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During the acute phase it is important that the child  rest physically and cognitively if they are symptomatic.  Following the initial assessment the Neurocircuit clinician will work with the student, parents and educators to facilitate a return to school.  Individuals will experience various types and degrees of symptoms and therefore the return to learn steps and necessary accommodations will be tailored to their needs.

Students will be encouraged to return to school when it’s deemed safe for them to do so. It has been shown that social interaction can help relieve the emotional symptoms.

Our clinicians will provide recommendations to help facilitate this process. Understanding symptoms will help guide accommodation strategies. The educator can play an important role in recovery by allowing for accommodations.

The chart below lists different management strategies that may be useful:

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RETURN TO LEARNING FOLLOWING CONCUSSION
Step 1
REST AND RECHARGE
*Limit visual, physical and cognitive stimulation.
Wear sunglasses and earplugs
* Avoid screens (cell phone, computers, televisions etc).
*Avoid crowds and busy places.
* Avoid looking out of your periphery.
*Avoid multitasking as it increases the cognitive demand of the task.
Take naps during the day to help you recuperate.

Step 2
PACE AT HOME
Identify your triggers and pace yourself so that your symptoms do not return. Start with activities in the following order and gradually increase the length of time for each as tolerated:
Audio: Low volume music, podcasts.
*Audio/Visual: paint, draw, cook, audio books.
Visual – far work: Short periods of TV at a distance.
Visual – close work (no screens): reading short passages, board games, crafts, models.
Visual – with screens: Computer, iPad, texting (dim the screens, enlarge the font).
* Shorten your naps to 30 minutes and establish a normal bedtime routine.
* Walking for short periods of time (10 – 15 minutes).
Remember to limit the time you spend on any one activity to “below symptom levels”. Take breaks as you go from one level to the next.

Step 3
READINESS FOR SCHOOL
If you can read for 30 minutes and pace through two hours of cognitive (“thinking”) work, then you are ready for 1/2 days at school. Individualized accommodation recommendations will be sent to the school.
* Begin by auditing your classes.
* No note taking, in class assignments or testing.
Begin by attending morning classes only.
* Taking breaks in a designated quiet area as needed (nurses office, library etc).
* Avoiding triggers (busy places, noisy classes etc).
* Pacing cognitive (“thinking”) work below your symptoms (reduced homework).
No after-school activities: you may need a short nap before trying homework.
* Pacing homework to short blocks of time (below symptoms).
Continue walking for short periods of time every day.
Go to bed early, eat healthy meals, and stay hydrated.

Step 4
FULL DAY AT SCHOOL (NO TESTING)
If you are asymptomatic during and following your half day of school you are ready to progress to full days. Remember to identify your triggers and avoid them. Read or do cognitive (thinking) work below your symptom levels and pace. We will ask you teachers for reduced work and extra time to complete your assignments.

Step 5
FULL ACADEMICS
When you are able to attend a full day of school, keep pace with the current work and have caught up on the material you missed, you may start writing tests.

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