AFTER YOUR CHILD HAS RECEIVED THE DIAGNOSIS OF CONCUSSION, HOW DO THEY RETURN TO SCHOOL, RETURN TO LEARN AND EVENTUALLY RETURN TO PLAY?

In REAP, the term Return to School is not interchangeable with Return to Learn… and both have to happen successfully before Return to Sport/Play

Return to School is defined as the process of the student physically walking back into a school setting; aka, their “seat in a seat”. The decision to send a child to school on any given day is directed by the parent, often with HCP input, and is dependent upon the student’s ability to manage symptoms.

After a concussion, some students have minimal symptoms, some students have intense symptoms. That is why a one-size-fits-all-step-up approach to returning your child physically to school does not work. Typically, after a few days of relative rest at home, a child/adolescent will be ready to return to school. It is not expected that symptoms will be gone at that point, just that symptoms can be, and should be, managed at school.

Parents: DO NOT hold your child at home due to symptoms for the duration of the concussion.

HCP Providers: DO NOT advise parents to keep students home from school until they are “symptom-free”.

Holding students out of school disrupts their development; it can make them feel socially isolated, get them off-track academically, make them feel “sicker” than they are and eventually can lead to downstream development or exacerbation of depression, anxiety and school avoidance.

Additionally, partially returning to school (half days or every other day) can be disruptive to student's learning, teacher's teaching and parent's schedules. In contrast, being at school full days, with some symptom management help from the school) allows the student to hear instruction, passively listen and learn and provides teachers the opportunity to remove and reduce some in-class work and homework because they know the student was present to hear the lesson.

Failure to RETURN TO SCHOOL, predictably & full-days, impacts the school’s ability to provide a robust RETURN TO LEARN plan.

Return to Learn is defined as the process by which educators, primarily classroom teachers, help students with concussion maximize learning while minimizing symptom flare-ups.

A student with a concussion who has returned physically to school, all day, every day, can now be supported by their school team for the duration of the concussion.

Return to Learn refers to the “magic” provided by general education teachers who adjust the environment in the classroom (preferential seating, audiobooks, buddy notes) and who adjust the workload (group presentation instead of individual report, a collage instead of an essay, even problems instead of even + odd problems). These Return to Learn “gifts” cannot be given to students who have not heard instruction (i.e. students who have been absent). It is also impossible for teachers to eventually assess mastery of material and to give a fair grade if the student has not attended or missed instruction. 

Falling grades post-concussion are usually the result of either: a parent’s / HCP’s failure to RETURN a child to SCHOOL (due to anxiety about symptoms) or a teacher’s failure to provide an adequate RETURN TO LEARN plan.

A quick RETURN TO SCHOOL, followed by a supportive RETURN TO LEARN are necessary requirements prior to starting steps toward RETURN TO SPORT/PLAY.

When returning a student to school:

• Parents should communicate with the school (school nurse, health tech, teacher, school mental health and/or counselor) on the student’s first day back to school following the concussion.
• Parents and the school should decide together the level of academic
  adjustment needed at school depending upon:
  • The severity of symptoms present
  • The type of symptoms present
  • The times of day when the student feels better or worse
• The child must not participate in high risk physical activity in school/recreational/club sports, gym/PE class, dance class, and recess until medically cleared.
• Consider temporarily removing child from band or music class if symptoms are provoked by sound but return them quickly with noise reduction ear/headphones.