We spend a lot of time in sports medicine focusing on return to play after concussions. We emphasize that concussed athletes need to report symptoms and avoid returning to play too early. We don’t focus enough on some of the difficulties these kids face in the classroom after the brain injury. Learning after a concussion is an area, though, that causes much frustration and anxiety for not only the young athlete, but also the parents and teachers.
Outside of the symptoms of concussions (which I will discuss shortly) that can hinder learning, many experts believe that using a concussed brain could worsen symptoms and increase the time to full recovery. Reading, studying and other brain-stimulating activities could further stress the brain. Trying to determine the balance between cognitive rest and exertion can be challenging. It must be determined on an individual basis.
An excellent report from the American Academy of Pediatrics’ Council on Sports Medicine and Fitness and Council on School Health addresses some of these challenges. The authors stress a team approach – the medical team, the school team and the family team – to guiding a concussed athlete back into the classroom. I encourage you to read it.
Challenges with learning after a concussion
I want to focus here on some of the common signs and symptoms of a concussion, why they cause problems with learning, and what can be done to overcome the challenges.
Headaches are common after concussions. In school, loud noise and bright lights can cause or worsen them. These headaches can make it difficult to concentrate in class, to do homework, or to study for tests. Schools can allow the student to take breaks when necessary and to rest in a quiet place occasionally.
Sensitivity to light or blurry vision
These concussion symptoms can make the students use of technology difficult. Computers, tablets and even slide presentations could trigger these symptoms. Schools can allow the concussed student to wear sunglasses indoors. The student could listen to audiobooks instead of reading. Reducing the brightness of screens might help as well.
Sensitivity to noise
This symptom can make multiple aspects of school difficult. It isn’t just certain classes that are noisy, like physical education, music and shop. Students might become uncomfortable in crowded hallways and cafeterias. Some class changes can be made. The concussed athlete can also eat lunch with another person in a quiet place. Teachers could allow the student to leave class a few minutes early to avoid the crowded hallways.
This is another common concussion symptom. Walking in crowded hallways might be difficult for the student. Bright, flashing lights with rapid, such as those on computers and videos, might trigger dizziness or lightheadedness. Avoiding crowded hallways by leaving class early can help with dizziness too. Allowing the student to put his or her head down when dizzy might be necessary as well.
Sleep disturbances can cause a concussed athlete to fall asleep in class. Learning after a concussion, especially learning new material, would be challenging when tired from lack of sleep. Schools could allow the athlete to come to school later in the morning and take breaks during the day to rest.
Difficulty concentrating or remembering
This concussion symptom will affect tests, studying new material, recalling and applying older content and much more. Schools might have to make more adjustments for these issues than any other symptom. Maybe the school could postpone standardized tests or give the student longer to complete one. They could offer a scribe to take notes or give the student prepared notes. They could even delay tests or projects until the student has recovered from the injury fully.
Halstead ME, McAvoy K, Devore CD, Carl R, Lee M, Logan K; Council on Sports Medicine and Fitness.; Council on School Health. Returning to learning following a concussion. Pediatrics. 2013 Nov;132(5):948-57.