Return to Learn Head Injury Protocol



**Each step in the return to learn process is determined on an individual basis. These steps give general guidance on the process.

Step 1: Immediately after a concussion, it is beneficial to take a break from cognitive (thinking, processing) activities for up to a few days, depending on the severity of symptoms.

· This may mean no school, no homework, no computer, no texting, no video games and maybe no TV if it makes symptoms worse. In general, it is beneficial to minimize screen time.

· As symptoms improve, slowly reintroduce light cognitive activity, if these activities do not increase symptoms.

Step 2: Light cognitive activity is resumed once symptoms have decreased at rest.

· The student may do activities that do not cause symptoms to get worse.

· Initially, the student may only tolerate five to 15 minutes of work at a time. Stop the activity when symptoms increase.

· The student may increase the length of cognitive activity as long as symptoms do not worsen significantly or as long as symptoms improve within 30 minutes of taking a break.

Step 3: School-specific activity should be increased gradually:

· When feeling better, your child should try to do some schoolwork at home, increasing the duration as tolerated.

Step 4: Follow these guidelines to determine when the student is ready to return to school:

· When the student can do one hour of homework at home, he/she may try to return to a modified school schedule.

o Examples of a modified schedule: Fewer classes, adjustments to decrease reading and note taking, and extra time to complete assignments and tests.

· If symptoms develop while the student is at school, he/she should take a break in a quiet, supervised area until symptoms improve. When symptoms improve, he/she may return to class.

· The student may increase his/her time in school as tolerated.