ConCussion FaCts For sChool ProFessionals

This fact sheet is for educators of a child or teenager who has recently had a concussion. It will tell you what to expect in the first days and weeks after the concussion and will offer suggestions for helping your student through the recovery process.

What is a concussion?other terms for concussion include

“head injury” and “mild traumatic brain injury”. a concussion usually is caused

by a sudden blow or jolt to the head

that disrupts normal brain functioning.

Common causes of a concussion are

car or atV crashes, falls from bikes and

skateboards, and accidents while playing

sports. after a concussion, less than 10%

of children lose consciousness or are

“knocked out” for a short time. a child

can have a concussion without losing

consciousness and even what seems

to be a mild bump to the head can be

serious. Most children don’t feel well for

a while after a concussion but recover

quickly on their own. however, every

child is different and some children take

longer to get better than others. Proper

response to a concussion can prevent

further injury and help with recovery.

What are the common signs and symptoms of a concussion?Common changes after a concussion fall

into 3 categories:

Physical • headaches

• Fatigue, trouble staying awake in class

• lack of energy

• seeming sluggish and slow-moving

• Blurry or double vision

• nausea

• sensitivity to noise or light

• Feeling dizzy or light-headed

• not “feeling right”

Cognitive

• Becoming easily confused

• slowness in thinking

• seeming “foggy” or “zoned out”

• Difficulty paying attention

• Forgetfulness, memory problems

• More difficulty at school than normal

Emotional and Behavioral• Becoming easily annoyed or angry,

seeming cranky and irritable

• seeming emotional, crying more easily

than usual

• seeming worried or nervous

• Personality changes

Medical guidelines recommend that students NOT participate in sports, PE or recess while experiencing any physical, thinking, emotional or behavioral symptoms of a concussion and until cleared to return to normal activity by a trained professional.

How do I know if my student should be referred to a medical specialist?serious complications after a concussion

usually occur within the first few days

after an injury and are rare. Seek IMMEDIATE medical attention if your student:• loses consciousness

• is drowsy and cannot be awakened

• Becomes increasingly confused or

agitated

• Vomits repeatedly

• has convulsions or seizures

• Complains of a severe or progressively

worsening headache that does not go

away

• experiences weakness, numbness,

decreased coordination, or trouble

walking

• has slurred speech or trouble talking

• exhibits any other sudden change in

thinking or behavior

school personnel must involve a

healthcare professional if the student has

persisting problems that last more than

two weeks, are not improving, and are

interfering with school performance. if

the problems are physical (for example,

headaches, dizziness), a referral to a

medical doctor or nurse practitioner

is appropriate. For a student who is

experiencing persisting or significant

cognitive, academic, behavioral or

emotional changes, a referral to a

pediatric neuropsychologist or sports medicine physician can be helpful. they

can formally evaluate the student and

offer treatment and school planning

recommendations.

When can student athletes return to playing sports after a concussion?Missouri law includes the Interscholastic Youth Sports Brain Injury Prevention Act. this legislation mandates that an

athlete who appears to have sustained

a concussion must immediately be

removed from play or practice for at least 24 hours. the athlete must be

examined by a licensed health care

provider trained in the evaluation and

1For more information call 314.454.KIDS or 800.678.KIDS

Concussion Facts School Professionals.indd 1 2/22/12 11:31 AM

management of concussions and must

receive written clearance to return to

play or practice from that provider.

Concussion information and education

for coaches, school personnel, athletes

and parents is available from the Brain

injury association of Missouri at www.

biamo.org or 800.444.6443.

What can school personnel do to help?1) Designate a school liaison

supporting a student recovering from

a concussion requires a collaborative

approach among school professionals,

parents and healthcare providers. a

school liaison should be selected to

coordinate communication. the school

liaison could be the school nurse,

classroom teacher, special education

teacher, guidance counselor, principal

or other school professional. the role

of the school liaison should be to:

• obtain information.

• Discuss the nature of the student’s

injury, current status, and expected

recovery course with the student’s

parents.

• Find out when the student will be

allowed to return to school and what

initial supports will be needed within

the school environment.

• Find out when the student will be

allowed to return to sports, Pe, and

recess/playground activities.

• Document relevant information in the

student’s school record.

• Deliver obtained information to all

relevant school staff.

• regularly check in with classroom

teachers and other involved school

staff until problems are resolved or,

if no problems are initially seen, for

several weeks after the injury.

• stay in touch with the student’s

parents. share information about how

the student is doing.

2) Monitor the studentsymptoms of a concussion can show

up right after an injury but may not

appear or be noticed until hours or

days after the injury. Most students

will recover completely from a single

concussion within a few weeks. But,

some students take longer to recover

than others. it is most important to

recognize that while a student may

appear normal, their brain function

is significantly hindered after a

concussion. in general, you should

watch for the common concussion

symptoms listed previously, any other

change in functioning within the

school environment, or unexpected

absences.

3) Provide immediate assistance and support • one of the most important ways you

can help is to make sure that your

student and his/her parents have

spoken directly with a healthcare

professional and understand the

nature and implications of the

concussion. Providing students and

parents with appropriate information,

reassurance, and advice has proven

beneficial for optimizing the recovery

process.

• school-based supports might be

needed and often can be instituted

informally. however, if problems are

severe or lasting, formalizing support

through a 504 Plan or ieP may be

warranted and a referral to the special

education team might be necessary.

Possible supports are listed below.

General modifications and accommodations • spend fewer hours at school at first,

return to a full schedule gradually

• allow breaks in the nurse’s office

(for example, at the first sign of a

headache)

• Provide rest breaks throughout the

day

• Postpone classroom or standardized

tests and exams until recovery is

complete

• excuse the student from completing

some/all missed work

• allow extra/extended time to

complete assignments and tests,

offer flexible due dates

• reduce class assignments, avoid

assigning any homework

• Provide extra help or tutoring to get

the student caught up

• Provide preferential seating to allow

for close teacher monitoring and

fewer distractions

• reduce time spent on the computer,

reading, or writing

• Provide complete copies of lecture

notes and overheads

Individualized assistance• Present small amounts of

information (for example, give

directions one step at a time)

• Provide checklists and written

information when tasks involve

multiple steps

• Check often for understanding of

material, provide extra practice and

review as needed

• help the student use an assignment

book, give reminders about missing

assignments

• review mistakes on assignments

and tests

• allow students to redo assignments

and retake tests when grades are

low

References Concussion in Children and teenagers: information about Concussion for school staff (2006), by Michael W. Kirkwood, PhD, Pamela e. Wilson, MD., & Joseph Wathen, MD.

Facts about Concussion and Brain injury (2010). Centers for Disease Control and Prevention: www.cdc.gov/Concussion.

living with Brain injury: a guide for the Family of a Child with a traumatic Brain injury (2007). Brain injury association of america.

slC8649_2/12 2 © Copyright 2012 St. Louis Children’s Hospital.

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