Mild Traumatic Brain Injury and Post-Concussive Symptoms: Knowledge and Practices in School Psychology
Date
2020-11-20
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Abstract
Background: Recovery from a mild traumatic brain injury (mTBI) may be straightforward and require minimal support. However, a percentage of students will require cognitive/academic supports (35%-73%) and mental health services (50%) as they return-to-learn. Unfortunately, within the educational system the effects of mTBI are still poorly recognized and the likelihood of this injury to be missed, misdiagnosed, or under-supported remains too high. School psychologists are well positioned to provide essential supports to improve recovery outcomes; however, limited research exists in understanding their current competence in this area. Purpose: To gain an understanding of school psychologists’ knowledge in three mTBI areas relevant to practice: (1) general mTBI knowledge; (2) post-concussive symptoms (PCS); and, (3) reintegration and management practices. Equally valued was the exploration of factors contributing to higher/lower mTBI knowledge and confidence development to improve post-injury services to students. Methods: A mixed-methods explanatory sequential design was employed. In Phase One, 56 school psychologists were recruited to complete a Return-to-Learn Questionnaire (RTL-Q) with confidence measures. Three multiple regression models were developed to determine predictor factors associated with professional experience (Years of Practice and Number of Children supported with mTBI). Based on response patterns, a subsample of 10 participants was selected for Phase Two interviews to further explore factors of practitioner competence in mTBI. Results: Professional experience was not predictive of general mTBI knowledge (F(2,50) = .277, p = .759), PCS (F(2,53) = .512, p = .602), or management practices (F(2,52) = 2.872, p = .066). Qualitative results identified five themes supporting these findings and contributing to the development of knowledge and confidence in managing children with mTBI: lack of formal training; misinformation; informal opportunities; limited understanding by allied professionals; and, factors of personal and professional influence. Conclusion: Results indicated specific gaps in school psychologists’ mTBI understanding, practices, and confidence. Improving these areas will require the concerted efforts of ministry policy and guidelines in conjunction with formal training curriculum and professional development to improve and support the neurocognitive and social/emotional recovery of students with mTBI/concussion.
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Keywords
mild traumatic brain injury (mTBI), concussion, school psychology, return-to-learn, questionnaire, knowledge translation, post-concussive symptoms, management practices, online confidence
Citation
Fitzer, K. R. (2020). Mild Traumatic Brain Injury and Post-Concussive Symptoms: Knowledge and Practices in School Psychology (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.