Returning to School

  • If you’re a student we recommend you follow a Graduated Return to Learn Strategy that can be designed by you, your healthcare team and school staff.  

  • We don’t recommend prolonged absence from school beyond a few days.

  • You should begin school work at home, followed by part time school, then progress back to full schedule.

  • Some guidelines recommend only progressing when you have no symptoms.  We suggest you continue progressing even if you have symptoms, as long as they are tolerable and you continue to feel better and do more over time.

  • If you stop making progress, dial back your activity until it becomes manageable.

 

 

Return to Learn Strategy Example

In formal return to school plans, you might see the following terminology often used:

  • Academic adjustments: informal changes lasting the first 1-3 weeks without changes to curriculum, homework or testing
  • Academic accommodations: formal changes that are implemented >3 weeks including extra time for assignments and tests, changing classroom environment, changing schedule
  • Academic modifications: prolonged and likely permanent changes to education plan (like an IEP)

 

Phase 1:  Out of school and rest with limited physical and cognitive activity for 1-3 days.  

  • May do light walking, light reading, and watch TV.
  • Limit computer work, video games, or texting.
  • Start to arrange for gradual return to school with adjustments.

 

Phase 2: Gradual increase in activity at home with “pacing” as soon as possible

  • Start with with various cognitive activities (eg. reading and homework) for 10 minute intervals followed by a rest breaks.  
  • Continue to pace work and build up to 45-60 minutes.
  • Attempt one half day of school.

 

Phase 3: Return to school part time with monitoring and adjustments

  • Some increased symptoms is expected, but should be tolerable (you should be able to return the next day to school and continue).
  • Use  temporary academic adjustments with additional supports (eg. More breaks, relaxed due-dates, shorter day, reduction in homework, changing seat position in classroom)
  • Mandatory extra breaks should be implemented

 

Phase 4: Return to school full time

  • If tolerating one half day of school, gradually increase to full day using pacing (e.g.,  rest breaks) to stay below symptom threshold.
  • Slowly change the academic adjustments back to normal school demands
  • If you are struggling, you should reduce school demands (bring back adjustments) but REMAIN AT SCHOOL in as normal of schedule as possible

 

For some more specific recommendations if you are a university or college student, see this article at AllConcussions.com