Return to school guidelines following concussion


In her latest blog Susie Aspinall an occupational therapist working with the brain injury community team at The Children’s Trust talks about new concussion guidelines developed by Can Child.

  Katy James recently wrote about concussion (you can read her blog here) and the importance of raising the awareness of all things concussion related and having this week read an article regarding return to school protocols following concussion, I thought it was important to share some of the key points as a sequel to Katy’s blog.
The article ‘A Balanced Protocol for Return to School for Children and Youth Following Concussive Injury’ explains that:
  • ‘the consequences of returning to school and other activity too early can include exacerbation of symptoms, prolonged recovery and the risk of sustaining another similar injury’
  • ‘prolonged absence from school may be as equally devastating to the young person due to loss of academic standing, social isolation, and may contribute to depression and/or anxiety’
  • ‘although children with concussive injuries may not have the cognitive ability to participate in learning, returning to a modified school environment represents normality and promotes a routine and supportive social environment’
As a part of this study, Can Child have produced return to school guidelines following concussion you can find these here.  Can Child also produce lots of other concussion resources which are available here.  The protocol focuses on return to school and not just return to learning. The developers of the protocol identify that it is beneficial to have a child return to their school environment first and then to establish when they are able to participate in learning. The guidelines are designed to strike a balance between the importance of returning to school and brain recovery and do this using a 5 stage process.
5 stage concussion protocol
Some of the key aspects include: Stage 1: Brain rest – No school No school for at least a week, lots of cognitive rest (no tv, video games, texting, reading) Stage 2: Getting ready to go back Begin gentle activity guided by symptoms i.e. 15 minutes of screen time twice daily, begin reading) Stage 3: Back to school/modified academics Focuses on changes to a child’s timetable/attendance, the curriculum, environmental modifications and activity modifications. A child may stay in stage three for days or months depending on their speed of recovery Stage 4: Nearly normal routines Back to full days of school but can do less than 5 days a week if needed Stage 5: Fully back to school Gradual return to normal activities including attendance, homework, tests and extracurricular activities. Within the Brain Injury Community Team we have met a few children with concussion whose return to school was too soon due to the limited information available surrounding this.  Why not print out a copy of the protocol and give it to your child’s head teacher or Special Educational Needs Coordinator and help spread awareness of the importance of returning to school at the right time following concussion?
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