CHARACTERISTICS OF INTERDISCIPLINARY PRACTICE
|Nicole E. Boivin, Heather Blevins, Vanessa Norton, Crystal Pierce, Amanda Stone, Mary Jane Weiss and Cory Whelan
An interdisciplinary practice model in education is an integrated approach to education involving continuous collaboration among students, their family members and the professionals responsible for delivering services to a student and his or her family. When implemented as intended, interdisciplinary treatment offers a comprehensive and holistic approach to addressing a student’s needs in a highly efficient manner, as solutions and interventions are implemented to address multiple presenting needs simultaneously.
At the core of interdisciplinary practice is a shared responsibility for decision-making and care among all team members. In other words, team members are equally accountable to implement, evaluate and recommend intervention strategies that will most effectively address a student’s educational goals. This requires members of the team to have an understanding of one another’s roles, as well as the scope and boundaries of each member’s skill set. Team members must also be willing to move away from an “expert” model in which each person has sole jurisdiction over his or her individual area of expertise. Instead, team members are encouraged to consider all interventions with a critical eye, and offer recommendations that are truly in the best interest of the student.
Elements of Interdisciplinary Treatment Planning
The interdisciplinary process should start even before a new student’s first day; it should start upon receiving an application for admission and an initial visit to the school. For example, while the behavior analyst on the team might consider a student a strong candidate for admission, the physical therapist may be consulted to ensure the school has the resources to properly accommodate any physical impairment or challenge that the student may have. Even though a potential student’s behavioral profile may be a good fit for the school, if the environment cannot be adapted to allow the student accessibility to programs, the placement may not be appropriate for that individual.
This collaborative approach should continue throughout each student’s tenure at the program. Through Individualized Education Program (IEP) planning meetings, biweekly academic and clinical review meetings, and parent meetings, the entire team is involved in making decisions about academic, clinical and therapeutic programming for students. For example, when developing a functional communication training program for a student who is non-vocal, the behavior analyst works with the speech-language pathologist and occupational therapist to select the best modality for the communication response. Without collaborating with the appropriate team members, the behavior analyst could inadvertently select an icon-exchange response when the student does not have the fine motor skills or icon discrimination skills needed to produce the response. From admission to graduation, each student’s programming is developed with the expertise and input from a variety of disciplines in order to ensure delivery of the highest quality services.
Effective Training Essential for Interdisciplinary Practice
To promote student success and progress, all team members involved in a student’s education plan need to be able to implement goals and objectives effectively. The interdisciplinary team works to train team members including related service professionals, behavior analysts, teachers, paraprofessionals and family members about how to best arrange the environment to support a student’s learning. Trainings addressing student goals, behavioral support plans, and adaptive equipment is typically “hands on.” Generally, skills are practiced in contrived situations and in role-plays before working with students. The trainer is then able to provide immediate and constructive feedback. Furthermore, each professional collaborates with all team members if implementation of an objective is ineffective or the student masters an objective and is ready to move to the next level. The team may then decide to make modifications to a student’s program and retrain all team members accordingly.
Another way to promote the teams, and therefore a student’s, success is to communicate the importance and rationale behind decision-making. The team continually researches and stays responsive to the best evidence available. Members of the interdisciplinary team share relevant information regarding their area of expertise to others to increase everyone’s understanding. Continual training is provided, and all team members are held accountable for student success.
Examples and Benefits of Interdisciplinary Education
The ways in which Melmark implements interdisciplinary practice are evident throughout a typical day. An example can be seen within the delivery of occupational therapy services. Although therapists routinely go into classrooms and residences to implement a student’s lesson plans, team members including parents, teachers and other specialists also carry out those programs when the therapist is not present. Therapists also use consultation sessions to observe program implementation by others in order to provide feedback, facilitate generalization of skills from the therapist to the other team members, and observe programs of other disciplines that might include component skills related to their own discipline. In turn, occupational therapists are also well-trained in ABA practices to ensure all IEP objectives are clearly defined and measurable, and decisions regarding programming are always driven by data. They may also collaborate with the behavior analyst for the development of behavior support plans, another situation where interdisciplinary practice is critical. For example, the behavior analyst may draft an intervention to address a student’s toileting skills; however, the plan may also require input from the student’s occupational therapist regarding any fine motor needs or accommodations that may need to be made related to clothing management during that process. Together, such interdisciplinary collaboration allows for more opportunities for students to perform each skill, generalize skills across various people and environments and acquire skills more rapidly across all domains.
This model is also easy to extend into public school environments, where multiple disciplines are routinely represented. The challenges in these settings are often practical; it can be challenging for busy public school employees to make time for meetings and for collaborative conversations. Yet, these conversations are essential to successful collaborations. Meetings and interactions provide the contexts for the demonstration of techniques and for problem solving about difficulties.
Troubleshooting for Continuous Quality Care
To give the impression that working in an interdisciplinary team is without its obstacles would be misleading. Beyond the everyday challenges of meeting timelines and completing the tasks related to service delivery, some of the greatest roadblocks for providers to be aware of and avoid are a lack of understanding of other team members’ roles and a lack of humility. Assuming that one person’s area of expertise is the most important component of a student’s educational plan devalues everyone else on the team, most importantly the student. It is essential that teams remember that students are made up of several different strengths and needs; to claim one is most important is simply poor practice. Understanding what each member of the team is able to contribute and valuing those contributions are vital to the success of the team and, ultimately, the student.
Nicole E. Boivin, Ph.D., CCC-SLP, BCBA-D, is Director of School Services for the Early Childhood Program, Melmark New England. Heather Blevins PT, DPT is Director of Rehabilitation Services, Melmark. Vanessa Norton, M.S., OTR/L is an Occupational Therapist for Melmark New England. Crystal Pierce, M.S., CCC-SLP is a Speech-Language Pathologist, Melmark. Amanda Stone, PT, DPT is a Physical Therapist, Melmark New England. Mary Jane Weiss, Ph.D., BCBA-D is Executive Director of Research, Melmark. Cory Whelan, M.A., CCC-SLP/BCBA is Clinical Coordinator, Melmark New England.
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