Return to Learn After Concussion

Returning to learning after a concussion can be challenging. Symptoms such as headache, fatigue, dizziness, sensitivity to light or noise, blurred vision, difficulty concentrating and feeling mentally “foggy” can make school, university, TAFE, vocational training or other study activities more difficult.

Concussion does not only occur during sport. It may result from a fall, motor vehicle accident, workplace incident, assault or another injury involving a force to the head or body. Return to learn support can therefore be helpful for anyone whose concussion symptoms are affecting their ability to study, process information or participate in education.

What is return to learn?

Return to learn is a planned and gradual return to education following a concussion. It aims to help a person resume learning without significantly worsening their symptoms or placing them under unnecessary cognitive, physical or emotional strain.

Learning involves more than attending a classroom. It can include:

• Reading and writing
• Using computers and other screens
• Listening to lectures or instructions
• Concentrating for extended periods
• Remembering and processing new information
• Completing assignments or examinations
• Working in busy, bright or noisy environments
• Travelling to and around an educational setting
• Participating in practical classes, placements or workshops

A person may appear physically well but still find these activities difficult. Return to learn should therefore be based on the individual’s symptoms and functional capacity, rather than simply the time that has passed since the injury.

Who may benefit from a return to learn plan?

Return to learn support may be appropriate for:

• Primary and secondary school students
• University students
• TAFE and vocational education students
• Apprentices and trainees
• People completing workplace training
• Adults undertaking professional development or further study
• People returning to cognitively demanding hobbies or community activities

The approach should be personalised to the person’s age, learning environment, course requirements, symptoms and stage of recovery.

When should learning resume?

Following a brief period of relative rest, generally during the first 24 to 48 hours, current concussion guidance supports a gradual return to everyday activities, including learning, as tolerated. Prolonged complete rest or isolation is not usually recommended.

A person does not necessarily need to be completely symptom-free before beginning a gradual return. A mild and brief increase in symptoms may be acceptable, provided symptoms settle with a break or adjustment. A significant or prolonged increase may indicate that the activity needs to be reduced or modified.

Return to learn should usually be established before progressing to activities involving a risk of another head injury, which is why it comes before the graded process on our return to sport after concussion page. This follows the Australian concussion guidelines.

A graduated return to learning

There is no single schedule that suits everyone. Progress may be faster or slower depending on the person’s symptoms and the demands of their learning environment.

These stages are flexible. Some people may remain at a stage for several days, while others may progress more quickly. If symptoms increase substantially, the person may need to reduce the duration or complexity of the activity rather than stopping all learning.

Helpful adjustments

Temporary accommodations can reduce symptom aggravation and help the person remain connected to their education. These may include:

• Shortened school or study days
• A reduced number of classes
• Regular rest breaks in a quiet environment
• Reduced homework or assignment load
• Extra time to complete tasks
• Flexible assignment deadlines
• Postponement or modification of tests and examinations
• Reduced reading or screen time
• Printed materials instead of screen-based work
• Adjustments to screen brightness, font size or contrast
• Permission to wear sunglasses, a cap or ear protection when appropriate
• Access to recorded lectures or lesson notes
• Avoiding noisy assemblies, workshops or crowded environments
• Reduced multitasking and complex instructions
• Breaking work into smaller, manageable sections
• Additional time to move between classes
• Alternative transport or a later start time
• Modification of practical classes, placements or activities with a risk of falls or further head injury

Adjustments should be reviewed and reduced gradually as the person recovers.

Symptoms that can affect learning

Concussion can affect each person differently. Symptoms that may interfere with learning include:

• Headache or pressure in the head
• Dizziness or balance problems
• Blurred, strained or double vision
• Difficulty reading or tracking words across a page
• Sensitivity to light, noise or visually busy environments
• Reduced concentration
• Slower information processing
• Memory difficulties
• Mental fatigue
• Sleep disturbance
• Irritability, anxiety or low mood
• Neck pain
• Difficulty tolerating travel, movement or busy corridors

Identifying which symptoms are creating barriers to learning helps determine the most appropriate treatment and educational adjustments.

How physiotherapy may help

At Advanced Neuro Rehab, our physiotherapists assess the physical and functional factors that may be affecting recovery and participation in learning.

Assessment may include:

• Balance and coordination
• Dizziness and vestibular function
• Eye movement and visual-motion tolerance
• Neck pain and headache
• Exercise tolerance
• Sensitivity to movement and busy environments
• The effect of physical and cognitive activity on symptoms

Treatment may include vestibular rehabilitation, balance exercises, management of neck-related symptoms, eye-head coordination exercises, graded aerobic exercise and education about pacing and symptom management.

Where appropriate, we can help develop an individualised return to learn plan and communicate recommendations to the person’s school, university, training provider, GP or other members of their healthcare team. Our concussion service works with both children and adults and provides coordinated support across rehabilitation, education and everyday activities.

When symptoms persist

Many people recover steadily, but some experience symptoms that continue to interfere with learning. Further assessment may be helpful if symptoms are persistent, worsening or preventing a gradual return to usual activities.

Depending on the person’s needs, care may involve collaboration with a GP, paediatrician, neurologist, neuropsychologist, psychologist, occupational therapist, optometrist, orthoptist or other health professional.

Urgent medical assessment is required if new or worsening warning signs occur, such as increasing confusion, repeated vomiting, seizure, severe or worsening headache, weakness, unusual behaviour, deteriorating consciousness or difficulty waking.

Return to learn support at ANR

Advanced Neuro Rehab provides individualised concussion assessment and rehabilitation for children, adolescents and adults. We understand that recovery is not only about returning to sport. It is also about returning safely and confidently to school, university, vocational training, work, family responsibilities and everyday life.

We can assist with:

• Assessment of symptoms affecting learning
• An individualised graded return to learn plan
• Recommendations for temporary educational adjustments
• Treatment of dizziness, balance, visual-motion and neck-related symptoms
• Graded exercise and activity progression
• Communication with schools, universities, training providers and healthcare professionals
• Support for persistent concussion symptoms

If concussion symptoms are making learning difficult, contact Advanced Neuro Rehab to arrange an assessment. Your rehab, our expertise.