Protecting Brains

What would you give to ensure that a child’s brain is prepared to operate in the adult world? What would you sacrifice to ensure that it has all the knowledge and skills necessary for the child to live a happy and productive life?

For the homeschooling community the answer to that question is “an awful lot”. Parents take their children out of free public education, dedicate their time and resources, drive endlessly to classes spread to the four corners of the earth in minivans and twelve seater vans and all manner of vans. They start co-ops, teach classes, get training, volunteer on boards, attend conferences, start outdoor clubs, run dances, and generally give themselves a much more difficult time than is required, all in the hopes that they can provide their child the best possible education.

This is precisely why it makes so much sense for homeschooling parents and teachers to take concussions very seriously, to understand them to a reasonable level, to understand the difficulties of dealing with a serious concussion, and to learn to give good support to students recovering from concussions.

Having had a number of students suffer concussions ranging from minor to very serious over the years, and having seen the long term consequences that can result from traumatic brain injury, it’s a topic I want to see well understood. I therefore offer this article.

While it is not a certainty that any given American teen will end up dealing with a concussion, it is a certainty that a large number of them will. One study published in 2021 concluded that approximately 25% of American teens had suffered a concussion at some point. Student athletes are particularly susceptible to concussion (experts estimate that 5-10% of athletes will get a concussion in a given sports season), but concussions can have many causes besides sports including car accidents, accidental falls, or anything that causes a strong impact to the head.

Thankfully, the large majority of concussions are resolved relatively quickly. The Cleveland Clinic reports that 80%-90% of concussions are resolved within a few weeks if they are treated properly. Unfortunately, that means that some concussions will cause longer term problems either because of the nature of the injury itself or because the concussion isn’t treated properly.

Lack of proper treatment creates a risk for enduring problems based on a two fold mutually compounding problem set. First, if students return to full activity before symptoms are appropriately under control, symptoms will tend to persist longer. Second, as long as serious symptoms persist the brain is more susceptible to sustaining another concussion. So premature return to activity extends symptoms and then extended symptoms increase chance of reinjury. This then further extends symptoms and on it goes. This is at least part of the reason that the more concussions a person has had, the more likely it is that they will suffer another concussion and the longer the recovery time from each successive concussion. This cycle can prolong recovery, causing major disruptions in a students life and having long lasting effects on cognition and quality of life.

So what to know and what to do?

Thankfully, the understanding of concussions and the treatment available for them is much better than when I was playing sports as a youth and kids were being told to “walk it off” after they had “gotten their bell rung”. This means that when a student gets a concussion, the important thing to know is what the symptoms of a concussion are, and the important thing to do is get students appropriate medical care and then follow protocols laid out by medical professionals.

I have no particular expertise in the symptoms of concussion, so on that front I’ll point you to this CDC article about the signs and symptoms of concussion. The article does an admirable job laying out the symptoms of a concussion, when they may show up, and has good guidelines on when it’s ok to get to the doctor with an appointment versus when it’s important to seek emergency care.

Now to the part in which I do have some experience and the real point of the article-

For the students, parents, and teachers identifying a concussion and getting a student care are the easy part. In my observations, the difficult part is helping students cope with concussion recovery, particularly a serious concussion with lasting symptoms.

To help you understand why, I’ll quote (with permission) from a semester reflection written by a student who was in the midst of recovering from a very serious concussion. First, I note that this was an extended recovery that was incredibly difficult for the student to deal with. Not every student recovering from concussion will feel the same or feel this way as intensely. But my experience has been that most students recovering from concussion feel this way to some degree. The student’s words-

“Somewhere along the way I created a belief that I didn’t have inherent value and that I had to continually be accomplishing something in order to be of value. So when I got in a car crash in 2017 all of the sudden I wasn’t able to continually work to guarantee my value and I was scared.”

Considering her words, can you see why many students recovering from concussion may feel the same? All their lives education has been emphasized. They are praised for working hard in school, gotten after when they slack off, and productivity is highly valued. And then, all of a sudden, they are told that they need to rest and not just rest their bodies (kids are relatively used to resting when they twist an ankle or break an arm) but to rest their brains. This is particularly difficult because the thing holding the student back is only visible in symptoms that only they can feel. In that environment it is unsurprising that students may see themselves as lazy, unproductive, and weak. Just as importantly, they can begin to fear that others see them this way as well.

It shouldn’t be surprising, then, that many recovering from concussion experience significant symptoms of depression (as this study reports it, approximately 20%). As students are thrown out of their usual routine and have to confront a lack of fulfillment (it turns out that the average student does in fact draw a great deal of meaning and satisfaction from their education), it can be difficult to cope.

As a result, the student may pressure themselves to prematurely return to activity. Again, from my student quoted above-

“The truth that I have been avoiding is that I am not okay. I wanted so badly to come back from summer break and be completely healed and healthy. So much so that when summer break ended I didn’t even bother consulting my body on the subject, I just decided that I was going to be healthy. The way I saw it was, I had done my share of healing, and even though I still got headaches, dizziness, brain fog, wordloss, tired really easily, and a plethora of other brain injury symptoms I refused to admit the truth, I created this pretty lie in my head that said that I was fine, that I was going to be able to come back to school like nothing had ever happened, only adding to the pain that I was already experiencing.”

Again, this was a fairly severe case, but I see similarities in even mild cases- such a strong desire for things to be normal that students push themselves back into activity before they are ready and then prolong the issue.

This is where caring parents and teachers can be of real help to the student. They can be particularly helpful asking them how recovery is going, really listening to the answers, checking in on a student’s emotional state, and helping students cope with the difficulties that can come with recovering from concussion. Specifically, teachers and parents can reinforce that being busy isn’t what makes a student valuable and that their brain is important enough that it is worth every bit of boring and frustrating recovery that is necessary for the student to fully recover.

Even more importantly, it is critical that students don’t receive suspicion that they are faking their injury in order to avoid work or demands that they keep up on their school work when they should be resting. In terms of practical application, I simply stop taking homework records or having any particular requirements for students in my class who are recovering from concussion. I let them know that I’m invested in them achieving a full recovery, and whatever part my class can play in that is great. If they come to class, great. If they need to step out because the noise is getting to them, no problem. If they feel like they can do an activity, wonderful. If they can’t, then no problem. I express trust that they aren’t faking anything and emphasize the importance of not doing further harm to their brains. And I try to do this in front of the class so that classmates know what to expect and can model that behavior as well. This status continues until they are ready to fully reintegrate into class as determined by their symptoms and their doctor. Until that time, I try to be as supportive as possible.

I hope that other teachers in the homeschooling community are taking and will take a similar approach. The particulars may be different, but the commonality should be an investment in helping students deal with the difficult process of concussion recovery so that we can see students return to the best possible version of brain activity. In the 1970’s the UNCF (a philanthropic college fund for African Americans) coined the popular slogan “A mind is a terrible thing to waste.” We can and should apply that idea here. Kids have to live with their brains for the rest of their lives. Therefore, I propose that we do our best to help them preserve that precious asset for the future.