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Returning to School After a Concussion

Football legend, Brett Favre, recently talked about being concerned over memory lapses he’s been experiencing. He believes the lapses may be a result of the numerous concussions he suffered as...

Football legend, Brett Favre, recently talked about being concerned over memory lapses he’s been experiencing. He believes the lapses may be a result of the numerous concussions he suffered as a professional football player. He joins an ever-expanding group of ex-NFL players that report serious memory issues as well as depression, anxiety, suicidal thoughts and devastating diseases. Many of the ex-players believe that the frequent concussions they received are at the root of their mental health problems.

As more and more adult sports figures talk about their concussion related medical problems, the spotlight shifts to concern for young student athletes and protecting them from experiencing concussions.  From grade school through college, experts have been creating and implementing programs to prevent concussions as well as guidelines for when a student can return to participate in sports after receiving a concussion.

Researchers are now beginning to explore another side to student concussions – when should a student resume classwork?

The American Academy of Pediatrics (AAP) has issued recommendations for “return to learn”, a checklist to alert doctors, school administrators and parents to potential cognitive and academic challenges to students who have suffered concussions.

“They’re student athletes, and we have to worry about the student part first,” said Dr. Mark E. Halstead, the lead author of “Returning to Learning Following a Concussions,  a clinical report in this week’s Pediatrics.

People tend to associate children’s concussion only with sports related activities, but that leaves out a whole other group of kids that get concussions for a variety of reasons. From skateboarding to car-accidents, from tree climbing to slipping off a curb while texting and not watching where you’re walking – there are lots of ways you can sustain a brain injury.

The brain needs time to heal and requires rest after an injury. Experts have come up with a game plan for when to return to physical activities, but what about “cognitive rest” for tasks such as studying, taking tests and reading? Researchers aren’t sure how long the brain needs to rest before returning to schoolwork.

Experts have not identified at what point mental exertion impedes healing, when it actually helps, and when too much rest prolongs recovery. Although many doctors are concerned that a hasty return to a full school day could be harmful, this theory has not yet been confirmed by research.

The student’s pediatrician, parents and teachers should communicate about the incident, the recommendations said, and be watchful for when academic tasks aggravate symptoms such as headaches, dizziness, sensitivity to light and difficulty concentrating. The academy acknowledged that case management must be highly individualized: “Each concussion is unique and may encompass a different constellation and severity of symptoms.”

Most students have a full recovery within three weeks, the article said. But if the recovery seems protracted, specialists should be consulted.

Schools can have a positive impact on a child’s recovery by helping students ease back into the regular curriculum.  To alleviate a student’s headaches, for example, schedule rests in the school nurse’s office; for dizziness, allow extra time to get to class through crowded hallways; for light sensitivity, permit sunglasses to be worn indoors. Students accustomed to 45-minute classes might only be able to sit through 30 minutes at the outset, or attend school for a half-day.

“Parents need to follow up with schools and make sure plans are being followed,” Dr. Halstead said.

It may take a month before a child is ready to resume full school involvement.

Dr. Matthew F. Grady, a pediatric sports medicine specialist at Children’s Hospital of Philadelphia who may see 50 patients with concussions a week during the fall sports season, often suggests that before students return to class, they should first try modest amounts of school work at home, to identify if and when symptoms recur.

“But that ramping-up period will depend on the severity of the concussion and the cognitive demands on the student,” he said.

If your child has suffered a concussion, talk to your pediatrician or family doctor about a medical plan to help your child return to his or her studies. Notify your child’s school and let the proper authorities know about the concussion and your physician’s recommendations when your child is ready to return.

Source: Jan Hoffman, http://well.blogs.nytimes.com/2013/10/27/concussions-and-the-classroom/?_r=1&

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About Sue Hubbard, M.D.

Dr. Sue Hubbard is an award winning pediatrician and medical editor for www.kidsdr.com.  She is a native of Washington, D.C. who travelled south to attend the University of Texas at Austin and never left.Read More

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