Understanding the Process for Returning to School
Key Points:
- Sometimes concussions impact learning.
- For some, the process for returning to school may need to be gradual and supported.
- Your plan for returning to school can be flexible, and adjust to your changing needs.
- How quickly you progress through these 4 steps will vary from person to person - all concussions are different. Many people may be able to go back to most school activities a few days after their concussion.
- Return to school and return to activity/exercise should happen at the same time. It is recommended that a student fully return to all school activities before they return to full-contact sports
- You do not need to be 100% symptom free to return to school.
What is the process for returning to school?
One of the most common problems during recovery is returning to full activities, like school, too quickly.
After sustaining a concussion, it is recommended that you follow a 4 step process for returning to school. The time it takes you to go through the 4 step process will depend on how you’re feeling and what you’re able to do.
The goal is to have you return to your normal activities as soon as possible and with little disruption.
NOTE: This tool is a guideline for managing the return to school process following a concussion. Every concussion is unique, and recovery is very different for each individual. Not everyone will require a Return to School Strategy, and timelines and activities may vary for each individual.
Return to School Process
It is reasonable to miss a couple days of school following your concussion, to rest at home.
During Step 1, you will be at home and resting from strenuous physical activities, and cognitive activities that require a lot of thinking, concentration, and problem solving. This step usually does not last longer than 24-48 hours.
During this time, it is okay to participate in gentle daily activities such as:
- Spending time at home with family and/or socializing with friends.
- Listening to calm music, and/or engaging in relaxing hobbies.
- Preparing meals.
- Taking light walks around the block and/or spending time relaxing outside.
Remember to take regular breaks if you find any activities make your symptoms worse.*
Ask your caregiver(s) to notify your school of your concussion and reasons for your 2-day absence.
See How Brain Rest Works for Concussion Recovery [PDF].
NOTE: Resting longer than 24-48 hours after your concussion is not advised, and missing more than 1 week of school is not generally recommended.
*Mild exacerbation (worsening) of symptoms is okay. Mild exacerbation is defined as up to a 2-point increase in symptom severity when compared with the pre-activity value of that symptom on a 0-10 point scale.
You are encouraged to return to school as soon as possible, and as tolerated. Avoid being absent, even if you are only able to attend school for a short period of time. Based on your tolerance, you may return for social exposure to start, or even for a partial day, but you should not be restricting your return unnecessarily.
During Step 2, you are participating in cognitive activities at home, with the goal of gradually building up your tolerance for cognitive work at school. It will also be important to connect socially with peers.
During this time, you are encouraged to try the following:
- Reading, and participating in other cognitive activities.
- Taking breaks and adapting activities if your concussion symptoms worsen.*
- Monitoring how you feel throughout the day, including how you tolerate the physical environment such as noise and lights, and what types of activities may provoke which symptoms.
- Gradually resuming use of devices with screens, as tolerated.
- Attending classes at school, and listening and following along with the lesson.
- Paying attention to how long you can be in class before needing a "brain break".
If you are not able to go back to one of your regular classes - perhaps it’s too noisy or bright - you can ask about other options such as returning to a quieter room first, like the Learning/Resource Classroom.
If you are not feeling better and have been off school for a few weeks, talk to your doctor or health care provider. Your doctor may refer you to other health care providers to help manage your symptoms and get back to your normal activities.
NOTE: You do not need medical clearance from your doctor to return to school but you do need clearance to return to PE, sports teams, or other high-risk activities.
Before returning to school, ask your caregiver(s) to notify your school team that you are ready to return, so a plan can be created to address:
- How long you will be in school
- Which subject(s) you will return to first
- What types of support and accommodations you might need
*Mild exacerbation (worsening) of symptoms is okay. Mild exacerbation is defined as up to a 2-point increase in symptom severity when compared with the pre-activity value of that symptom on a 0-10 point scale.
During Step 3, you are back to school part-time or full-time, and you are gradually increasing class attendance and participation.
During this time, you are re-engaging in more demanding cognitive activities, such as school work. You are increasing your time at school and attending classes.
During this step, you may require temporary learning accommodations including:
- Extra time to complete school work and tests.
- Reduced workload.
- Access to an alternate, quiet setting (as needed).
- Self-initiated rest breaks throughout the school day.
A more comprehensive list may be found here: learning accommodations [PDF].
As you tolerate more in the school environment, your learning accommodations and supports will be adjusted and will gradually fade out.
NOTE: Returning to school after concussion is not a linear process - you will likely have some good days and some bad days. This is a normal part of recovery. Please talk to your caregiver(s) and/or point person at school if you need help, especially if you feel worried about falling behind or if you feel you are doing too much.
During Step 4, you are back to school full time and participating in all previous academic activities without requiring concussion-related accommodations.
This includes:
- Attending full days of school, consistently throughout the week.
- Attending all your classes.
- Participating in all your tests, school work, and homework expectations.
- No longer accessing any academic accommodations beyond ones you may have had before you got your concussion.
NOTE: During this stage, your doctor may be able to provide you with written medical clearance [PDF] for returning to all physical activities, including full PE programming.
For more information on this, see Return to physical activity.