Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-24T13:35:06.321Z Has data issue: false hasContentIssue false
  • English
  • Français

Thinking Otherwise: Bringing Young People into Pediatric Concussion Clinical and Research Practice

Published online by Cambridge University Press:  29 November 2021

Katie Mah ,
Brenda Gladstone ,
Deb Cameron  and
Nick Reed
Katie Mah*
Affiliation:
School of Occupational Therapy, Western University, London, Ontario, Canada
Brenda Gladstone
Affiliation:
Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada Centre for Critical Qualitative Health Research, University of Toronto, Toronto, Ontario, Canada
Deb Cameron
Affiliation:
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
Nick Reed
Affiliation:
Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
*
*Corresponding author. Email: [email protected]
Get access

Abstract

Background:

As rates of pediatric concussion have steadily risen, and concerns regarding its consequences have emerged, pediatric concussion has received increased attention in research and clinical spheres. Accordingly, there has been a commitment to determine how best to prevent and manage this injury that so commonly affects young people. Despite this increased attention, and proliferation of research, pediatric concussion as a concept has rarely, if ever, been taken up and questioned. That is, little attention has been directed toward understanding what concussion ‘is’, or how young people are regarded in relation to it. As a result, pediatric concussion is understood in decidedly narrow terms, constructed as such by a biomedical way of knowing.

Aim:

We aim to demonstrate how conceptualizing concussion, and young people, ‘otherwise’, enabled the co-production of a more nuanced and complex understanding of the experience of pediatric concussion from the perspective of young people.

Approach:

Drawing on an illustrative case example from a critical qualitative arts-based study, we demonstrate how bringing young people into research as ‘knowers’ enabled us to generate much-needed knowledge about concussion in young people.

Implications:

The critical thinking put forward in this paper suggests a different approach to pediatric concussion, which is shared in the form of implications for clinical and research practice.

Keywords

Young peopleconcussioncritical social theorydiscourseFoucault
Type
Original Article
Information
Brain Impairment , Volume 23 , Special Issue 1: Humanising Connections: Bringing people together in rehabilitation , March 2022 , pp. 104 - 117
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Allen, D., & Cloyes, K. (2005). The language of “experience” in nursing research. Nursing Inquiry, 12(2), 98–105. doi: 10.1111/j.1440-1800.2005.00259.x CrossRefGoogle Scholar
Armstrong, D. (2009). Commentary: Indeterminate sick-men--a commentary on Jewson’s “Disappearance of the sick-man from medical cosmology”. International Journal of Epidemiology, 38(3), 642–645. doi: 10.1093/ije/dyp184 CrossRefGoogle Scholar
Belsey, C. (2003). Poststructuralism: A very short introduction. New York, NY: Oxford University Press.Google Scholar
Birks, M., Chapman, Y., & Francis, K. (2008). Memoing in qualitative research: Probing data and processes. Journal of Research in Nursing, 13(1), 68–75. doi: 10.1177/1744987107081254 CrossRefGoogle Scholar
Boylan, A.-M., Linden, M., & Alderdice, F. (2009). Interviewing children with acquired brain injury (ABI). Journal of Early Childhood Research, 7(3), 264–282. doi: 10.1177/1476718X09336970 CrossRefGoogle Scholar
Brady, G., Lowe, P., & Olin Lauritzen, S. (2015). Connecting a sociology of childhood perspective with the study of child health, illness and wellbeing: Introduction. Sociology of Health & Illness, 37(2), 173–183. doi: 10.1111/1467-9566.12260 CrossRefGoogle Scholar
Brett, B. L., Kuhn, A. W., Yengo-Kahn, A. M., Solomon, G. S., & Zuckerman, S. L. (2018). Risk factors associated with sustaining a sport-related concussion: An initial synthesis study of 12,320 student-athletes. Archives of Clinical Neuropsychology, 33(8), 984–992. doi: 10.1093/arclin/acy006 CrossRefGoogle ScholarPubMed
Clair, R., Levin Allen, S., Goodman, A., & McCloskey, G. (2020). Gender differences in quality of life and symptom expression during recovery from concussion. Applied Neuropsychology: Child, 9(3), 206–214. doi: 10.1080/21622965.2018.1556102 CrossRefGoogle ScholarPubMed
Clark, A., & Statham, J. (2005). Listening to young children: Experts in their own lives. Adoption & Fostering, 29(1), 45–56. doi: 10.1177/030857590502900106 CrossRefGoogle Scholar
Coffey, A., & Atkinson, P. (1996). Concepts and coding. In Coffey, A. & Atkinson, P. (Eds.), Making sense of qualitative data (pp. 26–53), Thousand Oaks, CA: SAGE Publications.Google Scholar
Covassin, T., Elbin, R. J., Beidler, E., LaFevor, M., & Kontos, A. P. (2017). A review of psychological issues that may be associated with a sport-related concussion in youth and collegiate athletes. Sport, Exercise, and Performance Psychology, 6(3), 220–229. doi: 10.1037/spy0000105 CrossRefGoogle Scholar
Eakin, J., Robertson, A., Poland, B., Coburn, D., & Edwards, R. (1996). Towards a critical social science perspective on health promotion research. Health Promotion International, 11(2), 157–165.CrossRefGoogle Scholar
Eakin, J. M. (2016). Educating critical qualitative health researchers in the land of the randomized controlled trial. Qualitative Inquiry, 22(2), 107–118. doi: 10.1177/1077800415617207 CrossRefGoogle Scholar
Eakin, J. M., & Gladstone, B. (2020). Value-adding, analysis: Doing more with qualitative data. International Journal of Qualitative Methods, 19, 160940692094933. doi: 10.1177/1609406920949333 CrossRefGoogle Scholar
Einarsdottir, J., Dockett, S., & Perry, B. (2009). Making meaning: Children’s perspectives expressed through drawings. Early Child Development and Care, 179(2), 217–232. doi: 10.1080/03004430802666999 CrossRefGoogle Scholar
Eldén, S. (2013). Inviting the messy: Drawing methods and ‘children’s voices. Childhood-a Global Journal of Child Research, 20(1), 66–81. doi: 10.1177/0907568212447243 CrossRefGoogle Scholar
Foucault, M. (1971). Orders of discourse. Social Science Information, 10(2), 7–30. doi: 10.1177/053901847101000201 CrossRefGoogle Scholar
Foucault, M. (1980). Power/knowledge. New York, NY: Vintage Books.Google Scholar
Foucault, M. (1982a). The archaeology of knowledge. New York, NY: Pantheon Books.Google Scholar
Foucault, M. (1982b). The subject and power. In Dreyfus, H. L. & Rabinow, P. (Eds.), Michel Foucault: Beyond structuralism and hermeneutics (pp. 208–226), Chicago, IL: University of Chicago.Google Scholar
Funk, L. M., & Stajduhar, K. I. (2009). Interviewing family caregivers: Implications of the caregiving context for the research interview. Qualitative Health Research, 19(6), 859–867. doi: 10.1177/1049732309334105 CrossRefGoogle ScholarPubMed
Gibson, B. E. (2016). rehabilitation: A post-critical approach. Boca Raton, FL: CRC Press.CrossRefGoogle Scholar
Gibson, B. E., Nixon, S. A., & Nicholls, D. A. (2010). Critical reflections on the physiotherapy profession in Canada. Physiotherapy Canada, 62(2), 98–100. doi: 10.3138/physio.62.2.98 CrossRefGoogle ScholarPubMed
Gillie, B. L., Fazio-Sumrok, V., Eagle, S. R., Kegel, N., Trbovich, A. M., Collins, M. W., & Kontos, A. P. (2020). Clinical predictors of post-injury anxiety in adolescent patients following concussion. Applied Neuropsychology: Child, 16(4), 1–7. doi: 10.1080/21622965.2020.1799790 Google Scholar
Gioia, G. A. (2015). Multimodal evaluation and management of children with concussion: Using our heads and available evidence. Brain Injury, 29(2), 195–206. doi: 10.3109/02699052.2014.965210 CrossRefGoogle Scholar
Gladstone, B. M. (2015). Thinking about children of parents with mental illnesses as a form of intergenerational dialogue and practice. In Reupert, A., Maybery, D., Nicholson, J., Gopfert, M. & Seeman, M. V. (Eds.), Parental psychiatric disorder (pp. 85–95), Cambridge, UK: Cambridge University Press. doi: 10.1017/CBO9781107707559.010 CrossRefGoogle Scholar
Green, J., & Thorogood, N. (2018). Qualitative methods for health research (4th ed.). Thousand Oaks, CA: SAGE Publications.Google Scholar
Grover, S. (2004). Why won’t they listen to us?: On giving power and voice to children participating in social research. Childhood-a Global Journal of Child Research, 11(1), 81–93. doi: 10.1177/0907568204040186 CrossRefGoogle Scholar
Guillemin, M. (2004a). Understanding illness: Using drawings as a research method. Qualitative Health Research, 14(2), 272–289. doi: 10.1177/1049732303260445 CrossRefGoogle ScholarPubMed
Guillemin, M. (2004b). Embodying heart disease through drawings. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 8(2), 223–239. doi: 10.1177/1363459304041071 CrossRefGoogle ScholarPubMed
Hahn, R.A., & Kleinman, A. (1983). Biomedical practice and anthropological theory: Framework and directions. Annual Review of Anthropology, 12, 305–333.CrossRefGoogle Scholar
Hammell, K. W. (2006). Perspectives on disability & rehabilitation: Contesting assumptions, challenging practice. London, UK: Churchill Livingstone.Google Scholar
Harrison, E. A. (2014). The first concussion crisis: Head injury and evidence in early American football. American Journal of Public Health, 104(5), 822–833. doi: 10.2105/AJPH.2013.301840 CrossRefGoogle ScholarPubMed
Hartman, L. R., Tibbles, A., Paniccia, A., & Lindsay, S. (2015). A qualitative synthesis of families’ and students’ hospital-to-school transition experiences following acquired brain injury. Global Qualitative Nursing Research, 2, 233339361561430. doi: 10.1177/2333393615614307 CrossRefGoogle ScholarPubMed
Holmes, D., Murray, S. J., Perron, A., & Rail, G. (2006). Deconstructing the evidence-based discourse in health sciences: Truth, power and fascism. International Journal of Evidence-Based Healthcare, 4(3), 180–186. doi: 10.1111/j.1479-6988.2006.00041.x Google ScholarPubMed
Iverson, G. L., Gardner, A. J., Terry, D. P., Ponsford, J. L., Sills, A. K., Broshek, D. K., & Solomon, G. S. (2017). Predictors of clinical recovery from concussion: A systematic review. British Journal of Sports Medicine, 51(12), 941–948. doi: 10.1136/bjsports-2017-097729 CrossRefGoogle ScholarPubMed
James, A., & James, A. (2012). Key concepts in childhood studies. Thousand Oaks, CA: SAGE Publications, 10.4135/9781526435613 CrossRefGoogle Scholar
James, A., Jenks, C., & Prout, A. (1998). Theorizing childhood. New York, NY: Polity Press.Google Scholar
James, A., & Prout, A. Eds (1997). Constructing and reconstructing childhood: Contemporary issues in the sociological study of childhood. London, UK: Falmer Press.Google Scholar
Jewson, N. D. (1976). The disappearance of the sick-man from medical cosmology, 1770-1870. Sociology-the Journal of The British Sociological Association, 10(2), 225–244. doi: 10.1177/003803857601000202 Google Scholar
Kincheloe, J. L., & Mclaren, P. (2011). Rethinking critical theory and qualitative research. In Hayes, K., Steinberg, S. R., & Tobin, K. (Eds.), Key works in critical pedagogy (pp. 285–326), Rotterdam, NL: Sense Publishers.CrossRefGoogle Scholar
Kortesluoma, R.-L., Hentinen, M., & Nikkonen, M. (2003). Conducting a qualitative child interview: Methodological considerations. Journal of Advanced Nursing, 42(5), 434–441.CrossRefGoogle ScholarPubMed
Kroshus, E., Qu, P., Chrisman, S. P. D., Schwien, C., Herring, S. A., & Rivara, F. P. (2019). Parental concern about concussion risk for their children. Social Science & Medicine, 222, 359–366. doi: 10.1016/j.socscimed.2018.12.037 CrossRefGoogle ScholarPubMed
Kvale, S. (1996). The plurality of interpretations. In Kvale, S. (Ed.), InterViews: An introduction to qualitative research interviewing (pp. 210–228), Thousand Oaks, CA: SAGE Publications.Google Scholar
Lincoln, Y. S., Lynham, S. A., & Guba, E. G. (2011). Paradigmatic controversies, contradictions, and emerging confluences, revisited. In Denzin, N. K. & Lincoln, Y. S. (Eds.), The SAGE handbook of qualitative research (4th ed., pp. 97–128), Thousand Oaks, CA: SAGE Publications.Google Scholar
Literat, I. (2013). A pencil for your thoughts”: Participatory drawing as a visual research method with children and youth. International Journal of Qualitative Methods, 12(1), 84–98. doi: 10.1177/160940691301200143 CrossRefGoogle Scholar
Lumba-Brown, A., Yeates, K. O., Sarmiento, K., Breiding, M. J., Haegerich, T. M., Gioia, G. A., …Timmons, S. D. (2018a). Centers for Disease Control and Prevention Guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatrics, 172(11), e182853. doi: 10.1001/jamapediatrics.2018.2853 CrossRefGoogle ScholarPubMed
Lumba-Brown, A., Yeates, K. O., Sarmiento, K., Breiding, M. J., Haegerich, T. M., Gioia, G. A., …Timmons, S. D. (2018b). Diagnosis and management of mild traumatic brain injury in children: A systematic review. JAMA Pediatrics, 172(11), e182847. doi: 10.1001/jamapediatrics.2018.2847 CrossRefGoogle ScholarPubMed
Lupton, D. (2013). Risk (2nd ed.). Abingdon, UK: Routledge.CrossRefGoogle Scholar
Mah, K. (2021). “Freaked out” by pediatric concussion: An exploration of drawing and interview data produced by children ‘at risk’ of and living with concussion . Doctoral dissertation, University of Toronto, Toronto, Canada. 28152168. ProQuest Dissertations Publishing,Google Scholar
Mah, K., Gladstone, B., King, G., Reed, N., & Hartman, L. R. (2020). Researching experiences of childhood brain injury: Co-constructing knowledge with children through arts-based research methods. Disability and Rehabilitation, 42(20), 2967–2976. doi: 10.1080/09638288.2019.1574916 CrossRefGoogle ScholarPubMed
Mantey, D. S., Omega-Njemnobi, O., Barroso, C. S., & Kelder, S. H. (2020). Self-reported history of concussions is associated with risk factors for suicide completion among high school students. Journal of Affective Disorders, 263, 684–691. doi: 10.1016/j.jad.2019.11.047 CrossRefGoogle ScholarPubMed
Mathieu, F., Ellis, M. J., & Tator, C. H. (2018). Concussion education in Canadian medical schools: A 5 year follow-up survey. BMC Medical Education, 18(1), 316. doi: 10.1186/s12909-018-1416-7 CrossRefGoogle ScholarPubMed
McCrea, M., & Manley, G. (2018). State of the science on pediatric mild traumatic brain injury: Progress toward clinical translation. JAMA Pediatrics, 172(11), e182846. doi: 10.1001/jamapediatrics.2018.2846 CrossRefGoogle Scholar
Miles, M. B., & Huberman, A. M. (1994). Early steps in analysis. In Miles, M. B. & Huberman, A. M. (Eds.), Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks, CA: SAGE Publications.Google Scholar
Mills, S. (2004). Discourse: A new critical idiom (2nd ed.). Abingdon, UK: Routledge.CrossRefGoogle Scholar
Minney, M. J., Roberts, R. M., Mathias, J. L., Raftos, J., & Kochar, A. (2019). Service and support needs following pediatric brain injury: Perspectives of children with mild traumatic brain injury and their parents. Brain Injury, 33(2), 168–182. doi: 10.1080/02699052.2018.1540794 CrossRefGoogle ScholarPubMed
Mitchell, C., Theron, L., Stuart, J., Smith, A., & Campbell, Z. (2011). Drawing as research method. In Theron, L., Mitchell, C., Ann, S. & Stuart, J. (Eds.), Picturing research: Drawing as visual methodology (pp. 19–36), Rotterdam: Sense Publishers.CrossRefGoogle Scholar
Morrow, V. (2008). Ethical dilemmas in research with children and young people about their social environments. Children’s Geographies, 6(1), 49–61. doi: 10.1080/14733280701791918 CrossRefGoogle Scholar
Nixon, S. A., Yeung, E., Shaw, J. A., Kuper, A., & Gibson, B. E. (2017). Seven-step framework for critical analysis and its application in the field of physical therapy. Physical Therapy, 97(2), 249–257. doi: 10.2522/ptj.20160149 CrossRefGoogle ScholarPubMed
Packer, M. (2010). The science of qualitative research. Cambridge, UK: Cambridge University Press, 10.1017/CBO9780511779947 CrossRefGoogle Scholar
Patton, M. Q. (2002). Qualitative designs and data collection. In Patton, M. Q. (Ed.), Qualitative research & evaluation methods (3rd ed., pp. 207–255), Thousand Oaks, CA: SAGE Publications.Google Scholar
Phelan, S. K. (2011). Constructions of disability: A call for critical reflexivity in occupational therapy. Canadian Journal of Occupational Therapy, 78(3), 164–172. doi: 10.2182/cjot.2011.78.3.4 CrossRefGoogle Scholar
Punch, S. (2020). Why have generational orderings been marginalised in the social sciences including childhood studies? Children’s Geographies, 18(2), 128–140. doi: 10.1080/14733285.2019.1630716 CrossRefGoogle Scholar
Qvortrup, J. (1985). Placing children in the division of labour. In Close, P. & Collins, R. (Eds.), Family and economy in modern society. London, UK: Macmillan Publishers.Google Scholar
Ramcharan, P., & Cutcliffe, J. R. (2001). Judging the ethics of qualitative research: Considering the ‘ethics as process’ model: Ethics and qualitative research. Health & Social Care in the Community, 9(6), 358–366. doi: 10.1046/j.1365-2524.2001.00323.x CrossRefGoogle Scholar
Reed, N., Zemek, R., Dawson, J., Ledoux, A. A., Provvidenza, C., Paniccia, M., … Yeates, K. (2019, Living guideline for diagnosing and managing pediatric concussion, Toronto, ON: Ontario Neurotrauma Foundation,Google Scholar
Rose, G. (2016). Visual methodologies: An introduction to researching with visual materials (4th ed.). Thousand Oaks, CA: SAGE Publications.Google Scholar
Rosen, R., & Faircloth, C. (2020). Adult-child relations in neoliberal times: Insights from a dialogue across childhood and parenting culture studies. Families, Relationships and Societies, 9(1), 7–22. doi: 10.1332/204674319X15764492732806 CrossRefGoogle Scholar
Sandelowski, M. (1995). Sample size in qualitative research. Research in Nursing & Health, 18(2), 179–183. doi: 10.1002/nur.4770180211 CrossRefGoogle ScholarPubMed
Schmidt, J. D., Rizzone, K., Hoffman, N. L., Weber, M. L., Jones, C., Bazarian, J., … Svoboda, S. J. (2018). Age at first concussion influences the number of subsequent concussions. Pediatric Neurology, 81, 19–24. doi: 10.1016/j.pediatrneurol.2017.12.017 CrossRefGoogle ScholarPubMed
Schwandt, T. A. (2015). Post-structuralism. In Schwandt, T. A. (Ed.), The SAGE dictionary of qualitative inquiry (4th ed.). Thousand Oaks, CA: SAGE Publications.Google Scholar
Spyrou, S. (2017). Time to decenter childhood? Childhood-a Global Journal of Child Research, 24(4), 433–437. doi: 10.1177/0907568217725936 CrossRefGoogle Scholar
Tay-Lim, J., & Lim, S. (2013). Privileging younger children’s voices in research: Use of drawings and a co-construction process. International Journal of Qualitative Methods, 12(1), 65–83. doi: 10.1177/160940691301200135 CrossRefGoogle Scholar
Ulvik, O. S. (2015). Talking with children: Professional conversations in a participation perspective. Qualitative Social Work: Research and Practice, 14(2), 193–208. doi: 10.1177/1473325014526923 CrossRefGoogle Scholar
Vanderbeck, R. M., & Worth, N. (2015). Intergenerational space. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&db=nlabk&AN=1001874.CrossRefGoogle Scholar
Wiebe, D. J., Comstock, R. D., & Nance, M. L. (2011). Concussion research: A public health priority. Injury Prevention, 17(1), 69–70. doi: 10.1136/ip.2010.031211 CrossRefGoogle ScholarPubMed
Wyness, M. (2013). Children’s participation and intergenerational dialogue: Bringing adults back into the analysis. Childhood-a Global Journal of Child Research, 20(4), 429–442. doi: 10.1177/0907568212459775 CrossRefGoogle Scholar
Yates, S., & Hiles, D. (2010). Towards a “critical ontology of ourselves”?: Foucault, subjectivity and discourse analysis. Theory & Psychology, 20(1), 52–75. doi: 10.1177/0959354309345647 CrossRefGoogle Scholar
Zemek, R., Clarkin, C., Farion, K. J., Vassilyadi, M., Anderson, P., Irish, B., …Osmond, M. H. (2013). Parental anxiety at initial acute presentation is not associated with prolonged symptoms following pediatric concussion. Academic Emergency Medicine, 20(10), 1041–1049. doi: 10.1111/acem.12220,CrossRefGoogle Scholar
Zemek, R. L., Grool, A. M., Rodriguez Duque, D., DeMatteo, C., Rothman, L., Benchimol, E. I., …Macpherson, A. K. (2017). Annual and seasonal trends in ambulatory visits for pediatric concussion in Ontario between 2003 and 2013. The Journal of Pediatrics, 181, 222–228.e2. doi: 10.1016/j.jpeds.2016.10.067,CrossRefGoogle ScholarPubMed