Preparing to Return to School
Key Points:
- You do not need to be 100% symptom-free to return to school.
- You do not need a doctor's note to return to school.
- Notify your school team about your concussion before you return to school.
- Concussion symptoms can make it hard to be in the school environment and learn.
- Academic accommodations can help you be in school while recovering from your concussion.
- Accommodations for concussion are temporary and will fade out as you recover.
- Your medical team will let you know when you are ready to return to an adapted PE program. Avoid any activity that has a risk of hitting your head or falling down.
Is it safe to go back to school with a concussion?
The good news is you do not need to be 100% symptom free to return to school. You will likely take a couple days off from school initially, but after that, you are encouraged to return to school. For some teens starting with a small amount of time (eg. one class or one hour) and building gradually from that starting point can be helpful. Missing school for too long (mor than a week) is not recommended and can slow your recovery.
Learning to manage and tolerate your symptoms at school is your first step.
Your school team will be a great source of support for helping you return to school, by creating a plan to address your school schedule and workload, as you recover from your concussion and get back to your life.
The Adolescent Brain Is Under Construction
See Concussion and the Adolescent Brain for more details.
"Why am I finding school so difficult after my concussion?"
Concussion symptoms may make it difficult for you to be in the school environment and engage in learning for a while.
Learning takes energy. You spend most of your day engaged in cognitive activities that you might think are simple, but actually use a lot of “brain energy”, such as:
- reading
- attending class
- navigating hallways
- focusing/paying attention
- completing homework
These activities can make you feel even more tired, while your brain is recovering from the concussion.
The recovery process involves managing your activities, including school, to avoid making your symptoms significantly worse. Remember, it is okay to feel symptoms, and it is common and safe if your symptoms get a little bit worse when you do your activities while recovering from concussion.
The key is finding a balance between doing too much and too little.
Before you go back to school…
Most students with concussions can begin a gradual return to school after a couple of days of rest. This will depend on how you’re feeling and what your doctor recommends. This is the time to:
- Notify your school that a concussion has happened (ask your caregiver(s) to communicate with your school about your injury).
- If helpful, provide your school team with a medical note from your doctor, confirming that a concussion has occurred so that your initial absences can be excused due to medical reasons (your doctor’s note will also start the Return to School Plan📝A plan created by your child's school team, to allow for their safe and successful reintegration back into school following concussion.ning Process). Remember, a doctor's note is not required to "clear" or give you permission to return to school. You only need a doctor's note to medically clear you to return to full contact sports or activities that have a risk of falling or being hit on the head.
Here’s a sample Medical Assessment Letter [PDF] your doctor may use.
One of the most common problems during recovery is returning to full activities too soon, including school.
Return to school should be a gradual process, based on your symptoms. If you are still experiencing symptoms when you return to school, your school can provide you with temporary academic accommodations.
Click to download this accommodations list [PDF].
Academic accommodations are meant to reduce school demands, which helps with pacing and recovery. Accommodations will make it easier for you to be in school, and manage your learning while you recover.
Accommodations will be provided temporarily, and will fade out as your symptoms improve.
As you are able to tolerate more, your school demands will be increased gradually, by increasing either of the following (one at a time):
- The amount of work
- The length of time spent on the work or,
- The type or difficulty of work
See the next section for a detailed explanation of the 6 stages of “Return to School Protocol”.
During the early stages of your concussion recovery, it is likely you will be temporarily exempt from PE class.
You do not need to be 100% symptom free to return to an adapted PE program when your medical team thinks you are ready.
Certain aspects of PE should be avoided until your doctor says it is safe to re- engage. This includes activities such as:
- Weight lifting
- Contact sports
- Multi-player drills
- Fitness tests
- Gymnastics
In general, returning to regular exercise can be very helpful with your concussion recovery. Consider the following activities as alternatives to your PE class:
- Exercises prescribed by your physiotherapist
- Go for a short walk outside
- Complete individual drills (eg. shooting a basketball)
- Stretching/Yoga
Remember that these guidelines will apply to recess/lunch activities, including intramural sports.
Refer to Return to Physical Activity and Sports for more information.
Additional resources:
- Download this document [PDF] which can be used to notify school of concussion and resulting physical restrictions.
- Here’s CATT online for athletes and coaches [PDF].