What’s New in Psychology?

What’s Best for a Kid Following a Concussion?

Jim Windell

            What’s the best way to handle a child’s concussion?

            Conventional wisdom has it that the way to a faster recovery is to make sure the young person gets plenty of rest. Doctors have typically advised parents to let their kids rest and limit their brain activity to help them heal over a longer period of time.

            But the conventional wisdom may be wrong. That is the gist of a new study that was recently published in JAMA Network Open.

           The study looked at data from 1,630 children ages five to 18 who went to nine different emergency rooms across Canada. The study found that for kids ages eight to 18 who were recovering from a concussion, an early return to school, in two days or fewer, was associated with children experiencing fewer symptoms 14 days after their injury. That was not the case in children ages five to seven.  

           The research, led by Christopher Vaughan, Psy.D., a neuropsychologist at Children’s National Hospital based in Washington, D.C., noted that patients who followed recommendations for a slower return to activity, including being restricted from school and their electronics, took longer to recover and had more symptoms at 10 days post-injury on average than those that did not follow these steps.

           Earlier studies have shown that prolonged restrictions after a concussion are thought to increase a child’s risk of depression and anxiety. The researchers in this study, though, believe that socialization, reduced stress from not missing too much school, and returning to a normal sleep and school schedule may play a role in helping kids recover faster. They also suggest that light to moderate physical activity may also lead to a more rapid recovery.

           According to Vaughan, “We know that absence from school can be detrimental to youth in many ways and for many reasons. The results of this study found that, in general, an earlier return to school after a concussion was associated with better outcomes. This helps us feel reassured that returning to some normal activities after a concussion – like going to school – is ultimately beneficial.”  

           The findings of this study suggest that there could be a mechanism of therapeutic benefit to the early return to school. This could be due to:

• Socialization (or avoiding the deleterious effects of isolation).
• Reduced stress from not missing too much school.
• Maintaining or returning to a normal sleep/wake schedule.
• Returning to light-to-moderate physical activity sooner (also consistent with previous literature).

           Dr. Vaughan concludes that while it is important to take concussions seriously, “Clinicians can now confidently inform families that missing at least some school after a concussion is common, often between two and five days, with older kids typically missing more school. But the earlier a child can return to school with good symptom management strategies and with appropriate academic supports, the better that we think that their recovery will be.”

            To read the original article, find it with this reference:

Vaughan, C.G., Ledoux, A., Sady, M.D., et al. (2023). Association Between Early Return to School Following Acute Concussion and Symptom Burden at 2 Weeks Postinjury. JAMA Network Open. 2023;6(1):e2251839. doi:10.1001/jamanetworkopen.2022.51839