Role of special educators regarding psychotropic interventions for students with emotional and behavioral disorders

The use of psychotropic interventions to manage the inappropriate behaviors displayed by students with EBD has become more common over the past several decades (Forness, Kavale, Sweeney & Crenshaw, 1999; Mattison, 1999). The efficacious use of these medications requires monitoring students for desired behavioral outcomes, as well as potential side effects. Educators are in an excellent position to monitor medication effectiveness and provide feedback to the prescribing physician, because they are in close proximity of students for up to six hours per day. Prior to special educators effectively performing these additional responsibilities however, it is essential to determine the types of psychotropic medications currently prescribed for students with EBD, in addition to the level of knowledge teachers have regarding these medications. To date, few studies have been conducted for students with EBD in the most restrictive placement settings (i.e., special day schools and residential facilities). The purpose of this dissertation was to address four research questions: (1) Are there differences in the types and rates of incidence for psychotropic medications for students with EBD placed in special day schools and residential facilities? (2) Are appropriate monitoring procedures established within these settings to provide opportunities for staff members to provide feedback to prescribing physicians regarding behavioral improvements or adverse side effects caused by medications? (3) Do medication rates vary depending upon ethnicity, age, or gender of students? (4) Does teacher knowledge of psychotropic medications vary depending upon teaching experience, level of education, or type of educational placement setting? In order to assess this information an exploratory study was conducted, in which a self-questionnaire pertaining to perceived knowledge of psychotropic medications was administered to a convenience sample of 74 special educators from 12 nonpublic residential and special day schools. In addition, medication records of 557 students serviced by these schools were reviewed to compare medication rates. This survey found medication rates in residential facilities (76%) were significantly higher than in special day schools (18%). While there were no differences in medication rates based on gender, high school students were more likely to receive psychotropic medications than those in grade school. In addition, African American students were less likely to be prescribed antipsychotics, selective serotonin reuptake inhibitors (SSRIs) or receive polypharmacy than their Caucasian or Hispanic peers. Special educators reported having minimal knowledge of any medication with the exception of stimulants and SSRIs. Lastly, no significant difference was found between teacher knowledge of psychotropic medications based on level of education, teaching experience, or the type of educational placement setting they were employed