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Going back to school after a concussion: what parents need to know

Posted by Dr. Claire McCarthy  November 7, 2013 08:06 AM

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school after concussion.jpgWhen an athlete gets a concussion these days, we have rules and guidelines to help us decide when it's safe and healthy for them to go back to sports. But when it comes to going back to school (for athletes or non-athletes), well, it's a lot fuzzier.

We keep kids out of sports after a concussion both to prevent a second concussion (we know that getting another shortly after the first can lead to worse or permanent brain damage) and because physical activity after a concussion makes symptoms worse and can make recovery take longer. It turns out that the same is true for "cognitive activity", things like reading, writing, concentrating, watching videos or even thinking. Lots of stimulation by light and noise and activity can also be hard for someone who just had a bad bump to the head.

It's also just plain old hard to do schoolwork if your head hurts, you feel dizzy, you have trouble concentrating or you can't sleep at night. It's not really fair to ask a kid to do it, let alone expect them to do well at it. 

That's why the American Academy of Pediatrics came out with a clinical report to help doctors, parents and schools take the best care possible of children after concussions. Here's what parents need to know and do:

  • First and foremost: see a doctor. This should go without saying, but it's common for parents to think that if there's no blood involved and their kid is acting more or less okay, they don't need to see a doctor. But any headache after a head bump that is more than a mild one, and any headache that comes with dizziness, vision changes, sensitivity to light or noise, trouble with memory or concentration, or sleep problems warrants a visit to your doctor or an emergency room.
  • Kids shouldn't go back to school until they feel better and are able to concentrate and work for at least 30-45 minutes (which is about the length of the average lesson). This is important: they don't need to feel perfect, they just need to feel better and be able to get something out of school, even if it's just for part of the day and with built-in rest periods. While doctors can help figure out when to send kids back to school, ultimately parents are the ones who need to make the decision, because they know their kids best.
  • Parents, doctors and the school need to work as a team to figure out the best school program for a child who has had a concussion. The school team should have people involved in both academics and physical activity. It's really important that all team members communicate well and often.
  • The amount of work and homework a child gets should be increased slowly, making sure they can tolerate it. This is where the communication becomes really important!
  • If symptoms last more than 3-4 weeks (most get better by then), the child should see a concussion specialist (talk to your doctor about this) and there should be more formal changes made in the child's school program. 
  • Kids should be back to their academic baseline before they go back to full physical activity or extracurricular activities. This is one recovery you really don't want to rush.
I've found that most schools and coaches are really good about helping kids get back on their feet after a concussion. But not everyone knows what to do--and because kids can look and act pretty normal, it's easy for people around them to think they are back to normal when they're not. If you feel your child isn't getting the support her or she needs, talk to your doctor.

For more information on brain injury and how to treat and prevent it, visit the Concussion page of the Centers for Disease Control and Prevention website.

Is there something you'd like me to write about? Leave me a message on my Facebook page--and "like" the page for links to all my MD Mama blogs as well as my blogs on Thriving and Huffington Post. 

This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About MD Mama

Claire McCarthy, M.D., is a pediatrician and Medical Communications Editor at Boston Children's Hospital . An assistant professor of pediatrics at Harvard Medical School and a senior editor for Harvard More »

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