Exploring meaning structures among adolescents with traumatic brain injury

Traumatic brain injury (TBI) is caused by trauma to the head and is one of the most frequent causes of acquired disability in children and adolescents. This article explores meaning structures and action reasons among four adolescents after TBI and potentials for transcending marginal positions and expanding agency. The theoretical framework for the analyses understands TBI as a condition or as "cause-effect" relations from an external standpoint, i.e. relations obtained by neuropsychological examinations at the individual level. These "cause-effect" relations are understood in dialectical relation to the adolescents' meaning structures, and this dialectical relation constitutes agency in interplay with social practice in and between contexts. Agency is thus understood as moveable in and through the particular contexts relying on this dialectic relation. The findings show that the adolescents had individual struggles and subjective reasons for action. Not to dare emerged as central to the adolescents' action reasons. However, when the adolescents felt confident and part of a we, this represented potentials for transcending marginal positions and expanding agency. The adolescents had a contextual and intersubjective dimension to their understanding of themselves and others. Their personal relations to the joint contextual practices, arrangements and relationships influenced how they participated and from which positions. The acknowledgement of what counts as agency after TBI seems to rely on qualifications, as assessed by neuropsychological examinations, and on particular kinds of contexts in relation to which it is possible for the adolescents to make up sufficient personal preconditions for participation.