who is teaching the teachers? - brain injury...
TRANSCRIPT
Who is Teaching Tomorrow’s
Teachers? Jacqueline Vintar Smith
George Washington University,
Washington, DC
1
Overview
• The purpose of this presentation is to look at the need for
special education teachers trained to work with students
with brain injury and to discuss whether teacher
preparation programs are meeting that need.
• Review of the literature
• Identify the teacher preparation programs available with a
focus on brain injury
• Provide recommendations for change
• Provide list of resources/describe the program at GWU
2
The Problem
• Traumatic brain injury (TBI) is one of the leading causes
of death and disability in children under the age of
nineteen.
• In Canada and the US, approximately 65,000 children
and youth are hospitalized each year with moderate to
severe TBI (Canadian Institute for Health Information, 2006; Faul, Xu,
Wald & Coronado, 2010).
• Conservative estimates suggest that at least one third of
these children and youth will require special education
services for persistent cognitive, social and behavioral
difficulties that will create challenges for school success (Glang, Dise-Lewis & Tyler, 2006).
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Incidence - US & Canada
Emergency Room Visits/Hospital Admissions United States (Faul et al, 2010)
AGE Emerg. Rate Hosp. Rate Deaths Rate Total Rate
0 - 4 251,546 1,256.2 15,239 76.1 998 5.0 267,783 1,337.3
5 - 9 105,015 532.9 8,799 44.7 450 2.3 114,264 579.9
10 - 14 117,387 559.8 11,098 52.9 726 3.5 129,211 616.2
15 - 19 157,198 757.0 24,896 119.9 3,995 19.2 186,089 896.2
Total 631,146 60,032 6,169 697,347
Hospital Admissions Canada (CIHI, 2006)
0-19 - - 4,846 - 120 - 4966 -
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Cause - US & Canada
Emergency Room Visits/Hospital Admissions United States (Faul, et al, 2010)
AGE MVA Falls Assaults Struck by/
against Other/
unknown Total
0-4 12,852 161,455 362 53,922 22,954 251,545
5 - 9 7,310 42,371 1,033 35,583 18,718 105,015
10 - 14 6,529 42,843 11,385 34,572 22,057 117,386
15-19 40,466 32,740 22,272 36,512 25,207 157,197
Total 67,157 279,409 35,052 160,589 88,936 631,143 Hospital Admissions ONLY Canada (CIHI, 2006)
0-19 1955 1973 324 - (Sports & Rec)
1390 *
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Prognosis
The majority of TBIs are mild and people are expected to
have few, if any, long term impacts. Even many individuals
with moderate injuries will have good outcomes
But….
43% of individuals discharged from hospital with
complicated mild, moderate, or severe TBI will develop
persistent disability (Selassie, Zaloshnja, Langlois, Miller, Jones & Steiner, 2008).
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Why is it a Problem?
• Each year an additional 20,000 children will require
special education services for TBI-related disabilities
in the US (Ylvisaker, et al, 2005).
• The total number of children with TBI related needs in
US schools is estimated to be 130,000 (Glang, Tyler,
Pearson, Todis & Morvant, 2004).
• As many as 27,000 students in Ontario have special
education needs related to TBI (Segalowitz & Brown, 1991);
this is approximately 1 in 100 students.
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SPED - Canada
In Canada
• Education, including special education, is legislated by individual provinces and territories.
• Of the ten provinces and three territories, Newfoundland specifically names brain injury as a special education category.
• Researchers have concluded that, in general, Canadian education policies do not recognize brain injury as a disability that requires accommodation (Zinga, Bennett, Good, and
Kumpf, 2005)
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SPED in the US
• Special Education and disability supports in the US are
federally legislated.
• Educational for students with disabilities falls under the
auspices of The Individuals with Disabilities Education Act
(IDEA)
• Section 504 of the Rehabilitation Act of 1973 (1973, 29 U.S.C. §
794) provides for accommodations for students who require
adaptations to enjoy equal access to resources leading to
educational success.
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SPED in the US
The category of TBI was added to the IDEA in 1991 and is defined as
“…an acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma.” [34 U.S.C §300.8(c)(12)]
In spite of the high incidence rate, TBI is considered a low incidence disability meaning few children are served and resources are scarce.
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Discrepancy
There is a large discrepancy between the expected need and the actual supports provided:
In its 29th Report to Congress, the US Department of Education (2010) indicated that there were 23,509 students in the US who were categorized as having a TBI for the purposes of qualifying for services under IDEA.
But… If estimates are correct, there are ~130,000 children and youth with TBI in school systems in the US (Glang et al 2006) then this represents only 18% of students with TBI related learning needs receiving appropriate educational services.
What about in Canada??
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Why is this occurring?
• Children appear to recover well from TBI - problems become apparent when they fail to meet developmental expectations for social, behavioral and cognitive functioning (DePompei & Bedell, 2008; Glang, Todis, Sublette, Eagan-Brown & Vaccaro, 2010).
• Teachers (and parents) do not understand brain injury:
• Students are undiagnosed or misdiagnosed
• If diagnosed, teachers use learning strategies and environments designed for children with other disabilities (e.g. LD/EBD)
• Emotional and behavioral problems are misunderstood as being intentional (e.g. instrumental vs reactive aggression) and children are suspended/expelled.
• A recent study that followed children after their return to school found that less than half of the children with severe TBI had individualized education plans (IEP) or 504 plans; some had some informal supports; and 18.5% had no supports. (Glang, Todis, Thomas, et al. 2008),
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Consequences
• The impact of TBI can create lifelong challenges to
independence and productivity unless they are
appropriately addressed from the time of injury. If they
are not, the results can be devastating including:
• lower rates of literacy,
• increased risk for school failure and drop-out,
• psychosocial dysfunction,
• chronic psychological problems
• lower enrolment in post secondary education
• lower employment rates
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The Study
Researchers, educators and brain injury specialists have advocated for including education in TBI in teacher preparation programs for years however there have been very few investigations into whether this advocacy has made a difference.
• Savage (1995)
8% of American Special Education programs provided some training in TBI
• The National Association of State Directors of Special Education (NASDSE) (2000)
ten states had any type of pre-service courses in TBI
two states had established teacher endorsement for TBI but in-service training & coursework was minimal
• Zinga, Bennett, Good & Kumpf, (2005)
Canadian Universities have yet to recognize the importance of building specialized training that addresses the needs of this population into their programs
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Purpose
The purpose of this study was to update the literature on the
number teacher preparation programs preparing tomorrow’s
educators to teach children with brain injury.
Why? Given the increase in overall knowledge and
awareness of the brain and brain injury, I expected a relative
increase in number of programs available in post secondary
schools.
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Step one- Identifying the Schools
I selected formal special education teacher preparation programs in the United States and Canada at both the undergraduate and graduate level.
United States
• All special education teacher education programs in the US accredited by the National Council for Accreditation of Teacher Education (NCATE) AND recognized by the Special Professional Association (SPA) “Council on Exceptional Children”.
Canada
• All English universities with programs in Education were selected. A second search was conducted for Special and/or Inclusive Education listed with the Association of Universities and Colleges in Canada (AUCC) websites.
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Step two – Identifying programs
and courses
I searched…
• Online calendars, catalog/catalogues, bulletins
• Some web-based, some PDF documents
• Keyword “brain”
• Variations: brain injury, head injury, brain trauma, brain damage
• Schools were included if they had:
• A program with a brain injury in the title
• A program with brain injury in the program description
• A course with brain injury in the title, or
• A course with brain injury identified in the course description
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Results - Canada
• 20 Schools with special and/or inclusive education
selected for review from 34 schools with degree
programs in Education
• 1 school out of 20 has a course that includes brain injury
in its course description.
• No schools have a program in special education with
brain injury focus.
• No schools have a course in special education with brain
injury in the title.
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Results - US
• 289 schools in 40 states were included in the review
Programs Courses
Title Description Total
Programs Title Description
Total
Courses
States* 2 4 6 6 12 14
(n=40) 5% 10% 15% 15% 22.5% 35%
Schools 2 6 8 7 29 36
(n=289) < 1% 2% 2.8% 2.4% 10% 12.5%
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Results cont.
States/territories with programs:
District of Columbia: Graduate School of Education at The George Washington University
Graduate Certificate in Brain Injury: Educational and Transition Services
Masters in Secondary Special Education & Transition Services
Building Schools’ Capacity to Serve Students with Brain Injuries
Texas: College of Education at University of North Texas
Graduate Academic Certificate Specialist in Re-Integration of Students with Traumatic Brain Injury (Students can continue on to a Masters degree with TBI focus)
The following states refer to brain injury in their program description:
Arizona (1), Illinois (2), Pennsylvania (1), South Carolina (2)
States with TBI courses: Arizona, DC, Illinois, Oklahoma, Pennsylvania, South Carolina, Texas
Province with TBI in course description: Manitoba
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Discussion
• Compared with Savage’s 1995 data, the percentage of
special education programs offering some content in
brain injury has increased slightly
• Compared with NASDSE’s 2000 report, the number of
states offering programs with some focus on brain injury
has also increased
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1995 2012 8% 12.50%
2000 2012
10 States 14 States
Discussion
• There have been minor improvements in availability of special education programs that intentionally address TBI
However, not at a rate that meets the expected demand
• Students are not being identified as having TBI and/or TBI related needs
“This discrepancy perpetuates a cycle of under-funding, inadequate teacher training, and inappropriate educational services for this challenging disability group.”
(Glang et al, 2008, p. 478)
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Discussion
Children with TBI not
receiving appropriate education
Lack of training
Lack of identification
of TBI in classroom
Appearance of low
incidence
Lack of recognition of the real
need
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Recommendations
• In order to increase the awareness of TBI in children and
youth we need to do the following:
• Improve transitions from hospital to school.
• Teach parents to advocate for education services.
• Increase research/publications in special education journals.
• Take advantage of increase in concussion legislation/policy.
Get brain injury into the curricula of
special education teacher preparation programs.
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Limitations
• Selection criteria (i.e NCATE/CEC) may have excluded schools with programs/courses that are not accredited through NCATE and/or recognized by CEC
• The unique learning needs produced by brain injury may well be covered in available courses, but not described in titles/course descriptions.
• Predominantly French and Spanish schools may have met the inclusion criteria except for language.
• Study did not include schools with faculty and/or centers whose work is centered on the education of children with brain injury (i.e Brock University in Canada, Western Oregon University in US).
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Brain Injury Program at GWU
• The Graduate School of Education and Human
Development at George Washington University is one of
three programs in the US that has a Teacher preparation
program with a focus on TBI.
• Brain Injury: Educational and Transition Services.
• Graduate Certificate (Distance)
• Masters Degree leading to Teacher Certification (Hybrid)
• Proposed Masters Degree leading to Teacher Certification
(Distance)
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Brain Injury Program at GWU
• Students follow regular special education teacher preparation
program, but in addition they take the following courses:
• Introduction to Brain Injury: Programs, Policies, and Resources
• Impact of Brain Injury on Learning and Developmental Programming
• Family Partnerships for Systems Change for Children with Brain
Injury
• Instructional Methods and Strategies in Special Education and
Transitions for Children with Brain Injury
• Certificate students take these courses and an elective in
transition services or vocational assessment/evaluation
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Our Students
• Come from general or special education and wish to
specialize in brain injury
• Work with state education organizations and wish to have
formalized education
• Career changers
• Paraprofessionals who wish to work in other support
capacities in the classroom
• Career and vocational specialists
• Rehabilitation counseling
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Additional Resources Available for Teachers
Canada:
Educating Educators about Acquired Brain Injury (Brock University)
http://www.brocku.ca/abieducation/about.html
Teaching Students with Acquired Brain Injury
http://www.bced.gov.bc.ca/specialed/docs/moe_abi_resource_rb0116.pdf
U.S.
Center for Brain Injury Research and Training (CBIRT) (Western Oregon University)
http://www.cbirt.org/about-us/
BrainSTARS: (Children’s Hospital, Colorado)
http://orthopedics.childrenscolorado.org/what-we-do/rehab--physical-therapy/brainstars
http://www.brainline.org/content/2011/09/brainstars.html
Project Brain: Virtual School
http://www.tndisability.org/brain/cd/ProjectBrain/mediaframeset.htmlProject Learnet:
http://www.projectlearnet.org/events.html
National Association of Special Education Teachers
http://www.naset.org/traumaticbraininj2.0.html
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