Speech-Language Pathologists’ Behavior Management Training and Reported Experiences With Challenging Behavior

Abstract

The purpose of this exploratory study was to examine the extent that school-based speech-language pathologists (SLPs) received behavior management training and experience challenging behavior. We developed a web-based survey to address our research aims, and recruited participants via online community boards and social media. A sample of 233 school-based SLPs reported minimal focus on behavior management in their undergraduate and graduate programs, and that they often experience challenging behavior when delivering services. We conclude by inviting colleagues, both researchers and practitioners, to continue discussion around (a) the need for adequate behavior management training, (b) the potential promise of collaborative efforts between teachers, SLPs, and other related service providers, and (c) educators’ responsibilities to ensure that children and youth who receive special education services have access to the curriculum and demonstrate educational progress.

Keywords

survey research elementary school age speech-language pathologists (SLPs)

Language skills are essential for children’s social and academic success and they serve as a pathway to the development of successful relationships, and well as to knowledge and skill acquisition (Chow & Wehby, 2018; Hulme, Nash, Gooch, Lervåg, & Snowling, 2015; Johnson, Beitchman, & Brownlie, 2010). Seven percent of children begin school with communication challenges (Lindsay, Dockrell, Desforges, Law, & Peacey, 2010), which can impact their emotional and behavioral stability through increases in anxiety, withdrawnness, aggressiveness, and noncompliance (Beitchman et al., 2001; Maggio et al., 2014). Therefore, it is not surprising that children who begin school with language impairments are at a significantly increased risk for poor long-term academic, social, and behavioral outcomes (Catts, Fey, Tomblin, & Zhang, 2002; Chow, 2018; Norbury et al., 2017; Pickles, Durkin, Mok, Toseeb, & Conti-Ramsden, 2016; Snow, 2019; Tomblin et al., 1997). To best serve children with language impairments, we must make strong efforts to begin mitigating the adverse effects of language impairments that are early predictors of poor outcomes for young children (Chow, Ekholm, & Coleman, 2018; Westrupp et al., 2019; Yew & O’Kearney, 2013).

Speech-language pathologists (SLPs) in the United States are the related service providers that are most commonly responsible for identifying and addressing language impairments. Under federal regulations, such as the Individuals with Disabilities Education Act (IDEA; 2004), SLPs hold the legal responsibility within the public school system to provide the services needed to ensure children demonstrate educational progress. Because children with speech or language impairments (SLI) make up the second most common disability category in American schools, comprising 17.9% of children receiving speech and language services under IDEA (U.S. Department of Education; Duncan, Yudin, & Musgrove, 2015), efforts made to continually support these essential related service providers are a priority.

Many teachers do not receive effective behavior management training (Flower, McKenna, & Haring, 2017; Moore et al., 2017; Oliver & Reschly, 2010), but the extent that SLPs are properly equipped to manage behavioral challenges is unclear. This is a particular point of concern, as 81% of children with behavior disorders have clinically meaningful and unidentified language deficits (Hollo, Wehby, & Oliver, 2014) and these deficits emerge across subdomains of language (Chow & Hollo, 2018; Hollo, Chow, & Wehby, 2018). Furthermore, children with language impairments demonstrate more problem behaviors concurrently (Curtis, Frey, Watson, Hampton, & Roberts, 2018), and are twice as likely to demonstrate behavior problems later on than their typically developing peers (Yew & O’Kearney, 2013).

Given this common co-occurrence, an explicit focus on behavior management for school-based SLPs is an important area of need and further investigation is warranted. This is of particular importance, given that children with language impairments are likely to exhibit higher rates of problem behaviors than their peers (Curtis et al., 2018), and children with behavior disorders are more likely to need language intervention (Benner, Nelson, & Epstein, 2002; Chow & Wehby, 2019; Hollo et al., 2018). To date, the behavior management training of SLPs and the experiences SLPs have with challenging behavior in schools is limited (Beck & Dennis, 1997; Elksnin & Capilouto, 1994; Giddan, 1991). Thus, the purpose of this research note is to provide initial descriptive data on the prevalence of behavior management training in SLP preparation programs. Furthermore, we investigate the descriptive nature of SLPs’ experiences with challenging behavior while delivering services.

Given the high comorbidity of language impairments and behavior problems, it is likely that SLPs encounter challenging behavior while delivering services under IDEA. The purposes of this study were to (a) determine the amount of behavior management training school-based SLPs receive, and (b) better understand the extent that school-based SLPs report experiencing challenging behavior during service delivery.

Method

Recruitment and Participants

Participants included 233 SLPs working in school settings that completed an online survey regarding their experiences with challenging behavior and the level of training they received on how to manage behavior. For this exploratory study, we relied on social media outlets (Twitter, Facebook) and professional community boards (American Speech-language Hearing Association; Council for Exceptional Children) for dissemination. Data were downloaded for analysis approximately 30 days after initial release of the survey. See Table 1 for sample demographics and the Appendix for survey items.

Table 1.

Sample Demographics.

Sample characteristics (N = 233)	n	%
Gender
Female	227	97.42
Male	5	2.15
Other	1	0.43
Race/Ethnicity
African American	6	2.58
Asian	3	1.29
Hispanic	3	1.29
Other	3	1.29
White	213	91.42
Education level
Bachelors	3	1.29
Masters	222	95.28
Doctorate	8	3.43
ASHA certification
Yes	221	94.85
No	12	5.15
Location
United States	223	95.71
Other	10	4.29
	M (SD)	Range
Age in years	41.5 (12.1)	21–75

Note. ASHA = American Speech-Language-Hearing Association.

The large majority of participants were White, female, credentialed SLPs practicing in the United States. When asked about their work setting, 61% reported delivering services in preschool settings, 82% reported delivering services in elementary settings, and 44% reported delivering services in secondary settings, suggesting that SLPs in the current sample worked in multiple educational settings. In the present sample, 28% reported working in only one setting, and 24% reported working across all three settings.

Results

Findings from this survey, exploring the behavior management training of school-based SLPs, revealed as expected that the overwhelming majority of participants attended programs that did not offer a course dedicated to behavior management in their undergraduate (92.7%) or graduate programs (91.4%). When asked about the number of courses that provided coverage of any behavior management content, SLPs reported more course coverage in their graduate programs than their undergraduate programs (see Table 2). In spite of receiving minimal training, on average, SLPs overwhelming believe behavior management strategies are important when working in school settings (138 = strongly agree, 35 = agree, 2 = neutral, 0 = disagree, 1 = strongly disagree).

Table 2.

Preservice Training Received Related to Behavior Management (N = 233).

Characteristic	n	%
Undergraduate course devoted primarily to behavior management
Yes	17	7.3
No	216	92.7
Graduate course devoted primarily to behavior management
Yes	20	8.6
No	213	91.4
Number of undergraduate courses that covered any behavior management content
0	116	49.8
1	38	16.3
2	18	7.7
3+	13	5.6
Did not answer	48	20.6
Number of graduate courses that covered any behavior management content
0	53	22.7
1	73	31.3
2	27	11.6
3+	15	6.4
Did not answer	65	27.9

We also explored SLP’s experiences with challenging behavior during service delivery. When asked to respond to the statement, “I do not work with children who exhibit challenging behavior,” more than 95% reported they strongly disagreed or disagreed, and less than 5% reported neutral, agreed, or strongly agreed. When asked about the frequency of encountering student challenging behavior, SLPs reported frequently experiencing challenging behavior (see Figure 1). These results suggest that SLPs likely experienced what they believe to be challenging behavior during service delivery, and that many SLPs encountered challenging behavior on a relatively frequent basis.

Figure 1.

SLP-reported frequency of working with children who present challenging behaviors.

Discussion

The purpose of this survey was to investigate school-based SLPs’ reported training in behavior management in their preparation programs, and their experiences with challenging behavior during service delivery. As expected, most participants did not receive behavior management training in their preparation programs. This study aims to highlight the apparent lack of systematic preparation of current and future SLPs, and this is important because they are likely to deliver services to children who exhibit challenging behavior (Curtis et al., 2018; Yew & O’Kearney, 2013). Without adequate preparation, SLPs may not have the capacity to effectively manage disruptive behaviors, which can have adverse impacts on the effectiveness of their services, as well as the amount of services they are actually able to deliver.

It is important for SLPs and the faculty leading preservice preparation programs to focus on how language impairments and problem behaviors are related, and how common these deficits co-occur for both theoretical and practical reasons. Knowing about the comorbidity of these characteristics and the negative impacts they have on students’ academic and social well-being may encourage preparation programs to install behavior management training for their candidates. This will increase SLPs’ knowledge about, and capacity to reduce, problem behavior, and in turn, support children’s appropriate behavior and academic engagement. Doing so will help to ensure that they are able to provide the most effective services for their students with language impairment mandated by law under IDEA (2004).

In this study, our data revealed that majority of the sample did not receive a course focused on behavior management in their undergraduate or graduate programs. However, the majority reported that they believe behavior management training is an essential component to effectively provide services in the schools. SLPs may report importance because they often experience problem behavior during their service time and feel ill-prepared, further highlighting the significance of behavior management. Furthermore, fewer than 5% of the sample reported that they did not work with students who exhibited challenging behavior. The present study indicates that SLPs may not be receiving adequate behavior management training during their preparation programs, while this is a problem that clinicians commonly encounter. The field of speech-language pathology may not currently include adequate levels of training and education specifically focused on behavior management. This exploratory study aims to provide descriptive data to call attention to highlight this issue and the implications for current service delivery and clinical preparation.

About 85% to 91% of school-based SLPs provide services to children with language impairments (American Speech-Language-Hearing Association, 2018). Because of this high percentage and the association between language impairment and problem behavior, it is likely that majority of SLPs experience problem behaviors during their sessions. Not only should clinical preparation programs ensure that SLPs receive behavior management training, but continuing education and professional development should consider the overlap of needs between special education teachers, behavior specialists, general education teachers, and paraprofessionals. For example, districts could provide general behavior management training as well as classroom management training to all school professionals in a general session, and subsequently tailor individual sessions to the needs of each specific position.

Limitations

This study has several limitations. First, the survey relied solely on self-report, which may come with considerable variation in reporting on preservice training, knowledge, and perceptions of one’s experience with students’ challenging behaviors. This survey did not include some potentially important contextual information, such as how many years out of their graduate program they were, as well as if they received continuing education on this topic. We also released the survey in the summer months, which may have solicited different responses from school-based SLPs as they may not have been currently practicing when they completed the survey. Thus, their recall of group sizes as well as their perceptions of the impact of behavior problems on their service delivery may have been reduced or exaggerated. Second, we disseminated the survey via social media outlets and community boards which limits our findings to SLPs who are active on social media or community boards, or SLPs with whom the members of the community shared the survey with. Third, we developed the questions using current literature with the specific aim of better understanding the nature of the training school-based SLPs receive; however, we did not conduct a pilot survey or cognitive interviews around each questions, which may have enabled us to glean more detailed information from survey responses. Finally, what each individual SLP defines as problem behavior is likely to vary from one practitioner to another based on their training, general experiences, and perceptions of challenging behavior. Future survey research should work with SLPs directly to develop more detailed and tailored questions about, and definitions of, specific problem behaviors, which will likely provide more information on current issues SLPs face in practice.

This survey provides an initial view of the behavior management training and experiences with challenging behavior that a sample of SLPs in the United States experience. This is not intended to be a comprehensive analysis of a representative national sample, but instead, to point to the experiences and needs of a sample of related service providers that are expected to deliver special education services by law. We conclude by inviting colleagues, both researchers and practitioners, to continue discussion around (a) the need for adequate behavior management training, (b) the potential promise of collaborative efforts between teachers, SLPs, and other related service providers, and (c) the responsibility that all educators have for ensuring that children and youth who require special education services have appropriate access to the curriculum and can demonstrate meaningful educational progress.

Footnotes

Appendix

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Jason C. Chow

References

American Speech-Language-Hearing Association. (2018). 2018 schools survey: Summary report: Numbers and types of responses, SLPs. Available from www.asha.org

Beck

A. R.

Dennis

(1997). Speech-language pathologists’ and teachers’ perceptions of classroom-based interventions. Language, Speech, and Hearing Services in Schools, 28, 146–153.

Beitchman

J. H.

Wilson

Johnson

C. J.

Atkinson

Young

Adlaf

. . . Douglas

(2001). Fourteen-year follow-up of speech/language-impaired and control children: Psychiatric outcome. Journal of the American Academy of Child & Adolescent Psychiatry, 40(1), 75–82.

Benner

G. J.

Nelson

J. R.

Epstein

M. H.

(2002). Language skills of children with EBD: A literature review. Journal of Emotional and Behavioral Disorders, 10, 43–56.

Catts

H. W.

Fey

M. E.

Tomblin

J. B.

Zhang

(2002). A longitudinal investigation of reading outcomes in children with language impairments. Journal of Speech, Language, and Hearing Research, 45, 1142–1157.

Chow

J. C.

(2018). Comorbid language and behavior problems: Development, frameworks, and intervention. School Psychology Quarterly, 33, 356–360.

Chow

J. C.

Ekholm

Coleman

(2018). Does oral language underpin the development of later behavior problems? A longitudinal meta-analysis. School Psychology Quarterly, 33, 337–349.

Chow

J. C.

Hollo

(2018). Language ability of students with emotional disturbance: Discrepancies between teacher ratings and direct assessment. Assessment for Effective Intervention, 43, 90–95.

Chow

J. C.

Wehby

J. H.

(2018). Associations between language and problem behavior: A systematic review and correlational meta-analysis. Educational Psychology Review, 30, 61–82.

10.

Chow

J. C.

Wehby

J. H.

(2019). Profiles of problem behavior in children with varying language ability. Journal of Emotional and Behavioral Disorders, 27, 110–118.

11.

Curtis

P. R.

Frey

J. R.

Watson

C. D.

Hampton

L. H.

Roberts

M. Y.

(2018). Language disorders and problem behaviors: A meta-analysis. Pediatrics, 142(2), e20173551.

12.

Duncan

Yudin

Musgrove

(2015). 37th annual report to congress on the implementation of the Individuals with Disabilities Education Act, 2015. Alexandria, VA: U.S. Department of Education.

13.

Elksnin

L. K.

Capilouto

G. J.

(1994). Speech-language pathologists’ perceptions of integrated service delivery in school settings. Language, Speech, and Hearing Services in Schools, 25, 258–267.

14.

Flower

McKenna

J. W.

Haring

C. D.

(2017). Behavior and classroom management: Are teacher preparation programs really preparing our teachers? Preventing School Failure: Alternative Education for Children and Youth, 61, 163–169.

15.

Giddan

J. J.

(1991). School children with emotional problems and communication deficits: Implications for speech-language pathologists. Language, Speech, and Hearing Services in Schools, 22, 291–295.

16.

Hollo

Chow

J. C.

Wehby

J. H.

(2018). Profiles of language and behavior in students with emotional disturbance. Behavioral Disorders, 44, 195–204.

17.

Hollo

Wehby

J. H.

Oliver

R. M.

(2014). Unidentified language deficits in children with emotional and behavioral disorders: A meta-analysis. Exceptional Children, 80, 169–186.

18.

Hulme

Nash

H. M.

Gooch

Lervåg

Snowling

M. J.

(2015). The foundations of literacy development in children at familial risk of dyslexia. Psychological Science, 26, 1877–1886.

19.

The Individuals with Disabilities Education Act (IDEA) (2004). 20 USC §1400.

20.

Johnson

C. J.

Beitchman

J. H.

Brownlie

E. B.

(2010). Twenty-year follow-up of children with and without speech-language impairments: Family, educational, occupational, and quality of life outcomes. American Journal of Speech-Language Pathology, 19, 51–65.

21.

Lindsay

Dockrell

Desforges

Law

Peacey

(2010). Meeting the needs of children and young people with speech, language and communication difficulties. International Journal of Language & Communication Disorders, 45(4), 448–460.

22.

Maggio

Grañana

N. E.

Richaudeau

Torres

Giannotti

Suburo

A. M.

(2014). Behavior problems in children with specific language impairment. Journal of Child Neurology, 29(2), 194–202.

23.

Moore

T. C.

Wehby

J. H.

Oliver

R. M.

Chow

J. C.

Gordon

J. R.

Mahany

L. A.

(2017). Teachers’ reported knowledge and implementation of research-based classroom and behavior management strategies. Remedial and Special Education, 38, 222–232.

24.

Norbury

C. F.

Vamvakas

Gooch

Baird

Charman

Simonoff

Pickles

(2017). Language growth in children with heterogeneous language disorders: A population study. Journal of Child Psychology and Psychiatry, 58, 1092–1105.

25.

Oliver

R. M.

Reschly

D. J.

(2010). Special education teacher preparation in classroom management: Implications for students with emotional and behavioral disorders. Behavioral Disorders, 35, 188–199.

26.

Pickles

Durkin

Mok

P. L.

Toseeb

Conti-Ramsden

(2016). Conduct problems co-occur with hyperactivity in children with language impairment: A longitudinal study from childhood to adolescence. Autism & Developmental Language Impairments, 1, 1–11. doi:10.1177/2396941516645251

27.

Snow

P. C.

(2019). Speech-language pathology and the youth offender: Epidemiological overview and roadmap for future speech-language pathology research and scope of practice. Language, Speech, and Hearing Services in Schools, 50, 324–339.

28.

Tomblin

J. B.

Records

N. L.

Buckwalter

Zhang

Smith

O’Brien

(1997). Prevalence of specific language impairment in kindergarten children. Journal of Speech, Language, and Hearing Research, 40, 1245–1260.

29.

Westrupp

E. M.

Reilly

McKean

Law

Mensah

Nicholson

J. M.

(2019). Vocabulary development and trajectories of behavioral and emotional difficulties via academic ability and peer problems. Child Development. Advance online publication. doi:10.1111/cdev.13219

30.

Yew

S. G. K.

O’Kearney

(2013). Emotional and behavioural outcomes later in childhood and adolescence for children with specific language impairments: Meta-analyses of controlled prospective studies. Journal of Child Psychology and Psychiatry, 54, 516–524.