There has been lots of attention in the past few years regarding the right time for kids to return to play, after a concussion. Now there’s increased evidence that returning to the pressures of the classroom too soon may also slow healing and aggravate symptoms. And, parents, patients and physicians have gotten little guidance on how to manage a child’s return to learning after a concussion.

However, a new report in the journal Pediatrics addresses the discussion. The report emphasizes that, for a child with mild traumatic brain injury, the noise and chaos of school hallways, the eye strain of classroom instruction, and the pressure of homework and tests can tax the brain at a time when it needs to be healing.

The report acknowledges though, that school administrators have little guidance on the subject, and are under intense pressure to show improvements in test performances. “Schools are very structured places and are really geared toward the average: Everyone gets the same kinds of curriculum,” says Rosemarie Scolaro Moser, neuropsychologist and director of the Sports Concussion Center of New Jersey in Lawrenceville, N.J. “But every concussion is unique, and each student athlete heals at a different rate. So there’s no predictability and that unknown causes a lot of discomfort when you’re a school administrator trying to meet goals, deadlines and objectives in a student’s progress.

The Pediatric’s report offers checklists that parents, physicians, and schools can use to identify symptoms that may be triggered by school activities, and to track them as they resolve.

Krista Rickards, who’s daughter sustained a severe concussion a few years ago returned to the classroom too early and had bouts of dizziness and headaches brought on by the noise and chaos of the lunchroom and halls. By the end of the school year, Rickards had sought the help of a neuropsychologist for her daughter. Eventually, they were able to negotiate accommodations, including exemption from gym class.

“As a parent you have to push. I wasn’t aggressive, but I was persistent,” Rickards said. “It’s hard though, because a concussion is not a seen injury. You can see crutches, you can see a cast, or a wheelchair. You can’t see a concussion,” she said.  LA Times   10/28/13


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