Children should get a brief period of near full mental rest after sustaining a concussion, followed by a gradual return to normal levels of activity as symptoms diminish. The following steps can help ensure that period of full mental rest is achieved.

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    Put down the books. Schoolwork should be paused during the initial recovery period. Cognitive activities that require high levels of concentration—such as studying for a test or doing homework—can cause symptoms to worsen and prolong recovery. Even recreational reading can keep the brain from getting adequate rest.

    As symptoms improve, schoolwork can be reintroduced gradually.

    Turn off the screens. Children should limit the use of TVs, cell phones, tablets, and computer screens during recovery. Like schoolwork, instant messaging, texting, video games and other screen use require mental concentration. Screens also introduce lights and motion, which may also slow down recovery or aggravate symptoms.

    Stay out of the game. A child recovering from concussion is advised to take a break from athletics. Concussion patients who return to sports and other physical activities too soon run the risk of reinjuring or further harming themselves:

    • Slower reaction times and poor concentration increase the risk of sustaining another injury.
    • Sustaining a second brain injury before the first injury is healed may put the child at risk for a potentially rare and deadly condition known as SIS, or second impact syndrome.5
    • Physical exertion before recovery may worsen symptoms.6,7

    Children and teens should also not participate in recreational activities that require quick decision-making or may put them at risk for a second injury, such as driving, bike riding, or going on carnival rides.

    Rest, rest, rest. A child recovering from concussion should have a regular sleep routine. Late nights, sleepovers, and overnight outings should be avoided. Parents should encourage earlier bedtimes and good sleep hygiene (avoiding caffeine and snacks close to bedtime, keeping the bedroom dark, and having a regular bedtime routine).

    Similar to academics and employment, socializing requires brain activity. Kids may need to trade group activities for quieter activities. For example, parents may encourage short one-on-one visits from friends if children feel like being social.

As symptoms improve, more cognitive (and physical) activity can be introduced.

References:

  1. Mayo Clinic Staff. Concussion: Complications. Mayo Clinic. Apr. 02, 2014. Available at http://www.mayoclinic.org/diseases-conditions/concussion/basics/complica.... Accessed October 2014.
  2. Concussion: Determining when the brain has recovered. Mayo Clinic. Available at http://www.mayoclinic.org/medical-professionals/clinical-updates/neurosc.... Accessed October 2014.
  3. Sady MD, Vaughan CG, Gioia GA. School and the concussed youth: recommendations for concussion education and management. Phys Med Rehabil Clin N Am. 2011;22(4):701-19, ix.
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