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A concussion is a type of mild traumatic brain injury (TBI) caused by a forceful blow or jolt to the head that temporarily disrupts how the brain normally works. Usually the signs and symptoms are immediate.
As it relates to concussions in kids, keep in mind:
A TBI occurs when an external force causes injury to the brain.
The majority of TBIs are mild injuries or concussions and generally result in only temporary problems. Severe brain injuries often require extended hospitalization and frequently include damage to the brain.
Concussion symptoms vary from kid to kid. For most children these symptoms will be temporary.
Physical concussion symptoms:
Cognitive concussion symptoms:
Behavioral/Emotional concussion symptoms:
The following could indicate a child suffered a more severe brain injury than a concussion and needs immediate medical attention:
If you notice any of these behaviors, call 911 or go to the nearest emergency room.
Most young people recover completely from a concussion, and it can take a couple of days to weeks. Problems can last longer, but this is rare. Persistent problems can be related to the severity of the injury and to non-injury factors like stress.
With the involvement of a healthcare provider, along with appropriate monitoring at school, the concussed student may return to school even with some symptoms. Severe symptoms require additional medical follow-up. Keeping a child out of school for a long time often causes unintended academic, social and emotional problems.
In the first few days of recovering from a concussion, it may be helpful to reduce stimulation to help manage symptoms. However, watching TV or texting won't affect recovery. In fact, too much rest often does more harm than good.
In the vast majority of cases, students do not need special education services after a concussion. Short-term, informal adjustments for academic support are usually enough.
A Concussion Comeback Plan is a great way to make those adjustments while also allowing kids to return to normal activities following a concussion.
Create a Concussion Comeback Plan to help your student transition successfully back to school. Every student and concussion are different, so these steps serve as general guidelines. Each student will need a concussion recovery plan tailored to his or her specific needs and circumstances.
Know the basics.
FACT: After the first few days, it's important to return to normal daily routines like going to school. If a student is well enough to participate in leisure activities and socialize, then he or she should be well enough to attend school.
Your student's comeback coordinator could be a school nurse, counselor, psychologist, special educator or classroom teacher — someone at school who takes the lead in communicating and partnering with the student, family, school staff, athletic personnel and healthcare providers.
A comeback coordinator:
The educational team is important in providing a "soft landing" when returning to school after a concussion. For students who could benefit from a gradual transition, returning for an hour or two at first may be worthwhile before building up to half days, then full days. The educational team should remain flexible with the student’s schedule and workload expectations while the student is recovering.
The student may also need a variety of school-based supports. These are typically informal and temporary, and can include:
All involved school staff should carefully monitor the student for potential difficulties in the weeks following a concussion. The comeback coordinator should take responsibility for regularly checking in with classroom teachers and other relevant staff until symptoms have resolved. If any problems are apparent, the comeback coordinator should notify the parents and healthcare team.
In general, school personnel should look for:
It's rare to see serious complications after a concussion. If they do occur, they're generally apparent within the first few hours or days after the initial injury. However, there are some situations in which you may need to consult with outside healthcare professionals or brain injury specialists:
Which specialist to consult will depend upon the nature of the problem and the services available. Ongoing physical problems like headaches or dizziness warrant involvement from a qualified concussion expert. Lasting or severe cognitive or emotional problems warrant involvement from a neuropsychologist.
A minority of students may display persistent problems after a concussion that could interfere with school performance. A concussion specialist who has expertise in cognition and behavior, such as a neuropsychologist, should evaluate these students to better understand why they are not recovering as expected. Complicating factors such as underlying emotional, social, learning or attention challenges often play a role. These students may require formal accommodations at school, such as those implemented through a 504 Plan.
A Section 504 Plan is part of the civil rights law that prohibits discrimination against individuals with disabilities. Section 504 formalizes accommodations and modifications to ensure students with disabilities have equal access to a free and appropriate education. A 504 Plan is different than an Individualized Education Program (IEP), a more extensive special education program. IEP and 504 Plans are rarely needed for children recovering from a concussion.
In the rare cases of prolonged post-concussion symptoms, a 504 Plan might be helpful. Prior to implementing a 504 Plan, the student should undergo evaluation by a specialist to understand whether concussion or non-injury factors best explain lingering problems.
To schedule an appointment with the Concussion Program at Children's Hospital Colorado, call 720-777-2806.