Returning to school after a mild traumatic brain injury is one of the most difficult obstacles a student can face in their recovery.
Alyssa Dunbar tried to return to school a week after suffering a concussion in a car accident last year. The intensity of what she was experiencing caught her off guard.
“It was terrible, I got instant headaches as soon as I got there — lights, noise and concentration set them off really bad,” explained the Lindsay Thurber Comprehensive High School Grade 11 student. “I went back to school before I knew I had a concussion and the headaches were really intense. The school lights were really bad. Early on, it was pounding. I did not know your brain could pound like that.”
Lindsay Thurber student Cody Miner was overwhelmed with returning to school after he suffered a concussion in hockey and then another in basketball three months later.
“Concentration was a lot harder,” agreed Miner. “Simple things like a light flickering in a class would give me headaches and I couldn’t concentrate at all. I had trouble reading what was on the board and I had to get a pair of light reading classes for me to be actually able to read.”
For Lindsay Thurber student Lucas Walker, after suffering two concussions in hockey and one in football in a year’s time, returning to school was not even an option.
“Nauseous and headaches — everything was too loud, and busy,” said Walker. 16. “It just felt like I was dreaming or something. I wasn’t really in reality. I just was kind of dreaming and out of it. I wasn’t really myself at all.”
Although concussions are unique to each individual, students commonly struggle with noise, fluorescent lights, physical activity, concentration and mental fatigue. Academic testing also shows that students suffering from post-concussion syndrome struggle with focus, concentration, short-term memory, math and processing speed issues.
Every concussion presents a unique set of academic issues.
“The memory loss was the hardest because I was always really good at remembering formulas, but when I had to do science and math it was really frustrating because I couldn’t remember anything we did the day before,” explained Dunbar, 16. “I could only concentrate for five minutes and then my brain would think about something else or shut down completely.”
In an ideal world, students would not return to school until they are symptom free.
“It (returning to school too early) puts extra strain on the brain,” said Red Deer College instructor and concussion researcher Elena Antoniadis at recent concussion workshop.
“The brain is not ready to work yet. The brain needs to recuperate, to restore the ionic balance: the potassium, sodium and calcium. Until that occurs, it is really difficult to put the child back in the classroom, doing all that work and concentrating. Do not allow a child to return to the classroom until they are fully recovered!”
After his third concussion in 15 months, Hunting Hills High School student Blake Stillings returned to school too early and found the experience overwhelming.
“We were doing the hardest academic class, which was math,” said Stillings. “I remember having to leave the class to even do worksheets, anything. I couldn’t concentrate. It was totally stereotypical about what they tell you about concussions. The lights were terrible, couldn’t focus, I couldn’t think, I couldn’t wrap my head around the equations, especially algebra. Oh my gosh, I couldn’t do it ... I was wearing sunglasses inside the school.”
Stilling’s parents soon decided that there are more important things than education.
“We were still thinking how important education is,” explained Stillings’ mother Kahlanie. “It is important ... but for right now in this moment it is not helping him. You can always go and get education.”
Most students with mild traumatic brain injuries find that when they return to school, their grades drop by 10 to 15 per cent.
“I went from having 85s to 90s down to 70s,” explained Miner. “It dropped my marks by a good 10 to 15 per cent. It wasn’t a normal thing for me. I was used to getting those higher marks. It was something that happened that I couldn’t really control.”
There are a number of ways, however, that schools can assist students in their return.
Schools need to limit the return to one class initially and as the student get stronger, add in classes until the student can handle a regular schedule.
Modifying the workload and content also keeps students from getting overwhelmed.
Students may also need to reduce stimuli by wearing sunglasses and sound-dampening headphones in class. Allowing students to leave class early to avoid noise and congestion between classes also helps them to manage their days better.
Stress is one of the biggest triggers of post-concussion symptoms. The stress from an exam can create huge anxiety, headaches and brain fog in students with mild traumatic brain injuries (MTBI). Allowing them to write their exams in a quiet setting away from distractions will help them cope and achieve better grades. Giving them extra time on exams also helps them to relax and better access their short-term memory.
When students are having a bad day in class, allowing them to retreat to a quiet setting will help them cope with their symptoms. Having ice packs available for their necks will also help them slow down their symptomology.
Miner, Walker and Stillings had their Grade 9 years waived by administration, were allowed to bypass their provincial achievements tests (PATs), and were placed in Grade 10 based on their pre-concussion grades.
“The school was great, they were really supportive,” said Miner. “Lots of the teachers understood. I was in Grade 9 when my first concussion happened. I had to write my PAs ... you have to write them by government standards but the school was willing to take zeros for me on those tests, which didn’t reflect poorly on me but more on the school than anything.”
Dunbar, who had her concussion in first semester of Grade 10, went down to two subjects, dropping two others. In Grade 11, the school waived her prerequisites, allowing her to take both subjects at the next level.
For Kahlanie Stillings, having the school recognize what is going on and supporting her son has been crucial in his recovery.
“The minute we decided that Grade 9 was done, we had a conversation with one of the counsellors and they have all been fantastic over there. ... They said, don’t worry about Grade 9, look at his grades, he is fine. We will get everything set up for Grade 10.”
For Walker, Miner, Dunbar and Stillings, the return to school has been a struggle. But because of the support of their schools, family and personal perseverance, all returned to full-time studies this fall.
Doug Rowe is a local freelance writer and teacher who is recovering from his own concussive incidents.