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) developed 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 concussion will usually disrupt a child's ability to:
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 tolerable 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 he or she 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.
It is not necessary for a child to be 100% symptom-free before returning 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 and certainly within the first week of the concussion. Prolonged absences from school following a concussion is discouraged.
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 while recovering from their concussion:
All school and club sports
Physical education (PE) class
All physical play at recess
In addition, teachers should reduce cognitive demands.
Concussion Recovery Time
Most children will recover within 4 weeks of their injury.
Team Effort to Adjust and Heal
Supporting a child recovering from a concussion can benefit from 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 (pediatrician, concussion specialist, neurologist, psychologist, school/team physician).
A school may two teams to help manage concussion:
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.