in recognizing and responding to concussions in their students and athletes. If you are interested in learning about concussion education or further consultation please contact us.
Frequently Asked Questions for Schools
School preparedness is an important safety measure to support students with concussions. Schools and school systems should have written policy related to concussion, that is periodically updated to reflect current standards in concussion care. Teacher and staff training, including knowledge of concussion but also an awareness of danger signs for more serious brain injury is critical. When a concussion is suspected, parents and appropriate healthcare providers should be notified. Post-injury management in schools is best provided through coordination between the school, the parents and child, and knowledgeable healthcare providers who have evaluated that child.
It depends on the type and severity of the 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 their symptoms can tolerate. The simple rule is that if the mental activity worsens the child's symptoms greatly, the activity should be avoided or reduced.
The kind of school help will depend on the kinds of symptoms the child is experiencing. The school accommodation plan should be individualized for the child and modified as they child recovers and symptom patterns change. The kinds of supports the 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 the child to stay home from school entirely in order to maximize rest.
Resources for Schools