Returning to School After a Concussion in Children – Instructions

A concussion is a brain injury from a direct blow to your child’s head or body that causes the brain to shake quickly back and forth inside the skull. This can damage brain cells and cause chemical changes in the brain.

Concussions cause temporary difficulty with certain brain functions involving speech, memory, balance, and coordination. After a concussion, your child may have a headache, be dizzy or nauseated, and have trouble thinking clearly and concentrating.

Your child may also have problems remembering or learning new things. Concussions can have serious effects on a child’s developing brain.

Most concussions heal in 1–2 weeks, although some may take longer. It is important to help your child limit his or her activities during recovery. Doing too much can make recovery take longer.

When can my child return to school?

Your health care provider will tell you when it is safe for your child to return to school. Generally, your child can go back to school once his or her symptoms get better. While your child is recovering, teachers may need to make his or her workload less demanding. Work with your child’s teachers, school nurse, and health care provider to figure out which classes may cause your child’s symptoms to get worse. For example, classes with loud noises, such as music class, or classrooms with bright lights may cause worsening symptoms and need to be avoided until your child is better.

Watch for concussion symptoms in your child, especially signs of pain or headache, mood changes, frustration with daily activities, or trouble with balance. Encourage your child to let an adult know if symptoms of the concussion come back.

Your child’s school may have a team that specializes in helping children return to school after a concussion. They may work with you and your child’s health care provider to develop an individualized education plan, if needed. As your child’s symptoms improve, he or she can gradually return to his or her normal school work and routine.

When can my child return to physical education (PE)?

Your child will not be able to do PE class, physical activity at recess, dance, or sports until your child’s health care provider says it is safe. Once your child is back in a normal school routine, he or she no longer has any symptoms, and he or she is not taking any medicines for the concussion, then your child can start the gradual process of returning to PE, sports, and other activities.

What can I do to help my child recover?

Rest is a very important part of recovering from a concussion. This includes resting the body and the brain. It is important for your child to cut back on the amount of time he or she spends doing activities that require his or her brain to problem-solve (cognitive exertion). Your child’s health care provider may recommend cognitive rest, which means avoiding activities such as:

• Watching television.
• Using a computer or phone.
• Using social media or texting.
• Studying or doing homework.
• Reading or writing.

It can be hard to keep your child from these activities, but recovery will be faster if the brain has time to heal. As your child’s symptoms get better, he or she can increase time spent on these activities. Your child may need to take breaks if he or she feels very tired, has a headache, or has trouble concentrating.

How can I help my child cope with recovery?

Talk to your child as he or she recovers. It is normal for him or her to feel angry, sad, frustrated, or nervous. As he or she heals, these symptoms should start to go away.

What resources are available as my child recovers?

School counselors, teachers, and your child’s health care provider can help if your child is having trouble returning to school after a concussion. Some students may benefit from plans to slowly increase class time or to get more support at school.

What symptoms are important to report to my child’s health care provider?

Concussion symptoms may not appear right away. They could also get worse at any time. It is important to let your child’s health care provider know if your child has any new or worsening symptoms, such as:

• Drowsiness or fatigue.
• Headache.
• Memory loss.
• Confusion.
• Difficulty concentrating.
• Loss of consciousness.
• Problems with balance and coordination.
• Nausea and vomiting.
• Weakness or numbness.
• Slurred speech.
• Seizures.
• Trouble recognizing faces or places.
• Inability to remember events before or after the injury.
• Irritability.
• Changes in sleep habits.
• Changes in personality.

Let your child’s health care provider know if your child’s condition is not improving over time. Also, some health issues may make your child’s recovery from a concussion take longer. Let your child’s health care provider know if your child has a developmental disorder, such as ADHD, a history of migraines, or a mental health disorder.

What questions should I ask my child’s health care provider?

When your child has a concussion, learning as much as you can about his or her injury can help to protect your child’s long-term health. Ask your child’s health care provider the following questions:

• When can my child return to school and other activities?
• Should I limit how much time my child watches TV, plays video games, or uses a computer?
• Does my child need more sleep than normal?
• Does my child need medicine for a concussion?
• What are the potential long-term effects of my child’s injury?
• Could my child have problems with memory or learning?
• Should my child consider not playing sports anymore?
• What should my child tell his or her teachers or coaches about the injury?
• What should I do if my child’s symptoms do not improve or get worse?
• What happens if my child gets another concussion?
• What are the warning signs of a concussion?
• Could my child have a concussion without knowing it?
• How can I prevent my child from getting another concussion?