Re/producing the Pediatric Concussion Discourse in clinical rehabilitation practice

Purpose In the field of pediatric concussion, little to no scholarship has examined how clinical practice is shaped by patterned ways of thinking, talking about, and coming to understand concussion and young people (or "discourses of concussion in young people"). In this paper, we examine the ways in which one such discourse, the Pediatric Concussion Discourse (PCD), shapes how young people with concussion, their parents, and clinicians can think about, act in relation to, and experience concussion. Materials and methods This critical rehabilitation research is informed by the post-structuralist theory of Michel Foucault (1926-1984), and the key concepts of power/knowledge, discourse, and the subject. Results Circulating through clinical guidelines for the management of pediatric concussion, the PCD re/produces the expectation that young people with concussion and their parents will behave as "responsible" subjects who follow the recommendations of so-called experts without question. If recommendations are not implemented, the PCD has the potential to constitute these same groups as "nonadherent", re/producing problematic discourses of medical compliance. Conclusions By examining the effects of the PCD, it becomes possible to imagine how clinical practice and research might evolve in new ways that respect the knowledges and experiences of young people with concussion and their parents.