JOHN DOHERTY: Returning from concussion is a learning process

2013-10-28T21:00:00Z 2013-12-12T22:09:09Z JOHN DOHERTY: Returning from concussion is a learning processJohn Doherty Times Columnist
October 28, 2013 9:00 pm  • 

After a concussion, athlete, coach, and parents are naturally concerned with how soon a return to play is possible.

Perhaps, however, that concern is a bit misplaced because the vast majority of athletes who suffer a mild traumatic brain injury are students first. Because of the heightened concern surrounding concussion, more and more athletic programs at the collegiate and high school levels have become well-versed in the most up-to-date protocols regarding the management of a safe resumption of participation.

For that reason the American Academy of Pediatrics released on Sunday -- at its AAP National Conference & Exhibition in Orlando – a clinical report entitled “Returning to Learning Following a Concussion.”

As far as returning to sports competition is concerned, the report briefly concludes that “Students should be performing at their academic 'baseline' before returning to sports, full physical activity, or other extracurricular activities following a concussion.”

The remainder of the report focuses on the academic concerns surrounding this injury. Intended for pediatricians, it should be required reading for school administrators, guidance counselors, nurses, and teachers.

And one item featured in this report could be easily lost amid the current hysteria attached to the issue: most concussions resolve within three weeks of the injury

Consequently, the authors of the report note that “teachers' understanding and putting a few reasonable adjustments in place in the early stages of concussion will often help bring the student through recovery in the typical, expected timeframe of 1 to 3 weeks.” Teachers' understanding, though, is inhibited by the fact that most concussion victims have no outward appearance of being ill.

To improve teachers' “understanding,” then, the report advises “education, on a larger scale should be conducted to instruct school groups on the concepts of concussion management, particularly when introducing models of cognitive rest.”

“Cognitive rest,” reads the report, “refers to avoiding potential cognitive stressors, such as texting, video games, TV exposure, and schoolwork, as examples.” Doing so early seems to prevent serious and prolonged problems later.

Unfortunately, there isn't much research available to prove the benefits of cognitive rest. Therefore, the source of these guidelines is expert opinion. Even so, Bears neuropsychologist Dr. Beth Pieroth labeled the report, “Excellent.

“I am happy to see more emphasis on academic issues,” she continued. Pieroth plans to share it with all of her colleagues.

Munster neurosurgeon Dr. Wayel Kaakaji of the Concussion Clinic at Community Hospital was similarly impressed. “I like the following points,” he said. “The emphasis on identifying a point person in school who will coordinate the academic adjustments/accommodations (and) involving the parents in the decision as to when the child return to learn. They are the best judge of the student's ability -- and motivation.”

Motivated parents can learn more about about returning to learning after a concussion by going to the the AAP's website

John Doherty is a certified athletic trainer and licensed physical therapist. This column reflects solely his opinion. Reach him at Follow him of Twitter @JDohertyATCPT.

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