The identification and management of concussion is a growing public health issue. The science of concussion research and the clinical management of children and adolescents who have experienced concussion are rapidly evolving, presenting many challenges and opportunities for those serving this population. A concussion can impact cognitive, communicative, academic, and social success; students affected by concussion may be eligible for special education services. The current study is a national survey of speech language pathologists (SLPs) aimed at characterizing concussion knowledge and management in the schools. One thousand surveys were sent to school-based SLPs from 10 states. Twenty-eight percent of surveys were returned and the results offer a snapshot of current SLP practices and support improved identification and management of concussed children. Findings indicate school-based SLPs' uncertainty in some aspects of concussion knowledge and their role in concussion management. Increased training in pediatric TBI and concussion is needed, and research directed at identifying and developing sensitive assessments and effective treatments for pediatric concussion is required to ensure quality service delivery.

Introduction: To date, few research studies have evaluated pediatric feeding and swallowing practices in school systems across the United States. This study aims to i) understand the factors that impact a speech-language pathologists (SLPs) level of comfort in providing these services, ii) to identify barriers to service provision, iii) develop a concrete understanding of a SLPs role in providing feeding and swallowing services in a school setting, and iv) to identify the types of service suggested by school-based SLPs in response to a fictional case study. Methods: School-based SLPs and clinical fellows were invited to participate in a 10-15 minute web-based survey. The survey questions focused on basic demographic information, vocational history, barriers to treatment, and clinician comfort level. In addition, survey respondents were asked to develop a treatment plan in response to a fictional case study. In total, 200 anonymous survey responses were collected and analyzed. Results: Descriptive data, summarizing the demographic and vocational factors of the survey respondents, are provided. In addition, independent Pearson Chi-Square analyses were performed to determine the degree of association between the demographic/vocational factors and the SLPs self-reported comfort level. The results of these correlation analyses are reported and discussed. Barriers to dysphagia management and a summary of the services currently provided in the school setting are discussed from the perspective of professional practice issues. Analysis of the case study results indicated a wide range of treatment plans. The most common type of direct intervention suggested was an oral motor exercise regime, followed by diet modifications and the implementation of safe swallow strategies. Discussion: The survey results indicate a number of factors impact clinician comfort level including geographic region, previous medical experience and current service provision. A number of barriers to practice were identified which include academic and/or clinical preparedness and concerns related to the educational relevance of service. Approximately 26.5% of survey respondents indicated that there were providing feeding and swallowing related services in a school setting with 98.1 % of these clinicians providing collaborative consultation. The case study results highlighted the variability in treatment approaches.