Who is Teaching Tomorrow s Teachers? Jacqueline Vintar Smith George Washington University, Washington, DC

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1 Who is Teaching Tomorrow s Teachers? Jacqueline Vintar Smith George Washington University, Washington, DC 1

2 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 Overview 2

3 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). The Problem 3

4 Emergency Room Visits/Hospital Admissions United States (Faul et al, 2010) AGE Emerg. Rate Hosp. Rate Deaths Rate Total Rate ,546 1, , ,783 1, , , , , , , , , , , Total 631,146 60,032 6, ,347 Hospital Admissions Canada (CIHI, 2006) , Incidence - US & Canada 4

5 Emergency Room Visits/Hospital Admissions United States (Faul, et al, 2010) Struck by/ Other/ AGE MVA Falls Assaults against unknown Total , , ,922 22, , ,310 42,371 1,033 35,583 18, , ,529 42,843 11,385 34,572 22, , ,466 32,740 22,272 36,512 25, ,197 Total 67, ,409 35, ,589 88, ,143 Hospital Admissions ONLY Canada (CIHI, 2006) (Sports & Rec) * Cause - US & Canada 5

6 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). Prognosis 6

7 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. Why is it a Problem? 7

8 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) SPED - Canada 8

9 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. SPED in the US 9

10 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; psychosocial 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. SPED in the US 10

11 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?? Discrepancy 11

12 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), Why is this occurring? 12

13 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 Consequences 13

14 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 The Study 14

15 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. Purpose 15

16 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. Step one- Identifying the Schools 16

17 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 Step two Identifying programs and courses 17

18 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. Results - Canada 18

19 289 schools in 40 states were included in the review Programs Courses Title Description Total Programs Title Description Total Courses States* (n=40) 5% 10% 15% 15% 22.5% 35% Schools (n=289) < 1% 2% 2.8% 2.4% 10% 12.5% Results - US 19

20 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 Results cont. 20

21 Compared with Savage s 1995 data, the percentage of special education programs offering some content in brain injury has increased slightly % 12.50% Compared with NASDSE s 2000 report, the number of states offering programs with some focus on brain injury has also increased States 14 States Discussion 21

22 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) Discussion 22

23 Lack of training Lack of recognition of the real need Children with TBI not receiving appropriate education Lack of identification of TBI in classroom Appearance of low incidence Discussion 23

24 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. Recommendations 24

25 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). Limitations 25

26 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) Brain Injury Program at GWU 26

27 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 Brain Injury Program at GWU 27

28 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 Our Students 28

29 Canada: U.S. Educating Educators about Acquired Brain Injury (Brock University) Teaching Students with Acquired Brain Injury Center for Brain Injury Research and Training (CBIRT) (Western Oregon University) BrainSTARS: (Children s Hospital, Colorado) Project Brain: Virtual School Learnet: National Association of Special Education Teachers Additional Resources Available for Teachers 29

30 Thank you Merci Please send inquiries to the author at 30

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