A concussion, whether mild or severe, is a brain injury. Most children recover quickly and fully from a concussion; however, it is important to protect your child’s brain with rest and a gradual, step-by step return to school and play.  Because each child and each injury is different, the time it takes children to return to school and play varies. We recommend the “return to learn” and “return to play” steps below. Some children may take days or weeks to complete each step. Some may complete a step a day. Your child’s provider can help guide the recovery. 

Return to learn

Step 1: Rest the mind

Immediately following the injury, your child should rest their mind (brain and body) as much as possible. This may mean no school or homework and only 15 minutes per hour of TV and computer/video time. Keep in mind that simply watching video and TV can make your child’s symptoms worse. 

Step 2: Light mental effort 

As your child feels better, slowly introduce light mental activities such as watching TV, listening to audio books, drawing or cooking. Stop these activities if your child starts to feel worse (dizzy, headache). At first, your child may only be able to do five to 15 minutes of mental effort at a time. If the symptoms don’t worsen, you can add to the length of the effort. 

Step 3: Schoolwork at home

Slowly add schoolwork to your child’s light mental activity. Start with up to 30 minutes per hour and build from there.  

Step 4: Return to school 

When your child is able to do one or two hours of schoolwork at home for one or two days, they may try a half day of school. If your child is able to do three to four hours of homework, they may try a full day of school. Should your child start to feel worse at school, they should take a break in a quiet area with adult supervision. When symptoms go away, they may return to class. If the symptoms don’t go away, your child should go home. 

Return to play 

Step 1: Rest the body

Your child should rest their body until they feel better and the signs of the injury improve. Your child doesn’t need to stay in bed,but limit them to light walking for up to 20 minutes. Do not let them break a sweat or do any activity that causes the symptoms to return. 

Step 2: Light exercise 

When concussion symptoms subside, your child may engage in exercise such as fast walking and stationary cycling; however, they should stop if the symptoms return. Do not allow weightlifting at this phase.  

Your child shouldn't move to the next step until they can go through a full day of school without feeling any symptoms. 

Step 3: Mild exercise, sport-specific exercise 

Once your child has been able to do light exercise and go to school, they can start doing mild exercise or exercises that are part of their sport; for example, jogging, short periods of running, mild stationary biking, throwing a baseball and kicking a soccer ball. They should avoid any activity where they might get hit in the head. 

Step 4: Harder exercise, no contact 

At this point, your child can take part in more strenuous exercises: sprinting/running, hard stationary biking, weightlifting and drills. But keep it to non-contact activities. 

Step 5: Return to play 

Ask your child’s doctor if they’re ready for play or sports with contact. 

*If your child is still feeling effects of the concussion for more than two weeks, talk with your doctor about seeing a specialist who can address issues with balance, dizziness, thinking and memory.  

Call 911 if your child has any of these signs:  

  • Seizures (twitching or jerking movement of parts of the body; child may look stiff) 
  • Weakness or tingling in the arms or legs 

  • Cannot recognize people or places 

  • Confused, restless or agitated 

  • Impaired consciousness  

  • Hard to stir or to wake up 

  • Repeated throwing up (vomiting) 

  • Slurred speech 

For more information, contact the Legacy Concussion Program at 503-672-6005.

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