Cognitive Rest After a Child's Head Injury

Following a concussion, medical professionals might direct a patient to complete a period of both physical and cognitive rest. Both of these are important in helping the brain heal after an injury.

Cognitive rest is rest for the brain, just like physical rest is rest for the body. Resting conserves energy and allows the body and brain to use it for recovery. That said, it's hard to do—especially for kids and teens who might need to give up their favorite activities (at least temporarily).

How Long Is Cognitive Rest Needed?

People are often advised to rest until they no longer have any concussion-related symptoms (for example, some recommendations advise waiting until they have not had any symptoms for at least 24 hours before returning to their activities).

While the exact recommendation will depend on your child, a gradual return to their routine and activity level after a concussion is typically recommended. They should start with "light cognitive activities" (for about 30-minutes at a time) and slowly work up to those that require more brainpower.

A good way to gauge when they are ready to increase activity level is to monitor whether your child is able to focus on a task or activity without an increase in their symptoms, or symptoms that do not get better with a 30-minute break.

Activities children might need to avoid while recovering from a concussion include:

• Going to school (in person or online)
• Listening to music, talk radio, or audiobooks
• Reading, writing, and studying
• Using any device with a screen (which includes texting, playing smartphone games, using an e-reader or tablet, etc.).
• Watching TV or playing video games
• Working on a computer

How Schools Can Help

Following a concussion and a period of cognitive rest, some kids need a slow return to full activity (sometimes called "return to learn.") Having support at school can be a big help, and your child might need accommodations such as:

• A shortened school day, and/or extra rest breaks during the day
• Extended deadlines for assignments
• Help from a note-taker and/or a tutor
• Postponed or staggered tests, or different ways of showing knowledge (such as a portfolio of past work or an oral exam instead of a written one)
• Reduced distractions and sensory inputs, such as bright lights and loud noises. This could mean moving a child's seat away from a window or closer to the front of the room. It could also mean avoiding crowded hallways and noisy lunchrooms.

Emotional Challenges

It's also important to note that cognitive rest can be very difficult emotionally for a child or teen. Kids spend a lot of their time learning, reading, and interacting with screens (collectively, getting back to these activities is sometimes called "return to play").

It's hard for kids to avoid activities that they enjoy. They might express worry about falling behind in school, sports, or other extracurricular activities, as well as missing out on socialization at school, with friends, and online.

Children often need reassurance that while the recovery period from a concussion can be difficult, it's only temporary. If they seem especially eager to get back to their regular day-to-day life, you might need to remind them of how serious a concussion can be, and that there are consequences of returning to learn or play before they have made a full recovery.