Dove and hawk profiles in youth concussion: Rethinking occupational performance.

BACKGROUND: Youth concussion and its subsequent recovery have been described as heterogeneous; no one injury is the same, and each youth is different in how he or she recovers.

PURPOSE: This paper proposes a theoretical perspective on the management of youth with persistent concussion symptoms.

KEY ISSUES: When managing concussion within youth, further consideration of person, occupation, and environment factors may provide insight on (a) the differential spectrum of profiles that exist among youth who have experienced a concussion and (b) how these profiles can support client-centred rehabilitation. Passive-dove and active-hawk stress profiles from evolutionary literature will be used to contextualize return to occupational performance. An innovative, novel model-the Dove-Hawk Model of Allostatic Load for Youth With Persistent Concussion Symptoms-is proposed to illustrate these concepts, and approaches to rehabilitation across the spectrum of profiles are offered.

IMPLICATIONS: Viewing persistent youth concussion recovery in this way may elucidate different approaches to client-centred rehabilitation.