Children Kept Out of School Long-Term After a Head Injury Have a Harder Time Recovering: Study

Keeping children out of school to recover after they suffer a concussion may result in longer recovery times, according to the findings of a new study.

A common medical recommendation following a concussion is to keep children out of school for a few days to a few weeks, to give them time to recover from their injuries. However, Canadian researchers warn that may lead to depression and anxiety, according to findings of a new report published on January 20 in the medical journal JAMA Network Open.

Researchers conducted a study involving data from nine Canadian pediatric emergency departments in the Pediatric Emergency Research Canada Network from 2013 to 2014, including 1,630 children between the ages of 5 and 18, who suffered a traumatic brain injury (TBI), also known as a common concussion.

Overall, 875 children were classified as having an early return to school, coming back within a few days of the injury. However, older teens commonly missed more school than younger children after a concussion.

The average number of school days missed increased across age groups. Children ages 5 to 7 years old missed an average of 2.5 days, youths 8 to 12 years missed three days, and children 13 to 18 years missed nearly five days.

Returning to school early was linked to experiencing fewer symptoms two weeks after the concussion. This was especially the case in the 8 to 12-year-old group, and the 13 to 18-year-old group. But researchers noted children ages 5 to 7 who returned to school early did not have fewer symptoms by the two-week mark.

Children who took more time to return to school and who were restricted from electronics took longer to recover overall and continued to have more symptoms two weeks after the injury, the researchers concluded.

In addition, children who experienced more symptoms at the time they suffered the concussion had fewer symptoms by the two-week mark if they returned to school early compared to children who had fewer symptoms after the initial injury.

Again, this was the case for all age groups except for the 5 to 7-year-old group.

Socialization May Help With Recovery, Prevent Depression

Some research has indicated keeping children out of school longer after a concussion and placing more restrictions on their activities and use of electronics may actually increase their risk of depression and anxiety.

Socialization with friends can help reduce stress and help children return to a normal sleep and school schedule. This may help children recover more quickly.

The researchers caution it is important to take a head injury seriously, limit activity, and have children rest in the first few days after a concussion, but after that children can return to activity and to school, and it may help them recover more fully. The only restrictions should be on sports and activities that can lead to a second head injury.

“These results supported the growing belief that prolonged absences from school and other life activities after a concussion may be detrimental to recovery,” wrote Christopher G. Vaughan, PsyD, lead author of the study. “An early return to school may be associated with a lower symptom burden and, ultimately, faster recovery.”