“Draw It… So They Understand”: An Arts-Based Reflexive Collective Case Study Exploring How Youth Navigate (Mis)Understandings About  Communication Changes After Concussion
Creators: Harasym, Jessica A.
Publisher: name: University of Alberta Library
Year: 2023

<p>Youth is a critical phase of social, emotional and cognitive development. With perspectives and needs distinct from both children and adults, youth are underrepresented in concussion research. A concussion can drastically reshape a young person’s social roles, family dynamics and academic performance, especially when changes in communication (talking, thinking, reading, writing and interacting with others) occur. Communication is integral to a young person’s identity, relationships, participation in meaningful daily activities and social-emotional well-being. Evidence shows that concussions can put youth at risk for academic challenges, difficulty returning to work, increased social isolation, depression, and anxiety. However, the lack of attention paid to how young people respond to communication changes during concussion recovery constitutes a critical barrier to current concussion management research and practices. </p>

<p>This research explores the intersections of communication, concussion recovery and well-being while centring youths’ voices in the work. Using an ecocultural lens, focused on social and cultural dimensions of communication changes as part of youth concussion recovery experiences, I asked the following research questions:</p>

<ol>
<li> How do youth respond to the effects of post-concussion communication changes in their daily life, including (a) daily routines, (b) identity, (c) relationships, and (d) participation in school/work and community activities?<br></li>
<li> What communication and concussion values, beliefs and assumptions do youth navigate and (re)produce as they adapt to post-concussion communication changes?</li>
</ol>

<p>The research was conducted from a constructionist paradigm aligned with theories from the field of interpersonal communication, emphasizing the bi-directional, relational, dynamic and co-constructed nature of communication. An arts-based reflexive collective case study was employed to meet the study’s objectives while responding to the participants’ communication needs and strengths. Five youth participants (16-25 years) and three family members participated in the study. Arts-based research methods provided cognitive and communication support for participants during interviews, added to the richness of data generated during data collection, served as an additional source of data in the analysis, and facilitated participant-researcher reflexive dialogue and researcher reflexivity. Reflexive thematic analysis was used to generate multidimensional and nuanced themes that tell the larger story of how youth navigated and adapted to post-concussion communication changes in the context of social, ecological and cultural factors.</p>

<p>Analysis yielded themes highlighting the diverse and creative ways youth navigated changes in communication tasks, daily roles and identity while feeling different, like an observer in their own lives, isolated and “off to the side.” Misunderstandings and assumptions about communication and concussion added to the recovery burden experienced by the young people in the study. Youth navigated, resisted and reframed values, beliefs and assumptions related to normative communication, time, hard work and independence. Participants engaged in several creative and innovative strategies and practice activities in response to the communication changes and concussion symptoms they experienced. Youth described the emotional toll of negative listener reactions and feelings of fear and anxiety they experienced while attempting to present themselves as “normal communicators.” This desire to save face and avoid judgement and ridicule led some youth to avoid social situations, further contributing to feelings of isolation and reducing opportunities for support from family and friends. Youth insightfully reflected on their experiences and shared recommendations for family and friends seeking to support other young people experiencing similar communication changes after a concussion. </p>

<p>Findings have implications for researchers and clinicians in communication care and concussion management and for young people who experience communication changes after a concussion and their families, friends, educators and healthcare professionals. With a better understanding of youths’ unique experiences, parents, teachers, and service providers can tailor services to facilitate communication in the context of daily routines and meaningful activities to improve quality of life. Additionally, this work makes methodological contributions to communication sciences, where qualitative research and arts-based research methods are emerging. Through their contributions of creative participant-generated materials and interview discussions, the youth participants challenge the reader to (re)consider their (mis)understandings of communication and concussion recovery.</p>

<p>This dissertation is composed of three integrated manuscripts including one manuscript exploring the applications of arts-based research (ABR) to conduct communication research, and two empirical manuscripts that present the main research findings. Additional chapters present contextual information and provide a space for deeper personal, disciplinary and functional reflexive engagement with the topic. </p>