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If your child or adolescent has been diagnosed by a doctor with a mild head injury, such as concussion, they will need time to rest and recover (see our fact sheet
Head injury – general advice). This fact sheet provides advice for safely returning your child to school and sport if they have had a mild head injury.
For moderate or severe head injuries, follow your doctor’s advice for returning your child to their normal activities.
While your child is gradually being returned to school or sport, monitor them for these signs and symptoms of concussion:
The recovery time for children with concussion can vary, as can their symptoms. Children and adolescents with concussion can take up to four weeks to recover, but most concussions will get better on their own over several days. For the first 24 to 48 hours, children should have a period of relative (not strict) rest but should
continue with their daily activities and return to light physical activity e.g. walking. Children should have sufficient sleep, a healthy diet, and limited screen time e.g. television, computers and smartphones during this initial period.
Physical exercise such as walking or stationary cycling, and other activities such as reading or passive screen time (e.g. watching a movie; not gaming or smart phone use), can be introduced gradually as long as your child only experiences mild worsening of symptoms of concussion for a brief period of time (less than one
Your child can continue to increase activities and move onto the next step if they are not showing any symptoms of concussion, or the symptoms are mild and brief in nature (less than one hour). Leave 24 hours between advancing to each step. If the activity results in more than mild, brief worsening of symptoms, go back to
the previous step. If your child cannot advance to the next step without substantially increasing symptoms of concussion, take them to see a doctor.
1. Daily activities at home
Start your child on typical daily activities, such as reading or gentle walking. Begin with five to 15 minutes at a time and gradually build up.
A gradual return to typical activities.
2. School activities at home
Complete light cognitive activities such as homework, school reading or other educational activities at home
To increase tolerance to cognitive work.
3. Return to school part time
You should consult with the school and gradually introduce schoolwork and a busy school environment. Your child may need to start with a shorter school day or have increased breaks during the day. Talk to your school about options for quiet break spaces at lunch or break time. School tests may need to be delayed.
To increase academic activities.
4. Return to school full time
Gradually increase school activities until your child can tolerate a full day.
Return to usual school activities and catch up on missed work.
Children and adolescents should
not return to sport until they have successfully returned to school. Allow at least 24 hours for each step, and a minimum of one week after the injury before your child returns to normal game play. Only move onto the next step if your child is not showing
any symptoms of concussion or the symptoms are mild and brief (less than one hour in duration). Steps 4-6 should only begin when symptoms are resolved. If concussion symptoms are experienced in steps 4-6 return to step 3 until symptoms are resolved including with and after exertion.
Simple daily activities that do not make symptoms worse, e.g. walking.
2A. Light aerobic exercise
Gradually introduce walking, swimming or stationary cycling at a slow pace. Do not allow resistance training at this stage.
2B. Moderate aerobic exercise
Gradually introduce walking, swimming or stationary cycling at a medium pace. Do not allow resistance training at this stage.
To gradually increase heart rate.
Your child can begin activities such as running, warm-up drills and practicing ball skills (with a soft ball). Do not allow any activities that involve head contact.
To add movement.
Non-contact training drills
Introduce harder, high intensity training drills, such as passing drills. Your child may start progressive training.
To introduce exercise, coordination and increased thinking.
Full contact practice
Following medical clearance, e.g.by a GP, participate in normal training activities.
Restoring confidence, and allowing coaching staff to assess functional skills.
Return to sport
Your child can now progress to normal game play.
Resume regular sporting activity.
Talk to your doctor if you are unsure about your child’s progress at any step.
Following repeated concussions, your doctor may recommend your child avoid contact sports and any activities with increased risk of head injury for a period of time. This is because after a head injury, your child’s reaction times and thinking may be slower, and this can put them further at risk.
At-risk sports and activities include:
Make sure your child always wears a helmet when riding a bike, scooter or skateboard.
Seek urgent medical attention at your local hospital emergency department if during your child’s recovery they have any of the following:
If your child’s symptoms worsen or your child is experiencing new symptoms of concussion, seek urgent medical attention.
If your child returns to sport too soon after a head injury, their reflexes may be dulled, their peripheral vision affected and their response times slightly slower. All of this reduces their ability to protect themselves and avoid collisions or being
hit by a ball. This increases their chance of sustaining another head injury.
Developed by The Royal
Children's Hospital Emergency, Neurosurgery and Neuropsychology departments. We
acknowledge the input of RCH consumers and carers.
Reviewed November 2023
This information is awaiting routine review. Please always seek the most recent advice from a registered and practising clinician.
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This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.