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Fatigue in school students with an ABI fact sheet

Fatigue in school students with an acquired brain injury

Fatigue is a problem that affects many students following a brain injury. The severity of this problem depends on many factors, including the extent of the injury. Fatigue levels usually decrease over time following the injury or illness. It is often a significant consideration when the student first returns to school but becomes less problematic over time. However, for some students, fatigue will remain an ongoing issue.
Fatigue can be divided into two types – mental and physical. These are very closely related and the student often experiences a combination of both. They are discussed separately in this section but it is important to note that they may cause similar problems and respond to similar strategies.

Mental Fatigue

What are the signs?

  • Deterioration in ability to concentrate on tasks and decreasing attention span.
  • Increasing distractibility.
  • Rubbing eyes, fidgeting, excessive yawning.
  • Deterioration in school work such as decreased accuracy, more mistakes, inability to complete tasks.
  • Decreased willingness to attempt school work.
  • Deterioration in behaviour such as decreased compliance, and increased frustration.

What can I do to help my student overcome these difficulties?

  • Change activities more frequently.
  • Organise the day so that the more demanding work is scheduled for morning classes.
  • Organise activities so that more relaxing/restful activities occur after activities that are physically or cognitively demanding.
  • Carefully grade the return to school from part-time to full-time as fatigue improves.
  • Develop strategies for dealing with the student once they are fatigued such as a break from the activity for the student to run an errand.
  • Allow increased time for exams or break exams into shorter sections with rests in between each section.

Physical Fatigue

What are the signs?

  • An inability to walk between classrooms without a rest or physical assistance.
  • A deterioration in their physical skills during the day. For example, the student may drag his /her feet or trip over more often toward the end of the day, or handwriting may become increasingly messy or slower during the day.
  • Decreased balance which may make the student less safe with mobility.
  • Decreased balance which may make the student less safe with mobility.
  • Increased tone or stiffness in muscles.
  • A deterioration in posture e.g. the student may slump more in their seat.
  • An increase in related medical symptoms such as headaches and dizziness.
  • Difficulty concentrating in class or increasing distractibility.
  • Deterioration in behaviour or compliance.

What can I do to help my student overcome these difficulties?

  • Give the student plenty of rests, especially during or after physical activities.
  • Identify times during the day when fatigue is most evident and consider modifying activities at that time of day.
  • When the student is fatigued, use orthoses or any other adaptive equipment to make tasks easier.
  • Use the student’s wheelchair to go long distances.
  • Develop a strategy to use when fatigue is noticeable. For example, allow the student to go to a quiet area in the classroom for 5 – 10 minutes.

Fatigue can be a very significant issue for attendance at school and participation in the educational program. Strategies aimed at minimising the effects of fatigue and dealing with the student who is fatigued need to be discussed with the family so that everyone is following the same plan. The student’s therapists can give assistance in developing these strategies if desired.

Contact us

Queensland Paediatric Rehabilitation Service
Queensland Children’s Hospital
Level 6, 501 Stanley Street, South Brisbane 4101
t: 07 3068 2950
t: 07 3068 1111 (general enquiries)
f: 07 3068 3909

In an emergency, always call 000.

If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.

Developed by the Queensland Paediatric Rehabilitation Service, Children’s Health Queensland. Updated: October 2017. All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.