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Re/producing the Pediatric Concussion Discourse in clinical rehabilitation practice.

Katie Mah1,2, Brenda Gladstone3,4, Deb Cameron5

  • 1Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.

Disability and Rehabilitation
|November 11, 2021
PubMed
Summary

The Pediatric Concussion Discourse (PCD) shapes clinical practice by expecting young patients and parents to comply with expert advice. This can lead to labeling non-adherent individuals, impacting pediatric concussion management.

Keywords:
FoucaultYoung peopleconcussioncritical social theorydiscoursepediatric

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Area of Science:

  • Rehabilitation research
  • Clinical practice
  • Pediatric concussion management

Background:

  • Limited scholarship exists on how thinking and talking about pediatric concussion influences clinical practice.
  • This study examines the "Pediatric Concussion Discourse" (PCD) and its impact on understanding concussion in young people.
  • The research is grounded in post-structuralist theory, utilizing concepts like power/knowledge and discourse.

Purpose of the Study:

  • To critically examine the Pediatric Concussion Discourse (PCD).
  • To understand how the PCD shapes the experiences of young people with concussion, their parents, and clinicians.
  • To explore how the PCD influences perceptions of responsibility and adherence in pediatric concussion management.

Main Methods:

  • Critical rehabilitation research informed by Foucault's theories.
  • Analysis of discourses surrounding pediatric concussion.
  • Examination of clinical guidelines and their underlying assumptions.

Main Results:

  • The PCD promotes an expectation of "responsible" subject behavior from young patients and parents, emphasizing unquestioning adherence to expert recommendations.
  • Failure to comply with recommendations can result in labeling patients and parents as "nonadherent," perpetuating problematic medical compliance discourses.
  • The discourse influences how concussion is understood, experienced, and managed in clinical settings.

Conclusions:

  • Examining the PCD's effects allows for reimagining clinical practice and research.
  • Future clinical practice should prioritize supportive therapeutic relationships that respect the knowledge and experiences of young people with concussion and their parents.
  • Rehabilitation research should engage with critical scholarship, pursue educational opportunities, and foster communities of practice.