Getting children back to school sooner after a concussion can mean faster recovery

Contrary to popular belief, rest may not always be the best treatment after a concussion, according to a new study published in the journal JAMA Network is open Find. In fact, an earlier return to school may be associated with a lower burden of symptoms after a concussion and, ultimately, a faster recovery.

“We know that missing school can be harmful to young people in many ways and for many reasons,” says Christopher Vaughan, a neuropsychologist at Children’s National Hospital and lead author of the study. “The results of this study found that, overall, an earlier return to school after a concussion was associated with better outcomes. This helps us feel reassured that returning to some normal activities after a concussion — such as going to school — is ultimately beneficial.”

In this cohort study, data were collected from more than 1,600 young adults between the ages of 5 and 18 across nine pediatric emergency departments in Canada. Due to the large sample size, several factors associated with a greater burden of symptoms and prolonged recovery were first taken into account by the complex statistical approach used to examine the data. The authors found that earlier return to school was associated with lower symptom burden 14 days after infection in the 8- to 12- and 13- to 18-year age groups.

“Clinicians can now confidently inform families that at least some school absence after a concussion is common, often between two and five days as older children miss more school,” says Dr. Vaughan. “But the earlier a child can return to school with good symptom management strategies and with appropriate academic support, the better we think their recovery will be.”

The findings suggest that there could be a therapeutically beneficial mechanism for early return to school. This may be due to:

  • Socializing (or avoiding the harmful effects of isolation).
  • Reduce the stress of not missing so much school.
  • Maintain or return to a normal sleep/wake schedule.
  • Return to light to moderate physical activity sooner (also consistent with previous literature).

Children’s National has long been a leader in clinical services and research for young people with concussions, particularly through its Safe Concussion Outcome Recovery and Education (SCORE) program. Given the many other factors that can be expected to influence when a child returns to school after a concussion—including the severity of the injury, specific symptoms, and pre-injury factors—a large sample size and a complex statistical analytical approach were required. Future randomized clinical trials and other research could help determine the best timing for a student to return to school after a concussion.


National Children’s Hospital

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