What to expect after concussion

Flexibility is key. Every student’s concussion is unique.

After concussion, the most significant problem for the student tends to be a decrease in mental energy or cognitive stamina, like a battery that runs down much quicker than before. The student’s energy level will also be more variable due to the injury, so what is manageable one day is not necessarily manageable the next. Importantly, it is usually not one specific subject or activity that causes fatigue, but the combined demands over the course of the day or week.

To start, review and follow the letters you receive from the medical team to understand the specifics of the student’s deficits. Then, consider the accommodations and tips listed below to help with the recovery process for students with concussion.

Accommodations for students with concussion

When concussion symptoms start to get worse, it usually means the student has reached the point of over-exertion and needs a break. When a student appears to be struggling with their symptoms, the best solution is to take a short break as needed.

Please remember every student’s concussion is unique and will likely require some but not all of these special considerations.

Tips for class work for students with concussion 

• Reduce workload to a level that is manageable for the student, including reduced homework and if necessary, a reduced course load
• Allow the student to work to just beyond the threshold of provoking symptoms and then rest in a quiet area, recover and then return to class
• Make sure the student does not carry a double workload of new and make-up work; allow sufficient time to make up missed work
• Allow extended time on tests and assignments to allow for slower processing speed
• Provide a copy of the class notes so the student does not have to multitask during a class and can focus on listening to the teacher

Other academic accommodations that may be useful for students with concussion 

• Providing a quiet room for testing to minimize distractions
• Offering preferential seating in the classroom to minimize distraction and allow better monitoring of attention and energy level
• Breaking information and assignments down into manageable chunks
• Helping the student stay organized in keeping track of homework and assignments

Tips to address special needs and deficits caused by concussion

Children with concussion may have temporary or longer-term deficits that can make the school environment and schoolwork extra challenging. The following tips can help teachers address the special needs and deficits caused by concussion.

Attention and concentration problems

• Use short and specific instructions and assignments, and be sure they get written in the student’s planner or assignment book
• Be alert to when the student’s attention drifts and use visual and verbal cues to redirect the student's attention without appearing to single them out in class
• Allow breaks if the student is having difficulty sustaining attention
• Use color coding and underlining to focus attention on important points
• Remove unnecessary distractions in the classroom (limit items on desk, etc.)
• Facilitate transitions from one topic or task to the next

Comprehension and memory problems

• Provide an overview or outline of material to be learned
• Use a tape recorder to record lessons, or provide teacher-generated notes
• Reinforce lessons with visual images
• Encourage the student to restate information in their own words
• Teach the student to use mnemonic devices, rehearsal, repetition, association, chunking and mental visual images to help memorize material
• Help the student relate new information to what he already knows
• Use multiple-choice and open-book tests to minimize the need for demand on memory, or allow student to prepare notes to use during the test
• Provide a word bank to help with recall

Executive function problems

• Assist in planning and sequencing events
• Use diagrams, timelines and charts to organize information and activities
• Encourage use of organizational strategies such as lists, journals, assignment sheets or planners
• Encourage goal-setting and self-monitoring of progress toward goals
• Provide feedback more frequently

Visual and auditory processing information

• Provide copies of notes prior to class to reduce demands on visual tracking (moving back and forth between blackboard and note paper) and auditory processing
• Check the student’s comprehension of directions or test questions
• Encourage strategies to improve visual tracking, such as using a ruler

Behavior, emotional or social problems

• Don’t put the student on the spot by asking them to present in front of the class or asking them to answer a question when they have not raised their hand
• When the student is frustrated or over-stimulated allow the student to leave the classroom and go to a prearranged location where they can rest quietly
• Encourage the student to seek help when needed
• Monitor the student’s peer relations
• Prepare the student for changes and transitions, such as by helping to set expectations or rehearsing new routes and procedures