STEP THREE: ADJUST/ACCOMMODATE for EDUCATORS (continued)
Most students with a concussion only need to miss a few days of school. If a student misses more than a few days, the school should meet with the parents and ask for a medical explanation.
Research shows that students who rest for a few days and then slowly return to normal activities—like school and spending time with friends—have fewer symptoms than students who stay in strict rest for five full days (Thomas et al., 2015).
Getting too much rest has not been proven to help students recover faster. The best way to recover from a concussion seems to be getting a reasonable amount of rest, then slowly increasing activities at home, in school, and light exercise, as long as those activities do not make symptoms much worse.
Symptom Wheel
Suggested Academic Adjustments
PHYSICAL:
- "Strategic Rest" proactive scheduled 15 to 20 minute breaks in clinic/quiet space (mid-morning, mid-afternoon, and/or as needed)
- Sunglasses (inside and outside)
- Quiet room/environment, quiet lunch, quiet recess
- More frequent breaks in classroom and/or in clinic
- Allow quiet passing in halls
- REMOVE from high risk physical activity in PE, recess, & dance class without penalty
- Sit out of music, orchestra and computer classes if symptoms are provoked
COGNITIVE:
- REDUCE workload in the classroom/homework
- REMOVE non-essential work
- REDUCE repetition of work (i.e. only do even problems, go for quality not quantity)
- Adjust due dates; allow for extra time
- Allow student to "audit" classwork (listen/learn without output demands)
- Exempt/postpone large tests/projects; alternative testing (quiet testing, one-on-one testing, oral testing)
- Allow demonstration of learning in alternative fashion
- Provide written instructions
- Allow for buddy notes or teacher notes, study guides, word banks
- Allow for technology (tape recorder, smart pen) if tolerated
Symptom Categories Diagram
Physical
Headache/nausea, dizziness/balance problems, light sensitivity/blurred vision, noise sensitivity, neck pain
Cognitive
Trouble with concentration, remembering, mental "foggy", slowed processing
Emotional
Feeling more emotional, nervous, sad, angry, irritable
Sleep/Energy
Mentally fatigued, drowsy, sleeping too much, sleeping too little, can't initiate/maintain sleep
EMOTIONAL:
- Allow student to have signal to leave room if symptoms are flaring
- Help staff understand that mental fatigue can manifest in "emotional meltdowns"
- Allow student to remove themself to de-escalate
- Allow student to visit with supportive adult (counselor, nurse, advisor)
- Watch for secondary symptoms of depression and anxiety usually due to social isolation and concern over "make-up work" and slipping grades. These extra emotional factors can delay recovery.
SLEEP/ENERGY:
- Allow for "Pacing" – 5 to 10 minute eye/brain/water rest breaks in the classroom (i.e. eyes closed, head on desk) after periods of mental exertion
- Alternate "mental challenge" with "mental rest"
Message to Educators
A brain that is not working at full strength (like after a concussion) can cause:
Difficulty concentrating and focusing
Mental fatigue (the student gets tired very easily and needs symptom support)
Slower thinking speed (the student needs less work)
Trouble with short-term memory (the student may struggle to learn new material and keep up with grades)
Think about how you already help students with these problems:
If a student is very tired (maybe from mono or stress at home), you might give more breaks or offer extra care and support.
If a student struggles to keep their focus and works slowly (maybe because of ADHD) and can’t finish classwork, you might:
Assign every other math problem
Let them use notes from a class buddy
Shorten assignments
If a student has been sick (like getting chemotherapy) and can’t take a regular test, you might let them do an oral presentation instead.
The main idea is something teachers already know how to do: change instruction to fit the student’s needs. If you know how to help students who are tired, think slowly, or have memory problems for any reason, you already know how to help a student with a concussion.
The most helpful change for a student with a concussion is:
Remove work that is not essential
Reduce work that is semi-essential
Simply giving extra time or letting work pile up is usually not helpful. Students who think more slowly cannot easily make up a lot of old work weeks later. Instead, lower the amount of work now and focus only on what is most important.
Adapted from GetSchooledOnConcussions.com/Teacher Acute Concussion Tool (TACT)