Following concussion, it is essential to allow the brain to heal. This involves physical as well as mental (cognitive) rest. It is not uncommon for children
to have to miss school or modify school activity until their concussion symptoms subside. Just as we have a graded program to help athletes return
to their sport after a concussion, there is a graded program to help these same athletes successfully return to school without a worsening of the concussion
symptoms. The recommended Return To Learn protocol progresses as follows:
| STAGE | DESCRIPTION | MODIFICATIONS |
| 1 | Full Cognitive Rest | No physical or mental activity that increases symptoms (such as video games, texting, loud music); no homework or school. |
| 2 | Light Cognitive Activity | Part-time school attendance (half-days, or alternating time in class with time resting in nurse’s office); core classes only; no tests or quizzes;homework only as tolerated with no due dates; limited screen time; avoid activity that increases symptoms |
| 3 | Part-time School with Accommodations | Prioritize importance of work given; extra time to take tests with only one test per day maximum; gradual increase in homework; avoid activity that increases symptoms |
| 4 | Full-time School without Accommodations | Full participation in schoolwork and classroom activity with no modifications required; able to tolerate full day of school without any recurrence of symptoms |
| 5 | Full-time School With Extracurriculars | May participate in Return To Play program to get back to sports |
A student must have at least 24 hours in each stage before progressing to the next phase of Return to Learn .It is essential to include teachers, school
nurses and administrators in the team of professionals working with you and your child during their concussion recovery.
