The majority of student athletes feel well-recovered from concussions in just weeks. In the past it was thought that all concussion patients “should” be recovered by about 3 months. Professionals working with athletes at all levels in recent years, however, have come to understand that some patients do remain symptomatic and disabled from full activity in school and sports for much longer. Some recoveries go on for months to years. A very unlucky few seem to have indefinite recoveries. Our clinical experience shows that slow recoveries often tend to be associated with having had multiple concussions – especially when two or more have occurred too close together in time – or from a very severe single concussion. What can be done for the slow-to-recover student?
- Use a team approach. Often the student will benefit most from the coordinated efforts of various specialists, including:
- Neuropsychologist – for evaluation and management of the student’s cognitive and emotional status
- Physicians – for ongoing medical diagnostic expertise and medications that may be helpful for sleep, headaches, attention, and/or mood changes
- Physical therapist – for treatment of vestibular and whiplash injuries, when indicated
- The School Team – including teachers, guidance counselor, school nurse, athletic trainer, psychologist, social worker
- Psychotherapist – if stress or post-concussion emotional effects have become an issue
- Behavioral Optometry – for diagnosis and treatment of post-concussion visual dysfunction
- Neuropsychological consultation is essential. All slow-to-recover students can be expected to have significant needs academically, as they typically have persisting cognitive limitations and will need a academic accommodation plan (known as a 504 Plan in public schools) or an Individual Educational Plan (IEP) which should be guided by the neuropsychologist’s assessment of the student’s specific cognitive strengths and limitations. Furthermore, this plan must take into account post-concussion symptoms which will likely be exacerbated when a student is pushed (or pushes him/herself) too much to keep up with regular academic expectations. Neuropsychologists are uniquely qualified to monitor students in their cognitive recovery and to advise the academic team as to the need for evolving accommodations as the student recovers over time.
- Support for the student and family. A long, slow recovery brings significant stress for the student as he or she copes with the loss of sports, disconnection from teammates and friends in school, frustration with unrelenting symptoms and worries about falling behind, or not being understood in school. There is also stress for parents who are worried for their child and find themselves spending considerable time dealing with school staff about their child’s accommodation needs. Students and parents need guidance and reassurance in managing the recovery and dealing with challenges as they arise in school and at home.
This process begins with neuropsychological consultation. Call us today at 617-959-1010 for more information.