An introduction to returning to education

Read our guide to managing the return to school after an acquired brain injury.

This section talks about managing the return to school. There is also information on homework, PE, siblings and bullying. It’s in the classroom that some of the most common misunderstandings about acquired brain injury can take place.1

The importance of awareness and information 

Whatever kind of school a child attends, they will almost certainly be in contact with different members of staff. Even if your child has only one teacher, they may run into other teachers on break duty, or dinner ladies at lunch.

If possible, parents should try to keep staff informed about the effects of a child’s acquired brain injury.2 Keeping the lines of communication open is vital when children return to school.3

Teachers are often in the habit of sharing information about individual children, whatever their circumstances. And a child with acquired brain injury may benefit from this sharing.4 Perhaps your child responds well to a particular approach, or being spoken to in a particular way.

It’s also useful for staff to know about the ‘hidden’ nature of some of the effects5, 6, and that some of the effects may not come to the surface immediately.7 

Teachers form a crucial link to the school for parents. And the Special Educational Needs Code of Practice for England8 makes explicit a need for parents and educational professionals to work in partnership. Keeping those lines of communication open will benefit everyone. 

Going back to school in stages 

There is no ‘one-size-fits-all’ solution for a child’s return to school. It will very much depend on how both parents and school feel about the child coming back.9 Many children may go back in stages. They might start with one day a week, before increasing their hours, for example.10

Michael was often just exhausted. He was doing a few sessions of physiotherapy a week and we just had to keep an eye on him and what he was able to do." Parent's experience

Fatigue and tiredness may be an issue here. It may be very difficult for a child to dive straight into a full working week.

When children are back on more regular hours, coping with homework might be extremely difficult. It’s also important that children still have some ‘gas in the tank’ for time with their friends and family.11

Going back to school isn’t just about catching up with schoolwork, of course. School is a very social place for children. Most of us can remember how quickly friendships change in school, and this may be tough for a child going back after an absence.

The other children had very much moved on when Casey went back to school. I think she must have seemed very young to them, and now she’s a little more comfortable with younger children than with her peers." Parent's experience

A child going back to school may have to make new friendships (sometimes with younger children). They might want to hook up with their old friends again.12 All of this puts a strain on children when there are plenty of other things going on. 

We spoke with Charlie’s teachers about easing him back in gently. He started with a couple of mornings – he would be exhausted by the afternoon – and then gradually stepped things back up." Parent's experience

What about PE?13

Some children are advised not to take part in ‘contact’ sports for up to a year after a brain injury.14 We know that the healing process can take some time.15

It’s also important to remember that anyone with an acquired brain injury may be at risk of having another injury because of some of the difficulties they face.16 Like any other issue, if you have any doubt at all, speak with your doctor.

This doesn’t mean the world of exercise and fitness should be off limits for your child. It’s true that some children may not be able to take part in strenuous exercises because of difficulties with movement or balance.17 But there are lots of gentler activities they can take part in.18 Some activities such as yoga and tai chi can be of help to children. 

What is a contact sport?

Contact sports are those where the chances are high that the player will make physical contact with other players, equipment, or the ground. For some children with an acquired brain injury, there may also be an issue of how quickly they are able to understand instructions.

If you think about the way instructions are barked out during a football match, and how quickly players must respond, it may not be a safe environment.19, 20

Some contact sports and activities:

  • High contact - Football, hockey, lacrosse, martial arts, rugby
  • Limited contact - Netball, basketball, rounders, cricket, cycling, squash
  • Some non-contact sports and activities:
  • Strenuous - Aerobics, dance, rowing, running, tennis, athletics
  • Less strenuous – Golf, tenpin bowling, swimming

It’s important that parents speak with the school about what your child can and can’t do. Sports and activities can be good ways for any child to relax, maintain a healthy lifestyle and take part in social activities.

Homework and study21

Our thanks to the South West Brain Injury Rehabilitation Service for its help with this information.

Knowing how far to help children with their homework can be tricky for every parent. A general rule of thumb is to remember that teachers want to see how your child is progressing in their lessons, rather than their parents. But that isn’t to say parents can’t spend time helping children with their organisation and planning.

This is a set of skills that children with acquired brain injury may struggle with.22, 23 Children might benefit from some help in drafting essays and setting out a structure as a plan.24

It can be hard for parents to know how hard their child should be pushing themselves with their schoolwork. Again, it's important to keep up a conversation with the child’s teacher(s). If your child is struggling with the volume or difficulty of homework, this may be something they can address. They may modify the homework to suit your child.24

Most parents know how well their children respond to encouragement. This may be a simple thing, but it can go a long way with children. Some children with acquired brain injury may struggle with attention, and seem distracted or over-excited as a result. Try to help your child focus on one task, and one step at a time.25

Some children are easily distracted by noise or things going on in the environment around them.26 Giving a child their own, quiet space for homework and study isn’t always possible. But if parents are able to create this kind of space at home, it may be worthwhile.27 

Try to involve your child in setting up their own study area. A weekly ‘clean-up’ of the study area can help keep things organised. It may also be worth taking the time to colour code stationery like ring binders by subject.

The emotional impact of returning to school 

Each child’s experience is different. Some children may struggle with the return to school. They may not be as able to do their schoolwork as they were before, and this may have an impact on their self-esteem.

Feeling down on themselves and their abilities may translate into bad behaviour.28, 2 likewise, difficulties with attention may make them seem easily distracted and may lead to behavioural difficulties.25

Although we had a bit of a bumpy ride, going back to school was a positive experience for Oliver, on the whole. I think it helped him feel like he was getting back into the swing of things in talking to schoolmates and teachers." Parent's experience

It can’t be stated enough that talking with teachers and the school can go a long way in helping everyone.3  The return to school is an important milestone, but it can be a trying time 30, and it’s important that parents remember to look after themselves.

Going back to school was quite difficult for us, as parents. Michaela had made brilliant progress, but she struggled with getting on with people and fitting in. I think it knocked her confidence a bit." Parent's experience

The reactions of other children

Like any aspect of acquired brain injury, the way a child is received back into a class very much depends on the individuals. Children may notice that the child with an acquired brain injury is behaving differently; they may pick up on difficulties with mobility or speech. They might spot signs such as memory loss, or that the child is struggling with conversations.31, 32

I think the other kids were baffled by Michael, in all honesty. His conversational style can seem a bit strange at first, and I wonder if the other children didn’t really know how to respond." Parent's experience

Almost every child finds the culture of ‘fitting in’ at school difficult. A child with an acquired brain injury may notice a change in the way people around them are behaving. And children with an acquired brain injury can sometimes struggle with insight. This means they may have only limited awareness of how their injury has affected them.33, 34

On the other hand, some children will be very much aware of their difficulties, and this can have an impact on their mood. Changes in their friendships and classroom alliances can be frustrating, upsetting and stressful for children.35

Again, parents should try to keep the lines of communication open with teachers and keep talking to their child about school. Our free books may help teachers and your child's class mates understand brain injury and its effects. 

Charlie was too tired to take part in after school clubs and sports. He felt very left out." Parent's experience

Talking with other children in class 

In some circumstances it may be helpful for other children to have some understanding of changes their classmate has experienced. This may form part of the preparation for your child returning to school.

After all, we know that an acquired brain injury may affect the way a child speaks with other children. We know that a child with acquired brain injury might say inappropriate things, or things that seem odd to other children. They might behave differently.36 Tiredness may mean they don’t have the energy to socialise.11

Other children in the school may not understand these difficulties. And there’s a risk that a child with acquired brain injury may become isolated from their classmates.37, 38

This means talking with their classmates can be a useful thing for a teacher to do. Talking with children about acquired brain injury demands a great deal of sensitivity and careful consideration from education professionals.

It’s important that parents are consulted about this. There are no set rules about how to go about this, partly because each set of circumstances is so different. Any conversation with a class must account for the age and understanding of the children, and must be pitched at an appropriate level.

Circle of Friends scheme

Ask your school about a Circle of Friends scheme. These schemes started in America, and are a way of trying to help children who are experiencing difficulties in school feel more included.

The idea is that teachers recruit volunteers from among the other children at the school. This ‘circle’ of children or young people will then support your child in their daily school lives. The circle meets regularly with teachers to discuss any problems they’ve had along the way and to set goals.

Children with acquired brain injury sometimes struggle with interaction with other children. A Circle of Friends scheme may help them work on the way they talk and interact with others.

Some research has suggested that the scheme helps children with difficulties in school or disabilities feel more included. It’s also thought to benefit the other children in the circle, because they’re encouraged to think about their own behaviour and take responsibility for others.

Perhaps your child’s school has experience of this kind of scheme. You can speak to your child’s teacher or the Special Educational Needs Coordinator.

Getting around 

Many children experience some form of physical difficulty following an acquired brain injury. Difficulties may include seizures, difficulty with balance, or tiredness.39

They may also have experienced difficulty in:

  • Getting around school – teachers may need to be flexible about allowing children to leave classes earlier to give them time to get around. Some schools will consider room and timetabling changes.
  • Getting to and from school – transport arrangements may need to be considered.
  • Getting around the playground.
  • After-school clubs – children may feel too tired to do anything after school and this may leave them feeling left out.11

Bullying 

Our information on bullying is used with kind permission from Contact, for families with disabled children: It was produced in May 2014.

Children sometimes respond to things they don’t understand with negativity. It’s important to remember that it isn’t only children with ABI who might experience bullying. Sometimes, siblings, friends or a child’s relatives may be bullied.

The following information has been provided by BullyingUK and Contact. BullyingUK offers support for children, parents and schools. Call the parentline on 0808 800 2222.

What is bullying?

Bullying can take place anywhere – in schools, the wider community and online. The Anti-Bullying Alliance defines bullying as "the repetitive, intentional hurting of one person by another, where the relationship involves an imbalance of power. Bullying can be carried out physically, verbally, emotionally or through cyberspace."

The Department for Education guidance defines bullying as "behaviour by an individual or group usually repeated over time, that intentionally hurts another individual or group either physically or emotionally."

How does bullying affect children in school?

Bullying can take many different forms. It can be:

  • verbal - name calling, insulting, teasing
  • physical - pushing, shoving, hitting, kicking, damage to property and belongings
  • indirect - spreading nasty stories, exclusion from friendship groups, rumour spreading
  • cyberbullying - bullying by text messages, mobile phones, email, chat forums, websites and instant messaging.

Are children with special educational needs or a disability more likely to be bullied? 

All children at some point may be subject to bullying. Children with a Special Educational Need (SEN) or disability may experience particular forms of bullying such as:

  • manipulative bullying – where a child is controlling another
  • conditional friendship – where a child thinks someone is being their friend, but friendliness alternates with bullying
  • exploitative bullying – where features of a child's condition are used to bully them.

What action should schools take to try and prevent and resolve bullying? 

Schools have a legal duty of care towards their pupils, and must act as any reasonable parent would to keep them safe. In England, the Department for Education has produced a guide called Preventing and Tackling Bullying. It contains information on the legal duties for schools and suggestions for preventing and responding to bullying. This guidance is aimed at schools but you may find it useful to have a look for ideas, especially if the school is struggling to resolve the bullying.

Schools are required to produce an anti-bullying policy which may be part of the overall behaviour policy. It must set out what the school will do to try and prevent bullying, how they will respond to bullying reports, and how they will resolve any situations that arise. You may find it useful to request a copy of the policy.

What should I do if my child is being bullied?  

  • Keep a record of times and dates of any incidents, and medical evidence if appropriate, such as a doctor's appointment card.
  • Take photos of any physical injuries.
  • Contact someone at your child's school and let them know your concerns. This could be the class teacher/form tutor, Special Educational Needs Coordinator (SENCO) or the head teacher.
  • Arrange a meeting at the school to discuss your concerns and hand over your own record of incidents.
  • Agree what action will be taken and arrange a future meeting to discuss whether the situation has changed.

How can I make a formal complaint about the bullying at my child's school? 

You may want to do this if the above steps do not help the situation. Ask for a copy of the school complaints procedure.

Make your complaint in writing, and state clearly that it is a formal complaint. List the incidents, describe the effect on your child and the steps you and the school have taken to try and sort the problem out.

Depending on the school's complaints procedure, you should address your letter to the head teacher or chair of governors. You could send the letter to the chair of governors in addition to the head teacher if you feel that the situation needs to be resolved swiftly.

If your child attends a local authority school, you may be able to complain to the local authority if the problem is not resolved by the school.

Contact produce a guide for dealing with bullying: for parents and carers of disabled children. The guide includes more detailed information regarding:

  • how to spot if your child is being bullied
  • talking to your child about bullying
  • strategies for addressing bullying
  • more suggestions for parents
  • taking further action
  • useful organisations. 

Siblings in school 

Another child (or children) in the family may go to the same school. Even if they don’t, what’s going on at home may have an enormous impact on siblings.40  We know siblings can experience:

  • Confusion about their situation41
  • Guilt42
  • Feelings of unfairness, jealousy, hostility
  • Feeling neglected42
  • Anxiety/stress43
  • A sense of loss at the sibling they had44

Some siblings may stop attending school45, 46, or will have to miss days because of their family circumstances.

Teachers can play a crucial role in supporting siblings through a difficult time. In some circumstances, children may be more comfortable talking to teaching staff than parents or friends.

It’s also important that staff at the school are aware of the strain a sibling may be under.47 Circumstances at home – which may be busy or fraught – may have an impact on a sibling’s ability to keep up with their schoolwork.

If possible, try to find somewhere quiet for the sibling to do their own schoolwork. As always, the key is in maintaining lines of communication with the school and the sibling’s teacher(s). And it’s always important to take time to talk with siblings wherever possible.

Moving from primary to secondary school 

Moving from the familiar environment of primary school to a bigger, busier secondary school can be daunting for all children. This is a move from Key Stage 2 (later primary school years) to Key Stage 3 (early secondary school years).

Children are getting to grips with finding their way around, meeting new people and new teachers. It can be an anxious time for children with acquired brain injury. There are different reasons for this.

One of the main reasons is that some of the effects of acquired brain injury can be ‘delayed’. We don’t use skills such as problem-solving and judgment until we’re older, and so it might not be obvious if a child has a difficulty with these things until they’re older.48 Sometimes, it may only become clear that a child has problems with certain skills when they have to carry out more difficult work at secondary school.49

Secondary school is tougher than primary school in other ways. In primary school, things are fairly routine and straightforward, and children don’t have to take too much responsibility for themselves. This changes in secondary school. A child may have to plan more for themselves (something children with acquired brain injury may struggle with).

The child may have to switch from one activity to another within a short space of time. These things may be difficult or distressing for children with an acquired brain injury.50, 51 But good preparation can go some way towards avoiding these difficulties.52

Most primary and secondary schools make arrangements for visits and for meeting new teachers before children start their new school. If for any reason your child misses out on this, there are some simple things you can do to help.

Tips for parents from our educational psychologist: 

  • Try visiting the new school before term with your child. Take photos of the different buildings and maybe some teachers too. If children can become familiar with the way the buildings and people look over the holidays, this may go some way towards helping them feel less overwhelmed.
  • Anything children can become familiar with before they start school is useful. If you can get hold of any material like planners or homework diaries, then your child can familiarise themselves with it first.
  • Make arrangements for your child to visit the form tutor before the new term starts.  

References

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  2. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, p36.
  3. Gore H, Wood, S (2006). Speech and language difficulties. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp152-170). Oxford: Oxford University Press.
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  6. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation. Rees SA, Skidmore D (2008). The classical classroom: enhancing learning for pupils with acquired brain injury. Journal of Research in Special Educational Needs, 2 (8) pp88-95.
  7. Middleton, JA (2001). Brain injury in children and adolescents. Advances in Psychiatric Treatment , 7, pp257-265. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  8. Special educational needs and disability code of practice: 0 to 25 years (2014). Department for Education and Department of Health. available at:https://www.gov.uk/government/uploads/system/uploads/attachment_data/fi…
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  33. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, p29. McCormick A, Curiale A, Aubut J, Weiser M, Marshall S. Paediatric interventions in acquired brain injury rehabilitation, Evidence-based Review of Moderate to Severe Acquired Brain Injury <www.abiebr.com > [consulted 15/12/11], PDF p19.
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  41. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, p53.
  42. Walker S (2009). Educational Implications of Acquired Brain Injury: a resource for educational psychologists. Brain and Spine Foundation, p53.
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  47. Savage RC, Depompei R, Tyler J, Lash M (2005) Paediatric traumatic brain injury: A review of pertinent issues. Pediatric rehabilitation, 8 (2), pp93-94.
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  49. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  50. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  51. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.
  52. Baldwin T, Demellweek C, Rankin P, Carleton F (2006). Cognitive problems. In Appleton R, Baldwin T (Eds.), Management of Brain-injured Children (pp171-222). Oxford: Oxford University Press.