School Psychologists’ Knowledge and Self-Efficacy in Working with Students with TBI

Abstract

Approximately 145,000 U.S. children experience lasting effects of traumatic brain injury (TBI) that manifest in social, behavioural, physical, and cognitive challenges in the school setting. School psychologists have an essential role in identifying students who need support and in determining eligibility under the Individuals with Disabilities Education Act. The purpose of this study was to assess the knowledge and perception of abilities related to TBI in a sample of school psychologists currently working in public schools. We surveyed school psychologists and found persistently low levels of knowledge and of perceived preparedness to work with these students. School psychologists with more experience working with students with TBI rated themselves significantly higher on their perceived ability to perform nearly all key duties of a school psychologist. To meet the academic and behavioural needs of students with TBI, all school psychologists need effective training in working with and evaluating students with TBI. ISSN 1918-5227 Pages 94109 This work was supported in part by grant #H133B090010 made by the National Institute on Disability and Rehabilitation Research to the Cincinnati Children’s Hospital Medical Center and the University of Oregon. The authors thank Elizabeth Backus, Laura Beck, and Jeff Gau for their assistance in the preparation of this manuscript. Follow this and additional works at: https://ir.lib.uwo.ca/eei Part of the Other Teacher Education and Professional Development Commons Recommended Citation Glang, A. E., McCart, M., Moore, C. L., & Davies, S. (2018) School Psychologists’ Knowledge and SelfEfficacy in Working with Students with TBI. Exceptionality Education International, 27, 94-109. Retrieved from https://ir.lib.uwo.ca/eei/vol27/iss2/5 This Article Open Access after 1 year is brought to you by Scholarship@Western. It has been accepted for inclusion in Exceptionality Education International by an authorized administrator of Scholarship@Western. For more information, please contact jspecht@uwo.ca. School Psychologists’ Knowledge and Self-Efficacy in Working with Students with TBI Cover Page Footnote This work was supported in part by grant #H133B090010 made by the National Institute on Disability and Rehabilitation Research to the Cincinnati Children’s Hospital Medical Center and the University of Oregon. The authors thank Elizabeth Backus, Laura Beck, and Jeff Gau for their assistance in the preparation of this manuscript. This article open access after 1 year is available in Exceptionality Education International: https://ir.lib.uwo.ca/eei/ vol27/iss2/5 Exceptionality Education International 2017, Vol. 27, No. 2, pp. 94–109 ISSN 1918-5227 94 School Psychologists’ Knowledge and Self-Efficacy in Working with Students with TBI Ann E. Glang, Melissa McCart, & Christabelle L. Moore University of Oregon Susan Davies University of Dayton Abstract Approximately 145,000 U.S. children experience lasting effects of traumatic brain injury (TBI) that manifest in social, behavioural, physical, and cognitive challenges in the school setting. School psychologists have an essential role in identifying students who need support and in determining eligibility under the Individuals with Disabilities Education Act. The purpose of this study was to assess the knowledge and perception of abilities related to TBI in a sample of school psychologists currently working in public schools. We surveyed school psychologists and found persistently low levels of knowledge and of perceived preparedness to work with these students. School psychologists with more experience working with students with TBI rated themselves significantly higher on their perceived ability to perform nearly all key duties of a school psychologist. To meet the academic and behavioural needs of students with TBI, all school psychologists need effective training in working with and evaluating students with TBI.Approximately 145,000 U.S. children experience lasting effects of traumatic brain injury (TBI) that manifest in social, behavioural, physical, and cognitive challenges in the school setting. School psychologists have an essential role in identifying students who need support and in determining eligibility under the Individuals with Disabilities Education Act. The purpose of this study was to assess the knowledge and perception of abilities related to TBI in a sample of school psychologists currently working in public schools. We surveyed school psychologists and found persistently low levels of knowledge and of perceived preparedness to work with these students. School psychologists with more experience working with students with TBI rated themselves significantly higher on their perceived ability to perform nearly all key duties of a school psychologist. To meet the academic and behavioural needs of students with TBI, all school psychologists need effective training in working with and evaluating students with TBI. Traumatic brain injuries (TBIs) are a leading cause of childhood death and disability worldwide (Faul, Xu, Wald, & Coronado, 2010). The Centers for Disease Control and Prevention estimates that each year in the United States, 60,000 children are hospitalized with TBI; an additional 700,000 U.S. children visit emergency rooms for symptoms related to TBI (Faul et al., 2010). Brain injury is typically categorized as mild, moderate, or severe based on initial symptoms at the time of injury. Most (70–90%) TBI-related emergency visits are considered mild (Cassidy et al., 2004; Faul et al., 2010). Children Glang, McCart, Moore, & Davies 95 Exceptionality Education International, 2017, Vol. 27, No. 2 with severe injuries are more likely to be hospitalized and to experience more significant disability. Children with moderate and severe injuries are likely to have cognitive, behavioural, and social difficulties that affect their long-term quality of life (Rivara, Vavilala, et al., 2012); with estimates of over 60% of children with moderate-to-severe TBI and 14% of children with mild TBI experiencing disability (Rivara, Koepsell, et al., 2012). Overall, approximately 145,000 children experience lasting effects of brain injury that manifest in social, behavioural, physical, and cognitive challenges in the school setting (Zaloshnja, Miller, Langlois, & Selassie, 2008). Effects of TBI on School Performance Following brain injury, children face multiple challenges that affect school performance (Anderson, Catroppa, Morse, Haritou, & Rosenfeld, 2005; Gabbe et al., 2014; Hawley, 2004). Challenges with executive functioning, memory, attention, concentration, and processing speed can all impact school performance (Gerrard-Morris et al., 2010; Hawley, Ward, Magnay, & Mychalkiw, 2004; Moser, Schatz, & Jordan, 2005). Behavioural or psychological symptoms, impulsivity, and social and emotional issues are also common after TBI (Barlow et al., 2010; Li & Liu, 2013; Limond, Dorris, & McMillan, 2009; Ryan et al., 2016) and can negatively affect school performance. This array of challenges can be long lasting, leading to poor long-term school outcomes (Babikian, Merkley, Savage, Giza, & Levin, 2015; Davies, Fox, Glang, Ettel, & Thomas, 2013; McKinlay, Dalrymple-Alford, Horwood, & Fergusson, 2002). Children injured before age 7 could be at greater risk for significant skill deficits than those injured later in childhood (Anderson & Moore, 1995). Furthermore, they often have poor long-term outcomes that educators do not attribute to their injuries (Anderson, Catroppa, Morse, Haritou, & Rosenfeld, 2009; Schwartz et al., 2003). In a study of longterm school outcomes of children with TBI, Prasad, Swank, & Ewing-Cobbs (2016) found that children with complicated-mild and moderate injuries needed more supports 6 years post-injury than they did 2 years post-injury. This finding emphasizes the need for school teams to track and monitor the progress of students with TBI so they can respond promptly if difficulties emerge and can provide appropriate accommodations or special education services (Prasad et al., 2016). A large portion of children with TBI require interventions or supports beyond what is offered in general education classrooms (Dettmer, Ettel, Glang, & McAvoy, 2014). Evidence-based instructional methods can help mitigate the academic and behavioural challenges associated with TBI (Ylvisaker et al., 2001). For example, cognitive strategy instructional approaches and Direct Instruction have substantial evidence bases and show preliminary evidence of efficacy with students with TBI (Glang et al., 2008). However, because of a pervasive lack of awareness of TBI among general educators, school teams need support in implementation of effective practices. Role of School Psychologists Because they lead the assessment and evaluation process in school settings, school psychologists need skills, knowledge, and training to accurately evaluate and meet the educational needs of students with TBI (Davies et al., 2013; Hooper, Walker, & Howard, 2001). Given their extensive training in the assessment, identification, and educational School Psychologists’ Knowledge of TBI Exceptionality Education International, 2017, Vol. 27, No. 2 96 intervention of learning and behaviour problems, school psychologists are uniquely positioned to support students with TBI (Davies et al., 2013). As a key member of the educational team that supports students, school psychologists have an essential role and are often viewed as the gatekeepers responsible for identifying students who need support and for determining eligibility under the Individuals with Disabilities Education Act (IDEA). School psychologists also provide guidance to educators about the services appropriate to meeting a student’s educational needs (Davies et al., 2013; Davies & Ray, 2014; Hooper, 2006). Surprisingly, multiple surveys of school psychologists indicate that they lack the training, knowledge, and skills the