Social support during youth concussion recovery

Figures & data

Table 1. Specific examples of valuable and meaningful support from close friends.

Specific actions	Examples of specific actions given by participants	Example quotes
Build a sense of social inclusion and highlight youth’s access to a support network	Checking in (texting, phone calls) that express youth are missed or provide updates on social life and school Visiting them at home	P10: I really enjoyed the surprise visit because I didn’t know they were coming over after basketball […] They wanted to see me and I thought that was really nice. … I am a really social person. I love being with my friends it’s always the best feeling to be around people that you trust and care about and when they came to my house I was just so happy […] ‘cuz yeah I didn’t really see that many people when I was at home like just my parents and my dogs.
Communicate understanding about limitations and build a sense of solidarity when accessing support	Genuinely asking youth about their specific needs and following up Validating youths need for rest, social support and school accommodations Asking about their limitations (e.g. difficulties in loud and busy environments) and planning social activities that consider youth’s limitations Helping youth advocate for their needs (e.g. joining them when talking to a teacher about accommodations) Standing up for youth when peers call them “fakers”	P07: She did meet up with me a couple times for dinner just to see how I was doing, and she would be mindful that I didn’t like crowded places. Like before my concussion I loved going to the mall and like really outgoing: And then after the concussion I was more reserved maybe it was like for that few months that I was detached from everyone that like I didn’t feel comfortable leaving the house anymore, so she would be pretty mindful about places we’d go to eat, and it meant a lot to me I guess.
Help with managing school	Sharing notes Carrying books between classes Taking on more work in a group project	P01: We were doing a really big project for school at the time and I was in a group of five people including myself. They all understood that with this concussion things might be a little slower and I might get less work done than usual and they were completely accommodating with that. They helped me out, they corrected some of my work more than they normally would. They were great and that really helped.

Table 2. Supportive actions best provided by peers with previous history of concussion.

Specific actions	Example quotes
Communicate understanding and empathize better with youth	P09: I have some friends at school that um had a concussion in high-school and they had to miss some, I think one of them had to miss an exam and she was like “oh yeah I know what you’re going through and it’s not easy and stuff like that” and so she was really helpful.
Share validating stories	P08: It was nice to be able to like talk to the other kids cause they went through the same thing too, and an interesting thing was schools not understanding how to support it and you know there’s so much work to do and it’s really difficult.
Anticipate and meet post-concussion needs	P01: Um with someone who didn’t have the experience it was more, it was awkward, and it was a lot more forced and ‘cuz they didn’t fully understand the situation […] things were a lot more robotic almost. It was like they had read up on something online like “this is what I am supposed to do” and then they did it, with my friend she um, she knew what it had felt like and she was able to kind of create the environment that she personally wanted when she had her concussion.

Table 3. Specific examples of valuable and meaningful support from parents.

Specific actions	Examples of specific actions given by participants	Example quotes
Provide access to healthcare and concussion resources	Finding concussion resources Scheduling health care appointments Transporting to appointments	P04: My mom was the most involved in the whole situation […] she would tell me what to say if I should schedule a meeting or whatever […]my mom was the most involved with her research, and coming to [hospital name].
Leverage credibility in school-based settings to advocate for accommodations	Managing communication with school administrators and teachers Advocating for accommodations if not initially provided	P08: [My mom] would call [saying] “listen this is ridiculous she’s doing her best she’s trying really hard I don’t get why [she] is not getting extra time”.
Mitigate concerns about academic challenges	Express an understanding of academic difficulties Allow youth to stay home from school when they are struggling Encourage a step-wise return to school and reassure youth it is okay to prioritize their health	P09: I wanted to go back to school full time […] I didn’t want to fall behind or draw extra attention to myself … and then my parents being supportive of me missing school for my health reasons was really good because I know a lot of other people’s parents are like “No school is what’s important I want you to be getting these marks on these tests”.