Question
How do updated concussion protocols guide the school based occupational therapy approach to post-concussion recovery?
Answer
The updated concussion protocols reflect a shift away from prolonged rest toward early, symptom-guided re-engagement in meaningful activities. These guidelines now recommend a brief 24- to 48-hour period of physical and cognitive rest, followed by a gradual return to occupation—emphasizing light aerobic activity and structured participation in school tasks. For the school-based occupational therapy practitioner (OTP), this means facilitating a controlled, progressive reintroduction to educational and social routines, ensuring that the student remains below their symptom threshold while gradually increasing activity demands.
Central to this protocol is the understanding that occupation—defined as the meaningful “doing” in a student's life—plays a critical role in both physical recovery and emotional well-being. The OTP supports this re-engagement by identifying appropriate entry points for academic tasks, modifying the environment, and integrating strategies that prevent symptom exacerbation. For example, this might include reducing screen time, adjusting task length, or supporting participation in low-stress classroom roles that restore confidence and a sense of belonging.
The “Return to Doing” and “Return to Learn” graphics serve as valuable tools for guiding interdisciplinary collaboration and education. These visual aids provide a shared framework for administrators, educators, parents, and coaches, helping to align expectations and ensure the student’s re-entry into daily routines is thoughtful, paced, and supportive. By promoting activity rather than avoidance, these protocols help prevent deconditioning, social isolation, and emotional distress—key concerns in the concussion recovery process.
This Ask the Expert is an edited excerpt from the course, "The Role of School Based Occupational Therapy in Concussion Management," presented by Jennifer Morgan, OTD-PP, OTR/L.