Concussions and the treatment after one is sustained have been at the forefront of media coverage in recent years. What once was viewed by some as brag-worthy or a badge of honor now is being taken seriously for its potential immediate and long-term effects.
While progress has been made in how the seriousness of a concussion is perceived, it's still relatively unknown when it's acceptable for individuals, including children, to return to normal cognitive and physical activity after suffering one.
According to a study by the Concussion Clinic at Children's Hospitals and Clinics of Minnesota, a child who sustains a concussion during the school year takes significantly more time to recover than one who suffers a similar injury during the summer.
"We were surprised at the magnitude of the differences," Robert Doss, PsyD, co-director of the Pediatric Concussion Program and one of the study's researchers, said. "We weren't surprised that it was in that direction; just simply that the magnitude was what it was."
Researchers took patients seen in the Concussion Clinic at Children's from 2011-12 — 43 children who suffered concussions during the school year and 44 injured in the summer — and monitored their progress. For the children who sustained a concussion in the summer, the average number of days to recover was 35. Recovery time more than doubled (72 days) when the injury was sustained during the school year.
Another study, "Returning to Learning Following a Concussion," published in October in Pediatrics, the official journal of the American Academy of Pediatrics (AAP), explains the difficulties children experience in a school setting after suffering a concussion. Post-concussive symptoms often can linger or increase in severity without proper adjustments to a child's environment or academic routine. Research suggests that academic demands and school environment may be a barrier to recovery.
Because each concussion and child is different, the AAP study recommends creating a multidisciplinary team to facilitate a student's recovery and help him or her return to normal activities. Those four teams are:
- Family (student, parents, guardians, grandparents, peers, teammates and family friends)
- Medical (emergency department, primary care provider, concussion specialist, clinical psychologist, neuropsychologist, team and/or school physician)
- School academic (teacher, school counselor, school psychologist, social worker, school nurse, school administrator, school physician)
- School physical activity (school nurse, athletic trainer, coach, physical education teacher, playground supervisor, school physician).
"It's important to understand the individual child," Doss said. "It seems like our practitioners are noticing more responsiveness by the schools to put forth accommodations for these kids. Some schools are more accommodating than others. Some seem to have a grasp of concussions.