School Personnel Knowledge of Autism: A Pilot Survey
By Kashunda L. Williams, Jennifer L. Schroeder, Catharina Carvalho, and Amanda Cervantes
Autism, or autistic disorder, is a life-long condition that is characterized by significant impairments in social interaction and communication, as well as restricted and repetitive patterns of behavior and mannerisms that are seen before the age of three (American Psychiatric Association, 2000). This disorder has major implications for an individual's academic functioning, social development, and community adjustment. The prevalence of autism is estimated to be 3.4 out of every 1000 children between 3 and 10 years of age in the United States (Yeargin-Allsopp et al., 2003). When considered with the related disorders, including Asperger's Disorder and Pervasive Developmental Disorder, NOS, the prevalence estimates rise to as many as 9 out of every 1000 children (Centers for Disease Control and Prevention [CDC], 2009).
In some cases autism is not diagnosed until the child begins school (Ruble & Gallagher, 2004). With increases in the prevalence of diagnosed autism cases (CDC, 2009), the demand for school-based and clinical services for individuals with autism is also increasing (Brock et al., 2006). To address the increased need for services in school settings, school personnel such as general and special education teachers, school counselors, and paraprofessionals are working to determine their role in the education and treatment of students diagnosed with autism.
It has been recommended that school personnel participate in trainings to support their efforts in becoming more competent service providers for students diagnosed with autism (Jennett, Harris, & Mesibov, 2003), since many educators do not feel that they have received adequate training in dealing with special education students – notably students with autism - which can in turn impact their effectiveness in meeting the students' needs (LeBlanc, Richardson & Burns, 2009). Formal continuing educational opportunities of this type are particularly important since school personnel can be influenced by information found on the internet, on television, and in printed media, leaving them with the difficult challenge of distinguishing inaccurate from accurate information (Bain, Brown, & Jordan, 2009). Models for transferring a broad range of research findings on best practices for children with autism to current school personnel have received less attention in the literature (Lerman, Vorndran, Addison, & Kuhn, 2004).
The level of training for service providers at the most basic levels of service delivery can vary. A review of the literature indicates that although school personnel are receiving some specialized training related to autism, their knowledge related to autism is low (Lerman et al., 2004; Stone, 1987; Stone & Rosenbaum, 1988). Researchers have created (Stone, 1987) and evaluated (Campbell, Reichle, & Van Bourgondien, 1996) instruments that assess respondents' knowledge of autism. To date, a systematic investigation aimed solely at surveying the perceived competence of school personnel, or what they believe they know about autism has not been conducted nor has there been a survey of school personnel's factual knowledge about autism.
The purpose of this pilot project was to serve as an exploratory investigation of teacher, counselor, and paraprofessional knowledge of autism. This survey attempts to answer the following questions: (a) What is school personnel's perception of their knowledge of autism? That is, to what extent do school personnel (teachers, counselors, and paraprofessionals) perceive they are competent in their understanding of autism?, (b) What is school personnel's factual knowledge of autism (i.e., regarding definition, assessment/ diagnosis, and treatments)?, and (c) To what extent do school personnel (teachers, counselors, and paraprofessionals) that work directly with students with autism differ in their perception of their knowledge of autism and factual knowledge of autism in comparison with school personnel who do not work with students with autism?
Fifty-four school personnel from a southwestern state participated in the current pilot survey. Participants were school district employees enrolled in various graduate level majors (within the College of Education) attending a small university in the Southwestern United States. Seven graduate classrooms were randomly selected from the list of course offerings within the College of Education. Class instructors were contacted and consented to allow the authors to solicit student participation. Criteria for participation included (1) being a current school employee, and (2) currently working with students with autism. Of those participating, 18.5% were male and 81.5% were female. The sample included general education teachers (n = 26), special education teachers (n = 14), school counselors (n = 7), and paraprofessionals (n = 7). Every participant had earned at least a bachelor's degree, with 22.2% having earned a master's degree or higher. When asked if they work directly with students diagnosed with autism (i.e., serve students with autism in a direct manner; instructor, interventionist, care-provider, etc.), 70.4% indicated that they do, while 29.6% indicated that they do not (i.e., serve students with autism in an indirect manner; consultant, academic planning, multiple disciplinary team member, etc.). When asked if they had ever participated in autism training(s), 38.9% of the participants reported that they had, while 61.1% reported that they had not. Finally, when asked if they would like to participate in autism training(s) in the future, 38.9% expressed a desire to participate, while 61.1% indicated they did not.
The Autism Survey, developed by Stone (1987), was considered to assess participants' perceptions and factual knowledge of autism. Because the tool has never been revised since its creation in 1987 and autism research has evolved greatly, the authors decided against its use. All measures utilized in this pilot survey were developed and constructed by the authors. The authors developed two measures, a Perceptions Survey and a Knowledge Survey. Items on the Perceptions and Knowledge Surveys were developed from empirically-supported findings in the research literature. Perceptions Survey items were designed to assess the respondents' perceived competence of their knowledge and ability to implement research findings. Knowledge Survey items were designed to assess the respondents' factual knowledge of research findings about autism that aligned with subsets of the measure.
Perceptions Survey. The Perceptions Survey contained 12 Likert items assessing the school personnel's perceived knowledge of autism. The Likert scale items ranged from 1 - strongly disagree to 5 - strongly agree. The Perceptions Survey is provided in Appendix A (PDF, 40KB). Following survey completion, the authors analyzed the Likert responses by creating three categories: low, average, and high perceived competence. These categories were created to aid in the identification of possible patterns within responses. The five-point Likert scale was divided into three equal units. That is, mean ratings ranging from 1 to 1.66 were interrupted as low perceived competence, mean ratings ranging from 1.67 to 3.33 were interrupted as average perceived competence, and mean ratings ranging from 3.34 to 5 were interrupted as high perceived competence. Low was defined as a lack of or limited perceived competence (i.e., participants believed they had no or limited competence regarding autism), average was defined as average perceived competence (i.e., participants believed they have average competence regarding autism), and high was defined as an elevated perceived competence (i.e., participants believed they have above average or elevated competence regarding autism). Internal consistency was calculated and the Crohnbach alpha was equal to 0.87.
Knowledge Survey. The Knowledge Survey contains 15 open-ended items, that assess school personnel's knowledge about autism, sorted into three subsets; definition (five items), assessment/diagnosis (six items), and treatment (four items). It is the authors' opinions that these items draw a parallel to a portion of the knowledge school personnel use when working with students with autism (i.e., identifying, making recommendations for assessment, academic planning, etc.). The Knowledge Survey is provided in Appendix B (PDF, 46KB).. Responses to the open-ended Knowledge Survey items were compared to empirically-supported findings in the research literature. A scoring rubric was created using government reports by the National Institute of Child Health and Human Development (NICHD) (i.e., Autism Overview: What We Know, 2005) and the National Institute of Neurological Disorders and Stroke (NINDS) (i.e., Autism Fact Sheet, 2009), both part of the National Institutes of Health (NIH) within the U.S. Department of Health and Human Services, and was used to score responses. For the purposes of scoring survey responses, items were scored on a three point scale: 0 - low response, 1 - moderate response, and 2 - high response. An low response was coded when participants' responses contained no correct content, a moderate response was coded when participants' responses contained some correct content and some incorrect content or correct content that did not fully align with research findings presented in the government reports, and a high response was coded when participants' responses contained only correct content that fully aligned with research findings presented in the government reports. Following survey completion and response coding, the authors analyzed responses by dividing the three-point scale into three equal units. These categories were created to aid in the identification of possible patterns within responses. Mean ratings ranging from 0 to .66 were interpreted as low and represent a limited level of factual knowledge, mean ratings ranging from .67 to 1.33 were interpreted as moderate and represent a fair level of factual knowledge, and mean ratings ranging from 1.34 to 2 were interpreted as high and represent a elevated level of factual knowledge.
Interrater Agreement. A portion of the Perception and Knowledge Surveys were independently coded to determine interrater agreement (IRA). IRA was calculated by dividing the number of agreements by the number of agreements plus disagreements, and multiplying by 100%. IRA was collected on 33.33% of the perception surveys. Mean IRA was 100%. IRA was collected on 33.33% of the knowledge surveys. Mean IRA was 89.63% (range, 73.33% to 100%).
Participants were recruited from university classrooms. The authors had no relationship with the participants. Consent was obtained from those volunteering and surveys were distributed in small group settings. Participants were discouraged from sharing responses. Upon completion, surveys were collected and de-identified. An identification number was assigned to each set of surveys for data entry and coding purposes. All school personnel that provided consent were included in the analyses. Because this pilot investigation was considered exploratory, only descriptive analyses were conducted.
Mean scores of school personnel on the Perception Survey and Knowledge Survey, respectively, and groups (i.e., overall, direct service providers, and indirect service providers) are shown in Table 1 (PDF, 65KB).
Perceptions Survey. Twelve Likertitems assess school personnel's perceived knowledge about autism. That is, the degree to which the school personnel believe they were competent in their knowledge of autism. The overall mean rating for perceived competence is 2.58 (SD = 1.09), which is interpreted as average. For school personnel that work directly with students with autism, the mean rating for perceived competence is 2.79 (SD = 1.07), and similarly falls into the average category. For school personnel that did not work directly with students, the mean rating for perceived competence is 2.08 (SD = 0.96), and is interpreted as average.
Knowledge Survey. The Knowledge Survey contained 15 open-ended items assessing school personnel's knowledge about autism. In the following paragraphs, each of the three Knowledge Survey item subsets will be discussed in turn, beginning with the definition, continuing with assessment/diagnosis, and ending with treatment. Knowledge Survey response percentages by group (i.e., overall, direct service providers, and indirect service providers) and category (i.e., low, moderate, and high) are shown in Table 2 (PDF, 62KB)
Definition. Five items assess school personnel's factual knowledge about the definition of autism. The overall mean rating for the five definition items is 1.19 (SD = 0.90), and is interpreted as moderate. For school professionals that work directly with students with autism, the mean rating for definition is 1.35 (SD = 0.85), and is interpreted as high. For school personnel that did not work directly with students with autism, the mean rating for definition is .94 (SD = 0.93), and is interpreted as moderate.
Assessment/Diagnosis. Six items assess school personnel's factual knowledge about the assessment and diagnosis of autism. The overall mean rating for assessment/diagnosis is 0.53 (SD = 0.71), and is interpreted as low. For school personnel that work directly with students with autism, the mean rating for assessment/diagnosis is 0.58 (SD = 0.71), and is interpreted as low. For school personnel that did not work directly with students with autism, the mean rating for assessment/diagnosis is 0.49 (SD = 0.73), and is interpreted as low.
Treatment. Four items assess school personnel's factual knowledge about the treatment of autism. The overall mean rating for treatment is 0.57 (SD = 0.69), and is interpreted as moderate. For school personnel that work directly with students with autism, the mean rating for treatment is 0.66 (SD = 0.72), and is interpreted as low. For personnel that did not work directly with students with autism, the mean rating for treatment is 0.48 (SD = 0.64), and is interpreted as low.
Group differences. A Chi-squared analysis was conducted to determine if ratings for school personnel that work directly with students with autism differ from those that do not. A significant difference [χ2(1, N =647 ) = 50.05, p = .000] is found when comparing the perceived competence scores of the groups. A significant difference is further identified on the definition response scores of the groups [χ2(2, N =270 ) = 13.11, p = .001]. However, no difference [χ2(2, N =324 ) = 4.03, p = .133] is found when comparing the assessment/diagnosis response scores of the groups, nor when comparing the treatment response scores of the groups [χ2(2, N =216) = 3.00, p = .223].
Overall, the perceived competence of general and special education teachers, school counselors, and paraprofessionals regarding their knowledge about autism is average. Although general and special education teachers, school counselors, and paraprofessionals that work directly with students and those that do not both are interpreted as having average perceived competence, these groups perceived their competence significantly different. That is, those working directly with students have a statistically significantly higher perceived competence. The results indicate that overall school personnel's factual knowledge about the definition of autism is correct 51.7% of the time while 48.3% of the time they share erroneous information. General and special education teachers, school counselors, and paraprofessionals that work directly with students correctly defined the disorder, while those that do not demonstrate moderate knowledge with some errors. School personnel's factual knowledge about the assessment/ diagnosis of autism is low. Both groups have low knowledge of assessment/ diagnostic methods and do not differ in their knowledge in this area. Finally, school personnel's factual knowledge about the treatment of autism is low and the groups do not differ in their knowledge in this area.
Limitations of the Study. There are several limitations to the study that need to be considered when interpreting the results, one being the homogeneity of participants. The present study resulted in a heavy concentration of general and special education teachers. This lack of even distribution creates a threat to external validity, or the extent to which these results can be generalized to the larger school personnel population. Control for school personnel job title distribution needs to be addressed in future studies. Second, all participants were enrolled in graduate course work. This could also threaten external validity and could have potentially impacted survey responses. Third, the number of participants in this pilot project is small. Future research should include a larger sample size. Lastly, the psychometric properties of the surveys used are mostly unknown. Future researchers should utilize measures that have data that demonstrate reliability and validity.
Contributions to the Literature and Future Research. This pilot survey advances the field by representing an exploratory investigation aimed at appraising what school personnel believe they know about autism (i.e., their perceived competence). To date, studies have not yet focused on either school personnel's perceived and/or factual knowledge of autism. The findings of this pilot survey raise several questions about general and special education teachers, school counselors, and paraprofessionals perceived and factual knowledge about autism.
A slight minority of the respondents in this survey indicated prior training in autism while a majority indicated they had no prior training and little interest in receiving education related to autism in the future. This is troubling given the results of the survey (i.e., average perceived competence and mostly low factual knowledge), in conjunction with the fact that all participants reported working with students with autism either directly or indirectly. It would appear that teachers, school counselors, and paraprofessionals overestimate their factual knowledge about autism and as a result fail to see a need for additional training.
The information obtained from this pilot survey should assist school psychologists in providing assistance to school personnel who serve (i.e., both directly and indirectly) students diagnosed with autism. In practice, school psychologists should be cautious about assuming that general and special education teachers, school counselors, and paraprofessionals have a factual understanding of autism. While consulting and collaborating with school personnel, school psychologists should tactfully and respectfully determine if an education/ training session is needed. Failure to do so could be detrimental to achieving effective communication, desirable consultation outcomes, accurate assessments, appropriate treatment planning, selection, and implementation, and most importantly, improved student outcomes. The results also imply that anecdotal reports are not sufficient when determining what content to include in trainings, and that direct assessments of factual knowledge is the preferred alternative.
This survey establishes a need for further investigation related to school personnel's perceived and factual knowledge about autism. A possible area of future investigation could include the impact of perceived knowledge on participation in continuing education/ trainings and willingness to participate in the consultation process. Moreover, does the perception of having sufficient knowledge about autism reduce participation in autism training and/ or cause school personnel to be more resistant to consultation? The authors ultimately would like to determine if autism trainings could be more beneficial to trainees if the trainings were more individualized. That is, assessing perceived and factual knowledge and tailoring trainings to match the deficits identified. It is critical that school personnel understand this complex disorder to help children achieve positive outcomes, especially since they bear the responsibility of serving this population.
Catharina Carvalho is now at Department of Psychology, Texas A&M University College Station. Amanda Cervantes is now at Department of Special Education, Individual Evaluation, Dallas Independent School District.
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