Special education is specially designed instruction, keeping in mind their unique needs and individual differences. Providing this involves a multi-disciplinary team consisting of various professionals of whom special educators play a very crucial role. They determine the eligibility of a student in receiving special educational services. For this they compile information about the child where clinical reports act as an important tool by providing information about the case history, diagnosis of the disability, results of medical tests etc. The current study was conducted to check the competency of the special educators in accessing and interpreting the information from clinical reports. This was conducted by taking two groups of special educators, one group (21) from All India Institute of Speech and Hearing Mysuru (AIISH) and another group (25) of special educators from eight other institutions in Mysuru. A validated questionnaire was prepared based on the clinical reports of communication disorders which included the domains of audiology, speech-language pathology, clinical psychology and general information and was administered on the special educators. The results indicated that the special educators from AIISH scored significantly higher than special educators from other institutions. It was seen that the special educators from other institutions fared poorly across all domains of clinical reports especially in general information. It was concluded that the probable reason for the better performance of AIISH special educators could be due to following multi-disciplinary approach for providing special educational services, continuous interaction with other professionals while discussing different cases and their clinical reports and thus learning functional utility of clinical reports.
Special educators are professionals who teach students with special needs keeping in mind that it should address their special needs and individual differences. Successful rehabilitation of CWSN requires a multi-disciplinary approach of various professionals like clinical psychologists, audiologists, speech-language pathologist, paediatricians, and special educators etc. who are critical for rehabilitation of individuals with special needs. They determine whether the child is eligible to receive special education services available for them. Then rehabilitative plans such as Individualized Education Program (IEP) or Curriculum Support Services (CSS) etc are planned. To provide an effective plan, the assessment of the child’s abilities across various domains should be accurate and for this the clinical reports and medical records are very crucial tools. Clinical reports provide details of the identity, current condition, case history, type & severity of the disorder, referrals and recommendations made by various professional etc. provide an insight to a special educator about the child’s present condition and gives an idea of the requirements needed to help the child’s progress. Thus it is important for a special educator to have a good understanding of the content of the clinical reports, and also have the ability to form appropriate reason to back their decisions on the basis of the information deduced from the medical reports. This study is aimed towards measuring the competency of special educators in accessing and interpreting the information from clinical reports. Based on the results it will be deduced whether there is judicious use of the information provided in the clinical reports. In case if it was found that there are discrepancies in the use of information from clinical reports, then the reason behind it and solutions for same will be discussed.
The method of this study was broadly divided into four phases
Phase I: Selection of Special Educators
Phase II: Preparation of Questionnaire
Phase III: Administration of Questionnaire and collection of dat
Phase IV: Analysis of data 3.1. Phase I: Selection of Special Educators Two groups of special educators were taken for the study which consisted of 21special educators from AIISH preschool and 25 special educators from 8 schools for children with special needs in Mysuru. All the special educators had minimum qualification of 1 year Diploma course related to special education and currently working as special educators with minimum work experience of at least two years. Purposive sampling technique was used for selection of special educators.
3.2. Phase II: Preparation of Questionnaire In order to find the competency of special educators in interpreting information from clinical reports, a questionnaire was developed on the domains of basic terms used in clinical reports especially from the summary report based on Provisional Diagnosis reported in the clinical reports and there inference. This report is exchanged among professionals when writing referrals. The questions were based on the domains of audiology, speech language pathology, clinical psychology and general information. The formation of the questionnaire underwent the following stages
1) Preparation of tentative questionnaire
2) Validation of questionnaire by experts
3) Carrying out pilot study
4) Finalization of questionnaire
In the first stage a tentative questionnaire was prepared with questions based on basic terms used in provisional diagnosis and their interpretation. Around 25 summary reports of CWSN of the disabilities like hearing impairment, cerebral palsy, mental retardation and multiple disabilities were studied and most common terms used were noted down. Objective type questions based on these terms and their inference were prepared with the answer key and scoring pattern.
In the second stage, the tentative questionnaire was then given for validation to a team of experts for their opinions, corrections and suggestions. The experts are individuals who have completed their Doctoral studies in their respective fields and are working as Lecturers in AIISH, Mysuru in the departments of Audiology, Speech Language Pathology, Clinical Psychology and Special Education. They were provided with the questionnaire and were asked to give their suggestions to correct the mistakes and improve the questionnaire. A total of eight lecturers i.e. two from each department were given the questionnaire for validation. Once the corrections and suggestions were given, they were incorporated and the improved questionnaire was presented again to the same members and finalized for conducting pilot study.
In the third stage, a pilot study was conducted on 5 students doing special education courses in AIISH Mysuru. The age range of the special educators for pilot study was around 21-23 years. It was observed that it took around 15 minutes to solve the questionnaire and 5 minutes for evaluation. The average score of the students was around to be 65%.
In the fourth stage the questionnaire was finalized. It had twenty questions of three types, which were of multiplechoice, true or false and arrange the following type questions. There were thirteen Multiple choice questions having four options and the special educators were instructed to tick only one answer among the four. There were four true or false questions and the special educators were given a statement and were instructed to tick whether the statement was true or false. There were three arrange the following questions and the special educators were given a set of steps of procedure and were instructed to assign numbers in ascending order of the steps. The finalized scoring pattern consisted of all questions having one mark and thus the questionnaire is of total 20 marks. For every correct answer 1 mark is awarded and no marks assigned for wrong answers. In arrange the following questions; half mark was awarded if there was a mismatch or interchange in only one step.
3.3. Phase III: Administration of questionnaire and collection of data The questionnaire was administered to the special educators in the form of a test. There was no time limit for completion of the test, but it was observed that it took an average of 15 to 20 minutes for completion of the test. The answers were scored and entered into separate columns of special educators of AIISH and special educators of other institutions.
3.4. Phase IV: Analysis of the data
A total of 46 special educators participated in the survey out which 21 were from AIISH Mysuru and 25 were from eight special schools in Mysuru. While analysing the questionnaire each correct answer was given as +1, and every wrong answer and the un attempted were given score of 0. Half mark was given in arrange the following question if there was mix-up in only one step. Greater marks in test will indicate better awareness level of the special educators about information in clinical reports and their interpretation and vice versa. The obtained data was statistically analysed using SPSS software version 17.
Results and discussion
The aim of the present study was to investigate the competency of special educators in accessing and interpreting information from clinical reports. To fulfil the aim of the study, the developed questionnaire was administered on 46 individuals from AIISH and eight other special schools in Mysuru. The response obtained from the special educators on awareness of the terms used in clinical reports and their inferences was done using the statistical analysis software SPSS (Statistical Packages for Social Science) version 17.0.
The analysis was started by administering Shapiro-Wilks test and is showed that the scores of both groups followed a normal distribution curve; it was then followed by the statistical analyses as given below
• Descriptive statistical analysis to know the mean and standard deviation of the obtained data under both groups
• Independent Two-Sample t-Test to test whether special educator mean scores are significantly different from each other.
The special educators of the survey were in two groups, 21 special educators from AIISH and 25 special educators from 8 special schools in Mysuru. The figure 4.1 gives the information about results obtained by special educators from AIISH and other institutions who participated in the survey.
Figure 4.1 Showing marks out of 20 obtained by special educators of AIISH and other institution
As it can be seen from the figure 4.1, majority of AIISH special educators scored in the range of 10-15 marks and majority of special educators of other institutions scored in the range of 5-10 marks. It was seen that the highest score obtained among the AIISH special educators was 18 and the lowest score was 7. The highest score obtained among special educators from other institutions was 14 and the lowest score was 4.
Performance of special educators of AIISH and other institutions for the questionnaire
The performance of the special educators of AIISH and other institutions based on the results obtained by administering the questionnaire was assessed using descriptive statistics and the results are shown in table 4.1.
Table 4.1 Shows the mean scores of special educators of AIISH, and other Institutions obtained after administering the questionnaire
In the table 4.1 it is observed that there is a difference of 4.26 among the means of both groups which is about 21.3%. It is seen that AIISH special educators have scored more than special educators of other institutions. To check if there is significant difference between the two groups an Independent two sample t-test was administered.
Comparison of the performance of the special educators of AIISH and other institutions for the questionnaire
An Independent two-sample t-test was used to compare the scores of the special educators from AIISH and other institutions. The results are shown in table 4.2.
Table 4.2 Showing the t-values, p values of special educators of AIISH and other institutions
From table 4.2 it is seen that there is significant difference (p<0.05) among the results of both groups and special educators of AIISH have scored significantly higher than the special educators of other institutions. Hence the competency level of special educators from AIISH and other institutions in accessing and interpreting clinical reports is shown and it is seen that AIISH special educators are more competent than special educators from other institutes in accessing and interpreting information from clinical reports.
To further emphasize the areas where the special educators performed poorly, a domain wise analysis was conducted. The questionnaire included questions having components from 4 domains which were related to audiology, speech-language pathology, psychology and general. The general components consisted of knowledge about referrals to other professionals, purpose of summary report and choosing a mode of communication for communication disorders. There were 8 components from audiology, 6 from speech-language pathology, 5 from psychology and 3 from general. The results of the performance of special educators of AIISH and other institutions are shown in figure 4.2.
Figure 4.2 Showing the scores (in %) of special educators of AIISH and other institutions across the 4 domains considered in the questionnaire
It is seen from figure 4.2 that AIISH special educators have scored comparatively high across all the domains, especially in the general section. It is also seen that the Special educators have scored considerably well in components related to psychology, but they have scored low in the general domain.
Some of the reasons which may explain the results obtained are, the rehabilitative services provided at AIISH are multidisciplinary in nature, where there is an effective collaboration among special educators and other professionals like audiologists, speech-language pathologists, clinical psychologists etc. There is constant exchange of information among these professionals regarding various cases where they discuss findings of various clinical assessments like Audiological evaluation, speech and language evaluation scores, psychological assessment etc. There are regular follow up sessions after every six months. All this information is treated with high level of importance while deciding the eligibility of child to enter pre-school setup and receive special education. The clinical reports are also referred while making periodical educational goals, plans, evaluation and while promoting a child to a higher grade. Thus we see that special educators of AIISH are exposed to functional usage of clinical reports on a regular basis.
Whereas the special educators of other institutions although providing rehabilitative services have lesser exposure to multidisciplinary team approach and thus lack functional understanding of clinical reports and the use of referrals. It is seen that the practice of referring clinical reports for eligibility, planning and evaluation of special educational services may not be followed strictly. It was also seen during the data collection period that many special educators from other institutes reported difficulty in understanding information in English language. But it is a fact that clinical reports provided by majority of heath care institutes and professionals are in English language. It was also observed that many times children were admitted in the special school setup with the screening level evaluation and not diagnostic evaluation which is officially recommended. Thus the opportunity to refer a detailed clinical report is considerably less for the special educators of other institutes. It is to be seen that if special educators from other institutes are provided an opportunity to work in a multidisciplinary team for rehabilitative services and substantial amount of exposure to clinical reports they might perform on par with special educators of AIISH. It is also to be seen that the information given in clinical reports should be provided in either simplified or regional languages so that it is easily understood by the special educators of other institutions.
The recommendations for further improvement include –
•Conducting enrichment programs regarding importance of clinical reports and how to access and interpret the information in them and apply it in all aspects of special educational services
•Conducting orientation programs for special educators regarding importance of multi-disciplinary approach and how to consult other professionals of a multi-disciplinary team
•A manual has to be prepared which is simplified and translated into different regional languages having the terms used in clinical reports and how to interpret them; it can be used by special educators for reference whenever they have to refer a clinical report.
Clinical reports are an important tool for assessment as they provide a whole range of information which are exchanged among Special Educators and other professionals in a multi-disciplinary team while deciding eligibility, forming goals, executing plans and evaluation of performance. Hence the present study was conducted with the aim of checking the competency of special educators in accessing and interpreting information from clinical reports. From the results it was seen that AIISH special educators scored better across all domains compared to other special educators. It was deduced that this could be because of the higher exposure to multi-disciplinary approach and functional use of clinical records by AIISH special educators.
The results of the study imply that
•There is a need for compulsory implementation of multi-disciplinary approach to provide special educational services in all institutions
•There is need to increase exposure of functional use of clinical reports to special educators of other institutes in Mysuru
•There is need to address the issue of language barrier in accessing and interpreting clinical reports
The authors express their sincere thanks Dr. S.R. Savithri, Director, All India Institute of Speech and Hearing for providing me the opportunity to carry out this study. They are grateful to Mr. Santosha C D for his valuable inputs and guidance in carrying out the statistical analysis. They are thankful to all the students of AIISH, special educators of AIISH pre-school and other institutions who participated in the survey. They wish to thank the staff of dept. of clinical services, electronics, and library sciences for their support and everybody who has directly or indirectly helped us in conducting this study.
Individuals with Disabilities Education Act (2004).
American Academy of Special Education Professionals (2006).
AASEP’s Staff Development Course – Roles and Responsibilities of the Special Education Teacher, Copyright AASEP. Pierangelo, R. A. (2005). Special Educator’s Survival Guide, Jossey Bass Publishers. Simeonsson, R. J., Edmondson, R., Smith, T, Carnahan S, Bucy, J. E. (1995). Family involvement in multidisciplinary team evaluation: professional and parent perspectives. Child Care Health Dev. PubMed PMID: 7621559.
Virginia Department of Education (revised 2010). Parents’ Guide to Special Education. Division of Special Education and Student Services, Virginia Department of Education.
Toth, G. (1999). The Role of Special Teacher in the Special Education. Department of Special Education - Faculty of Education and Human Sciences, Yokohama National University, Japan. Ali Yavar Jung National Institute for the Hearing Handicapped (n.d.).
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