A concussion requires time to completely heal. Your doctor may advise you to keep your child at home to rest after a concussion and get medical approval before returning to school. Rest from physical activities and activities that require thinking (cognitive) have been shown to be an effective treatment after a concussion. Your child should not participate in sports or other physical activities, such as gym class, until he or she has stopped experiencing symptoms during regular daily activity, including school work.
Limiting activities that require thinking skills is especially important. Your child’s brain needs to direct energy to healing, and it cannot rest if your child is performing tasks that require thinking. You may want to gradually adjust the amount of time your child spends playing video games, sending texts, using electronics and reading books. For teens, it may also mean no driving. Returning to school or physical activity while the brain is healing may lead to problems with learning later on.
It is important to emphasize to your child that he or she must be honest when reporting symptoms. Your child may feel pressured from coaches or friends to get back to “normal” quickly and return to practice or social events. They may want to “rest later” and push themselves to take that important test or go to that dance or game. However, your role is to enforce rest and reduce brain stimulation — by limiting screen time, visits with friends, etc. — during your child’s recovery.
It may be helpful to spend time explaining changes in your child to his or her siblings, especially if the siblings are younger. Depending on the age of your children, you may need to set new rules about horseplay or wrestling, remind them to be quiet during periods of rest, and ask them to be generally more patient with their brother or sister during the recovery process. You can tell them to remember that the problems are short-term, and their sibling is going to get better.
Every child’s injury and recovery time is unique, but with guidance from your doctor and help from other health care team members, such as the school nurse or school psychologist, your child can safely return to school after a concussion.
Prevent another concussion
If your child is still recovering, a second concussion may hinder recovery or cause some problems to linger or become permanent. These tips can help prevent your child from having another concussion:
- Don’t rush. Recovering from a concussion takes time. It’s important to ensure that your child fully recovers before participating in activities that may lead to a second concussion.
- Be a good role model. Communicate positive safety messages and model safe behavior: Wear a helmet and a seat belt, and follow safety rules. Although helmets do not prevent concussions, they do prevent skull fractures.
- Educate others. Use this first concussion as an opportunity to educate your child’s teachers, coaches and caregivers. The more they know, the more they will be able to help your child recover and avoid a second concussion. Talk to them about safety measures, as well as associated signs and symptoms of a concussion.
When your child returns to sports and recreation
- Gear up. Make sure they use the right protective gear (such as helmets, protective eye wear, etc.). Be sure that protective equipment is in good condition and worn correctly. Go to nhtsa.gov/bicycles for a step-by-step guide on how to fit a bicycle helmet.
- Practice makes perfect. Teach your child to practice safety skills and proper form. For example, knowing how to tackle safely is important in preventing injuries in football. Proper form may prevent injuries in baseball, softball and other activities.
How do I know if I am doing the right things?
There are several steps you can take to help your child:
- Monitor symptoms. One of the most important things that you can do is keep track of changes in your child. Are symptoms getting better or worse? Has there been no change at all? Using a symptom log, like the one at the end of the last section, can help you determine if your child is improving.
- Ensure rest. Make sure your child is getting plenty of sleep at night and rest breaks during the day. Stick to a regular sleep schedule and limit phone and computer time if they worsen symptoms.
- Promote independence. Help your child learn to take care of his or her own daily routine in age-appropriate ways, such as brushing teeth for younger children. Be sure to pay attention to slight signs of confusion, irritability or frustration during these tasks. If your child has trouble, try breaking activities into steps.
- Allow visits with friends, with limits. After a concussion, your child may need to be absent from school and other activities, which may cause him or her to feel isolated. You want to encourage interaction with friends, but ensure that the visits are short and do not trigger symptoms. (A phone call with one friend might be all that your child can handle.) Suggest something that is not a physical activity, such as watching a short movie or sharing a meal.
- Manage stressors. Deployments and other military-related duties that decrease the amount of time that a parent can be with the family can be stressful for everyone.
- Help manage feelings of stress by making sure you and your spouse agree on the approach to your child’s recovery. Take advantage of military support organizations or participate in stress-relieving activities. MilitaryOneSource.mil provides specific information about coping with the challenges of military life. The Military Kids ConnectTM website is a good resource for children to share their feelings with other military children.
- If you have other children, let them tell you how they feel about their sibling’s injury. Involve them in the recovery process by giving them ideas for how they could help.
- Consider parenting strategies. In addition to the injury, your child might be struggling with other issues, such as adjusting to a new school after a recent move. Focus on providing emotional support through a patient and nurturing home environment. Below are some steps you can take to help accomplish this:
- Be reasonable with your expectations, but continue to empower your child to accept responsibility for his or her actions.
- Be open and honest about what your child can and cannot do.
- Establish boundaries for your child’s behavior based on his or her age. For example, a teenager may respond to creating a written list of expectations. A young child may respond to a behavior chart that spells out the positive behavior and provides a visual reward (happy face) every time the child repeats that behavior.
- See a counselor who can give you feedback on what you or your child might need right now, especially if your child seems to be having behavioral issues. You can go to the school (or district) psychologist, who can meet with your child, if necessary.
Excerpted from "A Parent's Guide to Returning Your Child to School After a Concussion," produced by the Defense and Veterans Brain Injury Center.
Click here to see the full guide.