Misconceptions about traumatic brain injury among ...

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tlers) with CTE at relatively young ages (Yi et al., 2013). bs_bs_banner ... Specifically, Group 2 respondents attended schools in the states of ... HS diploma/GED.
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TRAUMATIC

BRAIN

INJURY

Misconceptions about traumatic brain injury among students preparing to be special education professionals KAREN HUX, ERIN BUSH, KELLI EVANS and GINA SIMANEK The researchers performed a survey study to determine the effectiveness of collegiate programmes in dispelling common misconceptions about traumatic brain injury (TBI) while preparing undergraduate and graduate students for special education (SpEd) careers. Respondents included 136 undergraduate and 147 graduate SpEd students in their final semesters before obtaining degrees. Each completed an 18-item true/false survey about TBI and the associated recovery process. Results were compared with survey responses from 318 lay public respondents who participated in a previous study. Two major findings emerged: (a) no significant differences existed in misconception endorsement between SpEd students completing Bachelor’s versus Master’s degrees; and (b) graduating students in SpEd teacher preparation programmes endorsed similar misconceptions as lay public respondents; hence, these programmes do not appear effective in dispelling common TBI misconceptions. Improving academic preparation for special educators regarding TBI is imperative for effectively identifying, assessing and serving student survivors. Key words: traumatic brain injury, special education, teacher preparation programmes, personnel preparation, higher education.

Misconceptions about traumatic brain injuries (TBIs) are rampant. Over 20 years ago, Gouvier and colleagues administered a survey to the lay public and found numerous false beliefs regarding TBIs and TBI survivors (Gouvier et al., 1988). Since that time, several researchers (e.g., Willer et al., 1993; Guilmette and Paglia, 2004; Hux et al., 2006; Chapman and Hudson, 2010; Ono et al., 2011) have confirmed that misperceptions about TBI persist and are widely endorsed across Britain, Australia, the United States and Canada. These misconceptions persist even among those who have personal experience with a brain injury (i.e.,

© 2013 NASEN DOI: 10.1111/1467-9604.12028

having sustained brain injury themselves or having a relative or friend with brain injury) (Chapman and Hudson, 2010). Furthermore, these misconceptions are not confined solely to the lay public. For example, Ernst, Trice, Gilbert and Potts (2009) administered a survey to beginning and advanced nursing students and found that TBI misconceptions persist among these individuals despite their professional training. Such findings confirm the long-standing, robust nature of false beliefs about TBI. Two factors have increased the public’s recent awareness of TBI and its potential consequences. First, medical professionals are identifying large numbers of military personnel as having sustained brain injuries because of exposure to explosive blasts while serving in combat settings. Recent estimates indicate that more than 22% of soldiers have sustained brain injuries (Terrio et al., 2009). The United States Department of Defense reported that medical professionals diagnosed 253,330 American soldiers with traumatic brain injuries between 2000 and the first quarter of 2012 (United States Department of Defense, n.d.). Researchers acknowledge that many mild injuries and concussions among military personnel likely remain undetected (Martin et al., 2008). A second factor increasing TBI awareness stems from increased publicity about professional athletes sustaining sports-related TBIs. Athletes who have sustained several concussions or other brain injuries during their careers and who, in later years, present with symptoms of progressive neurological disease have received substantial media attention. This type of dementia, coined as chronic traumatic encephalopathy (CTE), is often diagnosed in players between the ages of 30 and 49 years and was first identified in National Football League (NFL) players in 2005 (Yi et al., 2013). For example, Junior Seau – an NFL player who died from a self-inflicted gunshot wound – was recently diagnosed with CTE (Wilner, 2013), along with 33 other NFL players who have been diagnosed posthumously. In January 2013, five living, former NFL players were also diagnosed with CTE (Fainaru and Fainaru, 2013). In actuality, as early as the 1920s, physicians began diagnosing professional athletes (e.g. hockey players, boxers and wrestlers) with CTE at relatively young ages (Yi et al., 2013).

The heightening of public awareness in isolation does not ensure increased accuracy regarding beliefs about TBI; instead, professionals must couple increased awareness with educational efforts directly targeting misconceptions. The success of this type of approach is evident through studies performed with speech-language pathology (SLP) and school psychology professionals. In particular, Hux, Walker and Sanger (1996) found that training about TBI positively affected school-based SLPs’ knowledge of TBI case management, assessment and treatment. Hooper (2006) found that professional training for careers as school psychologists led them to outperform the lay public when surveyed about brain injury misconceptions, but the professionals still lacked knowledge sufficient to ensure their effectiveness in working with student survivors of TBI. Finally, Evans and her colleagues (2009) found that students beginning SLP graduate programmes and students matriculating from SLP graduate programmes outperformed the lay public regarding their awareness of facts about TBI; furthermore, between beginning and ending their graduate SLP training, students’ rejection of TBI misconceptions increased significantly. Hence, education appears to be an important factor in improving the accuracy of people’s knowledge about TBI.

purpose of this survey study was to determine whether students preparing for careers in SpEd endorse or reject TBI misconceptions. Specifically, the researchers sought to determine whether typical US collegiate programmes for training special educators are effective in dispelling common misconceptions about general TBI knowledge, coma, memory problems and the recovery process of people with TBI.

Methods Respondents

Special educators comprise another group of professionals directly involved in providing services to TBI survivors. This is because, in 1990, the Individuals with Disabilities Education Act (IDEA) specified TBI as a special education verification category (US Department of Education, n.d.); as such, federal law mandates that public school professionals identify and serve students with TBI who have special education needs. Both SpEd and regular education personnel share responsibility for providing these services, with special educators frequently chosen to develop and manage appropriate programmes. Because good case management is essential to effective service development and delivery for students with TBI (Ylvisaker et al., 2001), special educators need to be aware of the consequences of TBI and the associated recovery process (Jantz and Coulter, 2007).

Survey respondents consisted of three groups. Group 1 respondents included 318 members of the lay public residing in Nebraska who participated in the research previously performed by Hux and her colleagues (2006); Group 2 respondents included 136 undergraduate students nearing completion of their final semester of undergraduate preparation for SpEd teaching careers; and Group 3 respondents included 147 graduate students nearing completion of their final semester before receiving Master’s degrees in SpEd. Data for the three groups were not collected at the same time. Instead, Group 1 data were collected for a previous research project performed approximately three years prior to the current study. The researchers collected Group 2 and 3 data over a two-year period. Respondents were students enrolled in SpEd teacher preparation programmes in five different colleges/universities across the United States. Specifically, Group 2 respondents attended schools in the states of Illinois, Nebraska and New York; and Group 3 participants attended schools in the states of Illinois, Nebraska, New York, Massachusetts and New Hampshire. Upon completion of their programmes, all Group 2 and Group 3 respondents would be eligible to receive SpEd teaching endorsements within the state in which they had attended school. Respondent characteristics (i.e., gender, age and years of education) for all three respondent groups appear in Table 1.

At a minimum, such knowledge presumes recognition of the fallacy of commonly held TBI misconceptions. Hence, the

The three groups differed significantly regarding gender (χ2(df=2) = 33.279, p < 0.0001), with SpEd respondents

Gender Male Female Unknown Age 19–29 30–39 40–49 50–59 Over 60 Education