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Back to School After a Concussion

Center on Brain Injury Research and Training
Back to School After a Concussion
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Often students return to school with subtle cognitive, academic, or behavioral needs following concussion. If these are addressed early on it can alleviate long-term difficulties. Here are guidelines for when a student returns to school after a concussion or mild brain injury.

Inform school staff

Learn basic information about concussion/mild brain injury.

Monitor student

Watch for any of the possible red flags associated with concussion/mild brain injury.

Cognitive difficulties compared to pre-injury performance

  • Trouble paying attention
  • Difficulty remaining on task
  • Slowed responses and or processing of information
  • Difficulty shifting attention from task to task
  • Organization challenges
  • Reduced academic performance

Social behavior difficulties compared to pre-injury

  • Impulsive behaviors
  • Initiation difficulties (trouble starting things)
  • Changes in mood
  • Depression
  • Defiance
  • Fatigue
  • Confusion

Physical difficulties

  • Headaches
  • Blurred vision
  • Changes in taste or smell

Provide accommodations

If red flags appear, teachers can provide minimal accommodations on a temporary basis until symptoms subside (usually within 3-4 weeks). Accommodations might include:

  • Reduced assignment load
  • Increased time to complete assignments or exams
  • Use of an organizer to track assignments
  • Rest periods during the day
  • Directions in both oral and written formats
  • Clear expectations
  • Large tasks broken into smaller components

If the student continues to have academic difficulty after a month, the student’s concerns should be further evaluated by a team and the evaluation process for more formalized support such as a 504 plan or IEP begun.

Communicate with the family

Stay in regular communication about changes noticed at school and at home.

Posted on BrainLine June 21, 2010.

This information was adapted from Ylvisaker, M., Traumatic Brain Injury Rehabilitation, 2nd ed. Pages 381-384.

From the Center on Brain Injury Research and Training. Reprinted with permission.

Comments (1)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

Anonymous replied on

Parts of the neurology of cognitive changes due to brain concussions (paying attention vs inattention), etc. are discussed in educational books like Nerves in Collision by Walter C. Alvarez, M.D. and the Hyperactivity book about Inattentive ADHD with introduction by Anita Uhl Brothers, M.D.  Both Alvarez and Brothers mention medicines which, for a few (not everyone), temporarily help aspects of cognition/the ability to pay attention easily.  Meds, for a few only, do work occasionally quite well;  in other cases, meds are not the best answer at all.  Being med-free is the right decision for many.