CME Article

Importance of ‘Return-to-Learn’ in Pediatric and Adolescent Concussion

Christina L. Master, MD; Gerard A. Gioia, PhD; John J. Leddy, MD; Matthew F. Grady, MD

  • Pediatric Annals
  • September 2012 - Volume 41 · Issue 9: 1-6
  • DOI: 10.3928/00904481-20120827-09
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Abstract

CME Educational Objectives

1. Prescribe physical and cognitive rest for pediatric and adolescent concussion.

2. Implement a gradual “return-to-learn” plan for student-athletes after concussion.

3. Communicate specific school-based accommodations to facilitate a gradual reintegration to full school activities.

The concept of “return-to-play” after concussion is familiar to pediatricians who routinely care for injured student-athletes. Premature return-to-play of a student-athlete who is still injured from a concussion may result in more severe and potentially long-lasting deficits.

In contrast, “return-to-learn” plans for student-athletes have not received as much attention, perhaps because so much regarding concussion awareness comes from lay reports of professional athletes who play a sport for their livelihood, as compared with pediatric and adolescent-aged athletes for whom school is their primary “work.”

Pediatric and adolescent concussions have many unique features requiring special attention from the pediatrician in terms of diagnosis and management. This article addresses the importance of properly timing school re-entry.

AUTHORS

Christina L. Master, MD, is the Associate Program Director, Primary Care Sports Medicine Fellowship, The Children’s Hospital of Philadelphia; and Associate Professor of Clinical Pediatrics, Departments of Surgery and Pediatrics, Division of Pediatric Orthopedics and Sports Medicine, Perelman School of Medicine at the University of Pennsylvania. Gerard A. Gioia, PhD, is Chief, Division of Pediatric Neuropsychology; Director, Safe Concussion Outcome, Recovery & Education (SCORE) Program, Children’s National Medical Center; and Associate Professor, Departments of Pediatrics and Psychiatry & Behavioral Sciences; The George Washington University School of Medicine, Division of Pediatric Neuropsychology. John J. Leddy, MD, is an Associate Professor of Clinical Orthopedics, the Associate Director of University Sports Medicine, and Concussion Clinic Director, State University of New York at Buffalo, UB Orthopaedics & Sports Medicine. Matthew F. Grady, MD, is the Director, Primary Care Sports Medicine Fellowship, The Children’s Hospital of Philadelphia; and Assistant Professor of Clinical Pediatrics, Departments of Surgery and Pediatrics, Division of Pediatric Orthopedics and Sports Medicine, Perelman School of Medicine at the University of Pennsylvania.

Address correspondence to: Christina L. Master, MD, The Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA 19104-4399; email: masterc@email.chop.edu.

Disclosure: The authors have no relevant financial relationships to disclose.

doi: 10.3928/00904481-20120827-09

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