The schoolchild — twenty minutes at a time
| Patient | 10F, subacute phase |
|---|---|
| Injury | left parietal contusion |
| Severity | Worst GCS 12 |
| Days since injury | 21 |
| Before the injuryAge-appropriate. Year 5, plays netball, strong reader before the injury. | |
| PrecautionsFatigue-limited — twenty-minute cognitive bouts with planned breaks; Afternoon headache pattern — heavy cognitive work scheduled early | |
Test yourself
What does the return to school look like?
The teaching
The paediatric guideline is clear on the shape of this month: supported, graded return to school — not immersion and not removal — with accommodations formalized so they survive staff changes. Her complaint is dual-task, so the therapy is dual-task, dosed into noisy environments because that is where the deficit lives. What you do with it: write the 504, train walking-and-thinking, and steer the ramp with a weekly log rather than a vibe.
- Headache pattern changing — earlier in the day, waking her at night, or with vomiting
- New academic regression or behaviour change beyond fatigue — reassess the plan, do not just slow it
Read next
The full sequence
This page carries the case’s first decision. The full sequence — every decision, the examination by domain, and the debrief that grades you — is in the drill, and the library is included with membership.
Sources on this page: Lumba-Brown A et al. CDC guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatr. 2018. Glang A et al. Return to school following childhood TBI: who gets services? NeuroRehabilitation. 2008 · Evans JJ et al. Walking and talking therapy: improving cognitive-motor dual-tasking in neurological illness. J Int Neuropsychol Soc. 2009. Lumba-Brown A et al. CDC guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatr. 2018 · Lumba-Brown A et al. CDC guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatr. 2018. Bayley MT et al. INCOG 2.0 guidelines for cognitive rehabilitation following traumatic brain injury. J Head Trauma Rehabil. 2023