Comparing and Characterizing Trauma-Sensitive Behavior Management Decisions of Speech-Language Pathologists With Trauma-Sensitive Perspectives

Purpose: The purpose of this study was to classify and quantify the strategies used by speech-language pathologists (SLPs) when responding to behaviors that are challenging in children with a known history of adversity and to determine how trauma-sensitive perspectives, years in practice, and self-related familiarity of trauma-sensitive practices correlate with SLPs' use of trauma-sensitive behavior management strategies. Method: Fifty SLPs who worked with school-aged children completed the Attitudes Related to Trauma-Informed Care Scale–Version 45 Education (ARTIC-45) and responded to eight video-based, behavior management scenarios. The videos contained common, challenging behaviors exhibited by children with a history of adversity. Content analysis and descriptive statistics were used to classify and quantify the behavior management strategies used. Correlations evaluated the relation between trauma-sensitive perspectives, clinicians' years in practice, and self-related familiarity of trauma-sensitive practices with SLPs' chosen behavior management strategies. Results: SLPs were most likely to use connection-based strategies, closely followed by non–trauma-sensitive strategies and few regulation strategies. There was minimal evidence of a correlation between SLPs' responses on the ARTIC-45, their years in practice, or self-related familiarity of trauma-sensitive practices in relation to the strategies they used to address behaviors that are challenging. Conclusions: SLPs' perspectives on trauma-sensitive practices do not significantly relate to their described behavior management practices. Although SLPs use some trauma-sensitive practices—chiefly connection and engagement strategies—they also rely on non–trauma-sensitive behavior management strategies. This study provides a basis for the future study of SLP perspectives, behavior management, and child outcomes as related to a history of adversity and trauma. Supplemental Material: https://doi.org/10.23641/asha.33307506