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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.