It’s becoming frighteningly clear that a concussion is more than a bump on the noggin. In fact, multiple or severe concussions can have lasting cognitive effects, while even minor ones can affect students’ academic progress.
Participation in certain sports can increase the risk of sustaining a concussion. If you’re not sure whether your child should join a team, consider this information to help care for her most vital organ.
Essentially, a concussion is a sudden impact to the head that causes the brain to move rapidly inside the skull, causing both damage to the brain cells and chemical changes within the brain, according to the Centers for Disease Control and Prevention (CDC). While concussions, or minor Traumatic Brain Injuries (mTBIs), affect everyone differently, they are usually accompanied by emotional, physical, and cognitive symptoms. Most common are headaches, nausea, memory loss, inability to focus, and irritability.
The Journal of Athletic Training estimates that 300,000 sports-related brain injuries occur yearly in high school and college students, with football and soccer posing the highest risk. Girls are also much more likely to sustain concussions than boys in the same sport. Although many concussions go unreported, more schools are requiring baseline cognitive testing in order to recognize and report head injuries more accurately.
Grace O’Neil was warming up for the last field hockey game of her senior year at St. Lawrence University when she crashed into a teammate. Upright, but feeling dizzy, she was treated for a torn earlobe and allowed to continue. The following day, she sat for four hours in the library trying to read and couldn’t remember anything on the pages. Since St. Lawrence is one of the schools that mandates baseline testing, the athletic trainer gave her a simple cognitive task and recognized that Grace had sustained a head injury. Immediately, an email was sent to professors explaining that Grace would be unable to attend classes for the following week.
In a word, rest.
There are no current treatments that heal the brain more quickly than simple R&R. Students who have sustained a mTBI can best recover by avoiding screens (computers, phones, and so on), minimizing mental effort, and simply allowing the brain to heal. Straining to keep up with school or stressing over deadlines can delay healing.
A student with a mild concussion should be able to recover fully in one to four weeks, with no lasting symptoms. A second or more severe concussion — or pushing oneself to keep up with schoolwork — could result in a longer recovery. As a doctor permits a student to return to classes, the student should receive accommodations, such as a lessened workload, minimized use of technology, and an emphasis on understanding, not rote memory, of material.
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One of the most overlooked effects of a concussion is the frustration a student feels when she is unable to do the things she used to — and since head trauma makes you much more emotional overall, the stress can seem even greater. Students may feel uncomfortable asking for help with what appear to be simple tasks. Often, what they need is your permission to cut themselves a break. Adult recognition of their trauma is key.
Helping an injured student readjust to school requires, simply, monitoring and prioritizing. Team members — parents, teachers, and healthcare staff — should have regular check-ins with the student to determine what measures of support need to be in place. Adults should choose to prioritize recovery as a student eases back in — today’s homework assignment just isn’t more important than overall cognitive health.
Even if a student is well enough to go back to classes, the lights and noise, screens, or mental strain may preclude her from participating fully. Every student is different, and concussion symptoms may be triggered by anything. A healthcare professional should be leading the team and ultimately deciding when and how a student should return to school.
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Grace was out of classes for a week, checking in with a trainer daily. Following that, she attended class discussions without completing the written work. It was another two weeks before her focus returned to normal. Now a science teacher and a coach in Vermont, Grace feels better equipped to help students who have suffered mTBIs, both on and off the field.
As a coach, she was required to take a course on concussions, offered free through the National Federation of State High School Associations, but her personal experience allowed her to adapt instruction for a student with a severe concussion — a gymnast. “Having had a concussion, I knew what worked for me as a student, and I tried to make my classes like that: discussion-based, group work, visual on the board — not necessarily videos.”
While calculus and physics were too mentally draining for “Maria,” her student, to attend, and the reading for English class made her head spin, she was able to attend Grace’s class with accommodations like dimmed lights and help with note-taking. Teachers kept in weekly contact with Maria’s parents and school nurses to ensure they were all on the same page with respect to her progress, ongoing symptoms, and supports. Because her injury was so severe, the team decided that Maria qualified as having a disability, and a 504 plan and part-time attendance would be necessary. Unfortunately, Maria returned to gymnastics too quickly and suffered a second concussion. This injury took her out of school for the rest of the semester.
There is very little research regarding the long-term effects of concussions. There is some indication that having had a concussion can increase the risk of depression, memory, and behavior problems, according to a book published by the Committee on Sports-Related Concussions in Youth. It is clear, however, that the severity of symptoms and the chances of long-term effects increase dramatically with each subsequent mTBI, as much as 39 percent, according to Head Case.
Academic consequences vary from student to student, ranging from missing class (as with Grace) to missing most of the school year (as with Grace’s student Maria). While most teachers who understand the severity of head trauma are understanding, an inability to complete coursework may delay or complicate earning necessary credits for graduation or applying to colleges. “Maria had applied to Harvard,” Grace explained, “but then she had her concussion.” Maria had to accept incompletes for several of her classes, requiring her to retake them.
There are so many benefits to joining an athletic team — self-esteem, friends, exercise. There’s even research, noted in the <a href=”https://www.nytimes.com/roomfordebate/2014/10/21/taking-sports-out-of-school-2/high-school-athletes-gain-lifetime-benefits), that suggests high school athletes eventually get better jobs with better pay. That said, you only get one brain. Consider signing your child up for a lower-impact sport (stats available through New York Times” target=”_blank”>HeadCase and be on the lookout for signs of injury. If a young person does suffer a concussion, give her plenty of time to rest and recover fully (while consulting frequently with healthcare professionals) before allowing her to participate in school or sports again.
Davies, S., Gioia, G., Gordon, W., Halstead, M., McAvoy, K., Rossen, E. Heads up to Schools: Know Your Concussion ABCs. Centers for Disease Control and Prevention. Retrieved from CDC.
Driscoll, S. (2015) Mayo Clinic. Retrieved from Mayo Clinic
Gessel, L. M., Fields, S. K., Collins, C. L., Dick, R. W., Comstock, R. D. (2007). Concussions Among United States High School and Collegiate Athletes. Journal of Athletic Training. Retrieved from the National Center for Biotechnology Information.
McAvoy, K. (2012). Return to Learning: Going Back to School Following a Concussion. NASP Communiqué. Retrieved from the National Association of School Psychologists.
(2014) Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. National Academies Press. Retrieved from The National Center for Biotechnology Information.