Date of Award

12-1-2014

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Nickola W. Nelson

Second Advisor

Dr. Yvette D. Hyter

Third Advisor

Dr. Linwood H. Cousins

Fourth Advisor

Dr. Judith Vander Woude

Keywords

Traumatic brain injury, school reintegration, speech-language pathology, collaboration, contextual, defining success

Abstract

School reintegration following pediatric traumatic brain injury (TBI) presents a number of challenges. This dissertation comprises three studies exploring common themes of best practice, training, and supporting success for students with TBI in school settings.

Study 1 reports the results of a survey of 70 speech-language pathologists (SLPs) who responded to questions about their use of clinical activities that described more or less contextualized services. Current literature supports contextualized service delivery as best practice. Findings indicated that 98% of participants reported using at least one contextualized practice. Higher use of contextualized practices was associated with working in schools (compared to health care settings), access to experts, and having greater experience with TBI. Most frequently cited reasons for not using practices exemplifying contextualized service delivery included not fitting the student and scheduling issues.

Study 2 was a partially randomized controlled investigation designed to evaluate effectiveness of interprofessional TBI training to prepare 26 SLP and 11 special education (SPED) students to work collaboratively. The SLP students were assigned semi-randomly to a control group (n = 16), who received instruction in the traditional class format of TBI lecture with group discussions, and an experimental group (n = 10), who participated in an interprofessional training with the SPED students. Training incorporated lectures on TBI and collaboration, small group activities, and interprofessional role-plays. TBI knowledge for all three groups increased significantly over time, with the experimental and control groups making similar improvements. SLP students showed more TBI knowledge than their SPED counterparts at pre- and post-testing.

Study 3 used qualitative methods to explore perspectives about reintegration success through semi-structured interviews with children and adolescents with TBI, their parents, and clinical and educational professionals. Four themes emerged from the data associated with defining and supporting students’ success: communication and connection; knowledge and awareness; services, support, and strategies; and student attributes and circumstances.

Collectively, these studies offer new information about the complex process of returning to school following TBI. Insights gained include evidence that education and knowledge have the power to equip professionals and families to collaboratively support students with TBI as they attempt to achieve success.

Access Setting

Dissertation-Open Access

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