By Jan Hoffman, New York Times

Because of heightened awareness about the hazards of sports-related concussions, many states have implemented standards determining when an injured student may resume playing contact sports. But only a few states have begun to address how and when a student should resume classwork.

On Sunday the American Academy of Pediatrics issued recommendations for “return to learn” checklists to alert doctors, school administrators and parents to potential cognitive and academic challenges to students who have suffered concussions.

“They’re student athletes, and we have to worry about the student part first,” said Dr. Mark E. Halstead, the lead author of “Returning to Learning Following a Concussion,” a clinical report in this week’s Pediatrics.

For adolescents prone to risk-taking behaviors, concussions are not just the nasty by-products of sports. Halstead, an assistant professor in pediatric sports medicine at Washington University, recently treated a 15-year-old girl whose concussion came not from a soccer match, but because “she was running backwards in a school hallway and cracked heads with someone.”

The academy emphasized that research about recovery protocols and cognitive function is scant: There is no established rest-until-recovered timeline. The new recommendations are based on expert opinions and guidelines developed by the Rocky Mountain Youth Sports Medicine Institute in Denver.

Doctors generally recommend that a student with a concussion rest initially, to give the brain time to heal. That may mean no texting, video games, computer use, reading or television. But there’s a big question mark about the timing and duration of “cognitive rest.” Experts have not identified at what point mental exertion impedes healing, when it actually helps, and when too much rest prolongs recovery. Although many doctors are concerned that a hasty return to a full school day could be harmful, this theory has not yet been confirmed by research.

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