“Return to learn” after concussion

Concussions have been back in the news recently.  A detailed discussion of concussion is far too involved to fully review in this limited space. Quick definition: if your child sustains a head injury with loss of consciousness or has subsequent persistent headache or neck pains, dizziness, memory problems, nausea, vomiting or fatigue, then he or she has suffered a concussion.

As it happens not infrequently in medicine, the pendulum swings back and forth with respect to management of this problem.  So while a long time ago you might have tried to “walk it off”, more recently it had been advised to keep inactive and maintain almost complete rest until symptom resolution. Now a new article strongly suggests that early if gradual return to school may be best. This is called “return to learn”. Strategies I employ to assist my patients in that process include:

  • No video games or social media. They can do that after return to all other life activities.
  • No sports – that’s next to last.
  • If it hurts, stop doing it and rest.
  • Limit TV viewing, reading and homework. As above, if it hurts stop and rest. Perform these activities for shorter periods.
  • Listening to music (not playing an instrument) or drawing may be ok.
  • Take regular rest while attempting homework; gradually increase the homework session time
  • At school:
    • Your child may transition by attending school part time and gradually increasing duration in class.
    • Allow child to rest head on desk or retire to nurse’s office when symptoms increase. The amount of rest necessary may vary with the challenge that class presents to your child.
    • To ease eye strain, turn down computer screen brightness and use sunglasses or baseball cap to shield eyes from the bright light.
    • Your child might need to avoid noisy rooms like the gymnasium, cafeteria, or music hall.
    • Note taking may be problematic. Your child may record lessons, the teacher may give him or her the lesson notes, or a classmate might share his or her notes.
    • Obviously, testing should be postponed until resolution of symptoms.

The duration of the concussion symptoms varies with children and with the situation. We should keep in close contact  to monitor your child’s progress through the process of transitioning back to his or her full life’s activities.

Please contact me with questions, comments, or requests for future posts. Thanks for following.


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