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Concussion Information Center Chapter V: Return to Learn

Categories: Living with Brain Injury, Being a Caregiver

The best available evidence tells us that gradually returning to activity is very important to recovery. Balancing rest and activity are also important to recovery and a full return to regular activities after concussion. The concept of resting the brain is important and requires staying away from thinking, learning, memorizing, and even things like reading, texting, computer time, and watching TV for the first day or two following an injury. It also includes physical rest. A gradual return to activities, as long as it does not make things worse, is the best approach. You can help by making sure your student – athlete gets rest with both physical and thinking activities and then gradually returns to his/her typical activities. Communication between the student, parents, health professionals, and school staff is vital so that everyone understands the student’s specific needs for getting the proper balance of rest and activity based on his or her individual needs.

If your student has experienced multiple concussions, is experiencing stressful situations, or has other health conditions including anxiety, depression, post-traumatic stress disorder, or chronic pain, concussion symptoms may persist longer. Discuss these issues with a healthcare professional trained in the management of concussion.

Important Take-Away Points

  • Assure the student he/she will be OK and their symptoms will reduce soon by following a plan for recovery
  • Following the gradual sequence for return to school makes for a most successful outcome for the student
  • Care providers and all school staff should be involved
  • It is important to continuously communicate with healthcare professionals trained in the management of concussion during the recovery period
  • After sustaining a concussion it is very important to avoid any activity that places the student at risk of sustaining another concussion

Return to Learn Protocol

Total cognitive and physical rest is the first step in the recovery plan. This should last for three days or less if the student is symptom free for 24 hours. Activities that should be avoided include: video games, cell phone use (including texting), computer use, and video games. Activities that can be done include: Yoga, light meditation, light stretching activities, and breathing exercises. Watch the following video for specific suggestions for total cognitive and physical rest during the first few days of the recovery process.

Light thinking activities are the second step in the recovery plan. Activities that are appropriate include: music that is calm and relaxing and games that are familiar. Activities that were mentioned in the complete rest phase can be expanded upon (Yoga, meditation, stretching exercises, and breathing activities). Watch the following video for specific suggestions for light thinking activities.

Now you have reached the return to school phase in the recovery plan. Start with half-days or attending school part time. Discuss a 504 plan with accommodations with the teacher and school staff. Identify accommodations that will make the student most successful. Always monitor the student carefully, allow rest breaks, and look for signs that they are not doing well or feeling stressed. Everyone involved with the student should work together. This includes parents, student, and school staff. It is key for everyone to keep the lines of communication open while monitoring the recovery plan. Watch the following video for additional suggestions for supporting the student in the classroom.

Read Chapter VI: Return to Play