Table 4

Return to learn

Facilitate communication and transition back to school.

  • Notify school personnel after injury to prepare for return to school.

    • Obtain consent for communication between medical and school teams.

  • Designate point person to monitor the student’s status related to academics, recovery and coping with injury, and communicate with medical team.

    • School health professional, guidance counsellor, administrator, athletic trainer.

  • Develop plan for missed assignments and exams.

  • Adjust schedule to accommodate reduced or modified attendance if needed.

Classroom adjustments

  • Breaks as needed during school day.

  • Reduce inclass assignments and homework.

  • Allow increased time for completion of assignments and testing.

  • Delay exams until student is adequately prepared and symptoms do not interfere with testing.

  • Allow testing in a separate, distraction-free environment.

  • Modify due dates or requirements for major projects.

  • Provide preprinted notes or allow peer notetaker.

  • Avoid high-risk or strenuous physical activity.

School environment adjustments

  • Allow use of headphones/ear plugs to reduce noise sensitivity.

  • Allow use of sunglasses/hat to reduce light sensitivity.

  • Limit use of electronic screens or adjust screen settings, including font size, as needed.

  • Allow student to leave class early to avoid crowded hallways.

  • Avoid busy, crowded or noisy environments—music room, hallways, lunch room, vocational classes, assemblies.

  • Clinicians should individualise adjustments based on patient-specific symptoms, symptom severity, academic demands, as well as pre-existing conditions, such as mood disorder, learning disability or attention deficit/hyperactivity disorder.87 88

  • Athletes with complicated or prolonged recovery may require a multidisciplinary team with specific expertise across the scope of concussion management.