Returning to school after enduring a concussion is a positive step towards recovery from a brain injury. Parents often feel scared, anxious, or uneasy about sending their children back to school due to the risk of another injury while playing, in addition to the cognitive demands of the classroom environment. However, for a holistic recovery, a collaborative effort between the parents, physicians, clinicians, and even the teacher is recommended to provide the optimal recovery environment. So what can teachers do to support their students who have experienced a concussion?

1. Reduce the workload and modify assignments: Breaking down assignments into smaller more manageable pieces is an effective measure to reduce the demands on the student and their cognitive faculties.
2. Provide frequent breaks: This will help them stay more focused on the task at hand but, more importantly, it allows them to rest.
3. Allow for more time to complete assignments and tests. It is recommended to avoid testing initially to reduce stress and the demands on the brain.
4. Reduce sensory stimulation such as light and sound. Some studies suggest using sunglasses in class to reduce light intensity. The student can also be seated away from windows and the lights could be dimmed. As for sound, the teacher should discuss strategies to limit noise in the class with the rest of the students since it requires a collaborative effort. It would also be effective to allow the student to have lunch and breaks in a quiet location, unlike the cafeteria. 
5. Limit their exposure to electronic screens to reduce light exposure. Electronics require more brain effort to process all the information that is transmitted which can worsen the symptoms.
6. Assign a notetaker: If taking notes is applicable in the classroom, it is helpful to have another classmate take notes for that student or to have the teacher provide typed notes after the lesson.
7. Provide written instructions: some patients experience memory deficits following a brain injury, so rather than having to retain the verbal instructions, access to written ones easily could make the learning environment more manageable.
8. Modify seating assignments to have the concussed student at the front. This will reduce distractions and it will also allow the teacher to easily observe the student and watch out for worsening symptoms. Remember that a concussion is an invisible injury meaning that you often cannot see a physical presentation of the symptoms. 
9. Encourage them to use a planner and provide a checklist: Many patients may experience challenges with organization. Teachers can help by structuring the student’s time, provide a clear schedule, and use to-do lists to remind them of their tasks.
10. Explain to the rest of the class what their classmate is experiencing and how they can help. This can be especially important in order to get the whole class to support their classmate and be extra cautious while playing to avoid additional injuries.
11. Educate themselves about the symptoms of concussions and the academic accommodations that can be implemented.
12. Ask the student how they are feeling! No concussion experience will be identical to another. Thus, it is important to check in on the student and get feedback regarding which modifications have been helpful and how to make the classroom environment more comfortable.

Written by Lea Farah

References

Halstead, M. E., McAvoy, K., Devore, C. D., Carl, R., Lee, M., & Logan, K. (2013). Returning to learning following a concussion. Pediatrics, 132(5), 948-957. https://doi.org/10.1542/peds.2013-2867

Purcell, L. K., Davis, G. A., & Gioia, G. A. (2019). What factors must be considered in ‘return to school’ following concussion and what strategies or accommodations should be followed? A systematic review. British Journal of Sports Medicine, 53(4), 250-250. https://doi.org/10.1136/bjsports-2017-097853

Wan, A. N., & Nasr, A. S. (2021). Return to learn: An ethnographic study of adolescent young adults returning to school post‐concussion. Journal of clinical nursing, 30(5-6), 793-802.  https://doi.org/10.1111/jocn.15617

Center for Disease Control. Returning to School after a Concussion: A Fact Sheet for School Professionals. Retrieved July 16, 2021, from https://www.cdc.gov/headsup/pdfs/schools/tbi_returning_to_school-a.pdf

An Educator’s Guide to Concussions in the Classroom. Retrieved July 16, 2021, from https://www.nationwidechildrens.org/specialties/concussion-clinic/concussion-toolkit/an-educators-guide-to-concussions-in-the-classroom