Table 2

Graduated return-to-school strategy

Stage Aim Activity Goal of each step
1Daily activities at home that do not give the child symptomsTypical activities of the child during the day as long as they do not increase symptoms (eg, reading, texting, screen time). Start with 5–15 min at a time and gradually build upGradual return to typical activities
2School activitiesHomework, reading or other cognitive activities outside of the classroomIncrease tolerance to cognitive work
3Return to school part-timeGradual introduction of schoolwork. May need to start with a partial school day or with increased breaks during the dayIncrease academic activities
4Return to school full timeGradually progress school activities until a full day can be toleratedReturn to full academic activities and catch up on missed work