Kids who had a concussion may need to stay home from school

When student athletes get a concussion, they are held off the playing field until they are deemed healthy enough to return. Now, the American Academy of Pediatrics (AAP) is recommending that they should also be held out of the classroom.

"Students appear physically normal after a concussion, so it may be difficult for teachers and administrators to understand the extent of the child's injuries and recognize the potential need for academic adjustments," lead author Dr. Mark Halstead, an assistant professor in the division of orthopedic surgery in non-operative sports medicine at Washington University of Medicine in St. Louis, said in a press release.

"But we know that children who've had a concussion may have trouble learning new material and remembering what they've learned, and returning to academics may worsen concussion symptoms."

The authors reported that a typical school-aged student will recover from a concussion within three weeks.

However, if the symptoms are severe, some students may need to stay home to recuperate. Parents might want to consider alternative academic arrangements if the symptoms are severe or last longer than three weeks.

If the symptoms are mild or tolerable, the student can return to school, but they may need some additional changes to their academic course load until they are back to normal.

Students should be back to their regular academic performance before they are allowed to return to their sports.

Previous studies have shown that in kids, the brain changes caused by concussions can last for months. A recent Journal of Neuroscience study showed children who suffered concussions had different white matter structures (a portion of the central nervous system that facilitates signal transmission in the brain) compared to healthy kids, and they also scored worse on cognitive tests.

Research in the Archives of Pediatrics and Adolescent Medicine showed that even children with mild concussions may have attention and memory problems up to a year after their injury.

The AAP recommended in March that if a doctor is unclear about the severity of a child's concussion, they should be kept off the field. Previous advice graded the severity of the concussion, and then made suggestions as to how long the player should be kept out of the game based on the severity of the head injury.

The AAP also recommended in the new report that there be a collaborative team to help a student who has a concussion. This includes the child's or adolescent's pediatrician, family members, and staff at the child's school who handle the student's academic and physical schedule.

"Every concussion is unique and symptoms will vary from student to student, so managing a student's return to the classroom will require an individualized approach," Halstead said. "The goal is to minimize disruptions to the student's life and return the student to school as soon as possible, and as symptoms improve, to increase the student's social, mental and physical activities."

The information was published online on Oct. 27 in Pediatrics.