‘Do it afraid’: An arts‐based reflexive collective case study exploring youth responses to post‐concussion communication changes in daily life

• Published in: International journal of language & communication disorders 2024-11, Vol.59 (6), p.2294-2311
• Main Authors: Harasym, Jessica A., Gross, Douglas P., MacLeod, Andrea A. N., Phelan, Shanon K.
• Format: Article
• Language: English
• Subjects: Activities of Daily Living - psychology; Adolescent; Adult; arts‐based qualitative research; Brain Concussion - complications; Brain Concussion - psychology; Brain Concussion - rehabilitation; Case studies; Communication; Concussion; Data collection; Discourse strategies; ecocultural theory; Education; Emotions; Families & family life; Family - psychology; Female; Fluency; Humans; Interpersonal Relations; Interviews; Male; mild traumatic brain injury; Participation; post‐concussion symptoms; reflexive thematic analysis; Reflexivity; Well being; Young Adult; Youth
• ISSN: 1368-2822; 1460-6984; 1460-6984
• DOI: 10.1111/1460-6984.13082

Background Concussion and communication researchers have yet to study how post‐concussion communication changes affect youths’ daily lives. The lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a significant gap in current concussion management research and practices. Aims To explore how youth respond to the effects of post‐concussion communication changes in their daily life, including (1) daily routines, (2) relationships with family members, (3) relationships with peers and (4) participation in school/work and community activities. Methods & Procedures Five youths (16–25 years) and three family members participated in this arts‐based reflexive collective case study. Ecocultural theory provided the theoretical framework for study design, data collection and analysis. Cases consist of (1) pre‐interview demographic information, (2) three 60–90‐min virtual interviews, (3) optional family member interviews, (4) multi‐media arts‐based participant‐generated materials representing participants’ experiences of communication change and concussion, and (5) researcher observations, discussions and reflexive journal entries. Reflexive thematic analysis was used to analyse the data. Outcomes & Results Analysis yielded four themes that illustrate the ways youth navigated and adapted to post‐concussion communication changes: (1) navigating changes in communication tasks, daily roles, and identity; (2) re‐negotiating relationships and emotional reactions; (3) seeking control and learning to let go during recovery; and (4) helping youth adapt to post‐concussion communication changes. Conclusions & Implications The study findings deepen our understanding of the impact of post‐concussion communication changes on youths' daily lives and underscore considerations critical to the development of communication‐focused concussion education programs and interventions tailored specifically for youth. What this paper adds What is already known on the subject Youth is a critical period of social and emotional development. Communication is integral to identity, relationships, participation in daily activities and well‐being. Concussions can affect speech clarity, fluency, understanding and use of language, and social interactions. Re‐engaging in routine activities and pre‐injury roles can be challenging for youth experiencing communication changes as part of complex concussion recoveries. What this paper adds to the exi