{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T01:23:52Z","timestamp":1773969832463,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T00:00:00Z","timestamp":1719360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000155","name":"Social Sciences and Humanities Research Council of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Concussion and communication researchers have yet to study how post\u2010concussion communication changes affect youths\u2019 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To explore how youth respond to the effects of post\u2010concussion 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods &amp; Procedures<\/jats:title><jats:p>Five youths (16\u201325 years) and three family members participated in this arts\u2010based reflexive collective case study. Ecocultural theory provided the theoretical framework for study design, data collection and analysis. Cases consist of (1) pre\u2010interview demographic information, (2) three 60\u201390\u2010min virtual interviews, (3) optional family member interviews, (4) multi\u2010media arts\u2010based participant\u2010generated materials representing participants\u2019 experiences of communication change and concussion, and (5) researcher observations, discussions and reflexive journal entries. Reflexive thematic analysis was used to analyse the data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes &amp; Results<\/jats:title><jats:p>Analysis yielded four themes that illustrate the ways youth navigated and adapted to post\u2010concussion communication changes: (1) navigating changes in communication tasks, daily roles, and identity; (2) re\u2010negotiating relationships and emotional reactions; (3) seeking control and learning to let go during recovery; and (4) helping youth adapt to post\u2010concussion communication changes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Implications<\/jats:title><jats:p>The study findings deepen our understanding of the impact of post\u2010concussion communication changes on youths' daily lives and underscore considerations critical to the development of\u00a0communication\u2010focused concussion education programs and interventions tailored specifically for youth.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Youth is a critical period of social and emotional development. Communication is integral to identity, relationships, participation in daily activities and well\u2010being. Concussions can affect speech clarity, fluency, understanding and use of language, and social interactions. Re\u2010engaging in routine activities and pre\u2010injury roles can be challenging for youth experiencing communication changes as part of complex concussion recoveries.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to the existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Findings from this research illuminate how youth navigate and adapt to communication changes post\u2010concussion and support the development of youth\u2010focused communication education programs, assessments and interventions. Youth participants actively managed their recoveries by developing innovative strategies to support their communication during daily activities, learning about communication, practicing communication tasks sequentially, and facing fears. Youth also reframed and challenged narrow views of \u2018normal communication\u2019.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Findings highlight the need for more youth\u2010 and communication\u2010focused education materials and programs within youth concussion management protocols. Information about the specific ecological and sociocultural factors youth encounter during concussion recovery is needed to develop targeted communication\u2010focused education and intervention programs for youth and their families to mitigate risks of isolation, loneliness, and mental health concerns and increase youths\u2019 participation in family, community and cultural life. By learning from youth about how communication changes affected their participation in daily activities, identity and relationships, clinicians can provide information and interventions to reduce adverse listener reactions and help young people feel supported and understood.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.13082","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T07:20:56Z","timestamp":1719386456000},"page":"2294-2311","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["\u2018Do it afraid\u2019: An arts\u2010based reflexive collective case study exploring youth responses to post\u2010concussion communication changes in daily life"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7600-1451","authenticated-orcid":false,"given":"Jessica A.","family":"Harasym","sequence":"first","affiliation":[{"name":"Faculty of Rehabilitation Medicine University of Alberta  Edmonton AB Canada"},{"name":"Institute for Stuttering Treatment and Research (ISTAR), Faculty of Rehabilitation Medicine University of Alberta  Edmonton AB Canada"},{"name":"Women and Children\u2019s Health Research Institute University of Alberta  Edmonton AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2427-6277","authenticated-orcid":false,"given":"Douglas P.","family":"Gross","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Health Research Institute University of Alberta  Edmonton AB Canada"},{"name":"Department of Physical Therapy, Faculty of Rehabilitation Medicine University of Alberta  Edmonton AB Canada"},{"name":"Rehabilitation Research Centre, Faculty of Rehabilitation Medicine University of Alberta Edmonton AB Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4752-9476","authenticated-orcid":false,"given":"Andrea A. 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