PPT - Collaboration With a Multi Disciplinary Personnel

8/4/2019 PPT - Collaboration With a Multi Disciplinary Personnel

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Collaboration with a Multi

Disciplinary Personnel


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Organization of the PresentationIntroductionIssues affecting effective collaboration Ethical Issues

Turf issues

Professional collaboration with: SLP (Speech & Language Pathologist) PT (Physical Therapist)

OT (Occupational Therapist) Principals

Child Study Team

Board of Education Other professionals (medical doctor)

Suggestions for the future

References


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What is collaboration?

Working together to enhance thelearners experience

Respecting professional expertise


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What is collaboration? contparticipation in identifying, designing, anddeveloping inclusive program optionswith families and other professionalsforming partnerships has enhancedprofessional practiceearly childhood special educator'sexperiences, resources, and contacts can bevaluable assets to communities as they seek

to expand and sustain community-basedservice options(Allen & Polaha, 2003)


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What are the components of

collaboration?Communication

Decision MakingGoal Setting

Organization

Team Process

Nijhuis et. al. (2007)


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Why collaborate?

Learners and parents:

How many different people do they seebefore the child receives instruction?

What happens if parents and learners getconflicting information?


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Why collaborate? cont

Team Members:

Can we teach effectively in a vacuum?

Consistent instruction

Share ideas

Learn from each other


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Effective Collaboration

A basic understanding of:expertise

orientationterminologypotential role of the other professionalsin the collaborating team

(Geroski, Rodgers and Breen 1997)


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Helpful to Know

Qualifications +

Philosophy +

Professional terms +

Possible contribution to the team +

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Successful Collaborators

Willing to try strategiesInterested in using something newQuick to implement suggestions

High adopters had the most knowledge of curriculum and pedagogy knowledge and student friendly beliefs about

managing student behavior student-focused views of instruction ability to carefully reflect on students' learning

(Brownell et. al. 2006)


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Roadblocks to Effective

CollaborationExcessive paperwork

Difficulties identifying appropriate interventions withexisting resources

Lack of financial supportInadequate training in problem solving procedures

No release time for meetings

Meeting times difficult to arrange

Meetings last too long

(Yetter & Doll, 2007)


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Unsuccessful Collaborators

Moderate and low adopters were lessknowledgeable

Took longer to grasp ideas

Did not always implement them well

Some of these teachers needed to haveideas explained in detail

Would discard ideas they did not appear tocomprehend(Brownell et. al. 2006)


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Educating other professionals

Autism is a low-incidence disorder that has receivedincreasing attention as parents have organizedseeking more effective education services for theirchildren with autism 1

prepare early intervention practitioners to work withyoung children with autism, severe physicalimpairments, and other low incidence disabilities 1

The program features joint course work across the

Schools of Medicine and Education and seminars oncollaborationand teaming 2

1 Shriver, Allen, Mathews, 19992 Able-Boone, Crais, Downing, 2003


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Expanding Professional Roles

Will the shift from direct to indirect rolesaffect: job satisfaction

staff turnover potential for burn-out among early childhood

special educators

professionals who were originally attracted to

the field because of direct work with youngchildren and families may be less satisfiedwith roles that are now primarily adultoriented and facilitative in nature


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Ethical IssuesBefore we can collaborate, we need:

Mutual consent form signed by parents andstudent

Identify specific professionals to include Hand deliver, fax or mail

Make initial contact through a letter Avoid phone tag due to different schedules

Send parents a copy of the letterIndicate an interest in collaboration in thisletter


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Collaboration with

related serviceproviders


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Why should we collaborate?Coordination between the disciplines is importantwhen adding speech-language therapy to an appliedbehavioral program. All objectives must reflect acommon goal in order to build speech, language,

play, and social skills. (Parker 1996)... SLPs are not the only professionals who targetcommunication outcomes within the scope of theirpractice. Teachers, occupational therapists, readingspecialists, and behavior analysts do so as well,

either directly or indirectly. Therefore, cross-disciplinary collaboration is essential. (Koenig andGunter 2005)


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Benefits of CollaborationThe creation of evidence-based therapeuticapproaches and practices by individuals withcombined expertise in ABA and SLP

The ability to improve the integration of supportprovided by SLP and ABA professionals asparticipants on home-, school-, and center-basedintervention teams

A reduction in the number of reinvented wheels Discrete trial to establish skills and NET to generalize

(Koenig and Gerenser, 2006)


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The Role of the SLP

From the ASHA Position Statement Rolesand Responsibilities of Speech-LanguagePathologists in Diagnosis, Assessment, and

Treatment of Autism Spectrum DisordersAcross the Life Span

Collaboration: Speech-language pathologistsshould collaborate with families, individuals

with ASD, other professionals, supportpersonnel, peers, and other invested parties toidentify priorities and build consensus on aservice plan and functional outcomes.


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What do the fields of SLP and

ABA have in common?ABA and SLP are the treatment components most frequentlyrequested by parents

ABA and SLP therapists are highly focused on the individual, hisor her unique learning style, and the outcomes of treatment

Both ABA and SLP address skill deficits directly by teachingspecific language behaviors rather than treating the problemindirectly using specialized diets or sensory stimulationprograms

Both fields rely on procedures that are supported by evidence.Most therapists measure the child's performance by collectingdata to make decisions about progress and potential changes ininstruction.

(Harchik, 2005)


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Coordinating Speech-Language

Pathology with an AppliedBehavior Analysis Program

(Parker, 1996)

1. The SLP should develop language goalssimilar to those developed by the behaviorprogram in order to facilitate generalization.

- Ex. ABA program is working on expressive labels withthe Sd, What is this? The SLPs goal can be to use the

same vocabulary to request those items in a lowstructure, play context.


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2. The SLP should help to make the discrete-

trial goals of the behavior program ascommunicative and functional as possible. Ex. Work on requesting programs using objects of high

interest.

3. The SLP can add valuable informationabout speech-language goals that are beingaddressed in the behavior program. Ex. Suggest a prompt to remediate specific sound errors

such as placing a hand on the students throat to teach the

/k/ sound.


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4. The SLP helps to ensure that all therapists

are attempting to use similar vocabulary,commands, and toys in focusing on theirgoals.

5. The SLP can offer information to the

behavior team and parents ondevelopmentally appropriate linguistic formsand the developmentally normalcommunication sequence. Ex. Assists with the periodic reassessment of linguistic

goals.


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6. The SLP can demonstrate how to

incorporate specific goals into daily,preexisting activities, such as dinner,bath, and bedtime, which will be helpful

with generalization and sequencing. Ex. A daily activity such as cooking dinner can be

used to teach sequencing skills and specificlanguage forms. If the child is working on

prepositions, the parent can say, First we put thewater inthe pot, then the salt in, then the spaghettiin.


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7. The SLP should help develop reinforcers- bothtangible, such as food, stickers, and toys, and social,such as praise, hugs, and tickles.

8. The SLP should assess the manner in whichspeech-language skills are used within the classroomor play group in order to ensure maximum benefit

from these interactions. - Ex. Suggest that the teacher give the child a toy that she

knows another child likes, then encourage the two children toplay together.

- Ex. Encourage the classroom teacher to set up activities that

require a buddy, and pair the child with a peer who is both astrong language model and a friendly child.


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9. The SLP can also help troubleshootspecific linguistic problems. Ex. If the child is having difficulty remembering

the names of objects, the SLP can develop

appropriate categorization and world knowledgetasks.

10. The SLP can also aid in thediagnosis and treatment of concurrentdisorders (e.g. apraxia or dysarthria)


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Three models forteam interaction

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Component Multidisciplinary Interdisciplinary Transdisciplinary

Philosophy of

team interaction

Team membersrecognize the

importance ofcontributions from otherdisciplines.

Team members arewilling and able to

share responsibilitiesfor services amongdisciplines.

Team members commit toteach, learn and work across

disciplinary boundaries to planand provide integrated

services.

Family Role Generally, familiesmeet with teammembers separately

by discipline.

The family may or maynot be considered ateam member. Familiesmay work with thewhole team or teamrepresentatives.

Families are always membersof the team and determinetheir own roles.

Lines of

Communication

Typically informal.Members may not thinkof themselves as partof a team.

Team meets regularlyfor case conferences,consultations, etc.

Team meets regularly to shareinformation and to teach andlearn across disciplines (forconsultation, team building,etc.).

StaffDevelopment

Generally isindependent and

within disciplines.

Frequently shared andheld across disciplines.

Staff development is acrossdisciplines and is

critical to team

development and role

transition.


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Component Multidisciplinary Interdisciplinary Transdisciplinary

AssessmentProcess

Team membersconduct separateassessments bydiscipline.

Team members conductassessments bydiscipline and shareresults.

The team participates in anarena assessment, observingand recording acrossdisciplines.

Plan

Development

Team membersdevelop separate plans

for intervention withintheir own disciplines.

Goals are developed bydiscipline and shared

with the rest of the teamto develop a singleservice plan.

Staff and family develop plantogether based on familys

concerns, priorities, andresources.

Planimplementation

Team membersimplement their ownplan separately bydiscipline.

Team membersimplement parts of theplan for which theirdiscipline is

responsible.

Team members shareresponsibilities and areaccountable for how the planis implemented by one person,

with the family.

http://www.njeis.org/NJFoundationsSP.pdf


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The Consultative Model of

Service Delivery(Bellone, et. al 2005)


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Why should we use

this model?

For individuals with ASD, exclusive provision of

services through pull-out services does not addressthe underlying challenge of social communication

inherent in the disorder, the issues of

generalization, functional outcomes, or the

importance of collaborating with significantcommunication partners. (ASHA 2006)


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Why?, cont

Research on children with ASD suggests

that the greatest effects of any direct

treatment are reflected in the generalizationof learning achieved by working with

parents and classroom personnel.(NRC

2001)


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Traditional S&L services are

inadequate1-5 hours treatment per week

SLP is sole instructorIsolated setting

Skill generalization and maintenance difficult to

achieve given these limitations(Bellone, et.al., 2005)


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BUT

The pull-out model of service delivery continues to bethe most used model for preschool and school-age

children. (ASHA, 2004)

EVEN THOUGH

There is no evidence supporting the long-termeffectiveness of individual therapies implemented

infrequently (e.g., once or twice a week), unless the

strategies are taught to be used regularly by

communication partners in the natural environment.(ASHA 2006)


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Consultative S&L services

affordConsistent and continuous instructionthroughout the childs day

Skill generalization across people andsettings in childs natural environment

Skill maintenance through practice in

naturally occurring and programmedopportunities

(Bellone, et.al., 2005)


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The role of the SLP

Develop curriculum

Select data collection systems

Train teachers

Observe teachers & students

Attend meetings

Modify teaching procedures


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The role of the

teaching staffProvide multiple daily opportunities

Collect & sum data

Review data w/ SLP

Initiate questions, concerns

Troubleshoot w/ SLP

Incorporate changes into instruction


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The consultative model in a

public schoolSchool administrator contacted NECCs

consulting department

NECC directors met with teachers andadministrators

Defined role of SLPs and teaching staff

A letter was sent home to parents inviting them to

an informational meeting

After a follow up letter and phone call, 33% (n=24)

selected the consultative model


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The consultative model in a public school

Public School ContractServices were provided in 8 children in 3

classrooms

2 hours/mo of consultative (indirect) services fromSLP

40 hours/mo direct S&L instruction from lead

classroom teacher

SLP consult with Head teachers

Head teachers train teaching assistants


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The consultative model in a public school

Results

Public school students made progress/met

98% of objectives (2005)

NECC students made progress/met 90% of

objectives (2004)


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What do other disciplines

have to say aboutprofessional collaboration?


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Guide for Professional ConductPRINCIPLE 11

A physical therapist shall respect the rights, knowledge, andskills of colleagues and other healthcare professionals.

11.1 Consultation

A physical therapist shall seek consultation whenever thewelfare of the patient will be safeguarded or advanced byconsulting those who have special skills, knowledge, andexperience.

11.2 Patient/Provider Relationships A physical therapist shall not undermine the relationship(s)

between his/her patient and other healthcare professionals.

11.3 Disparagement Physical therapists shall not disparage colleagues and other

health care professionals. See Section 9 and Section 2.4.A.

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Code of Ethics

Principle 7. Occupational therapypersonnel shall treat colleagues andother professionals with respect,fairness, discretion, and integrity.(FIDELITY)

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Guidelines for Responsible Conduct For

Behavior Analysts9.0 The Behavior Analyst's Responsibility toColleagues.

Behavior analysts have an obligation to bring attention toand resolve ethical violations by colleagues, to make suretheir data are accurate and presented truthfully, and theyshare data with colleagues.

9.01 Ethical Violations by Colleagues

9.02 Accuracy of Data 9.03 Authorship and Findings 9.04 Publishing Data 9.05 Withholding data

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Are related serviceproviders a necessary

component of an effectiveprogram?


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A public program serving children in preschoolthrough eighth grade diagnosed with Autism and

related disabilities in Bergen County, NJThe speech-language department workscollaboratively with the classroom teachers topromote various communication modes such as thePicture Exchange System, computerized voice outputdevices, sign language, and fostering expressivelanguage. (McKeon, et.al. 2006)

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Does not employ related service personnel

Curriculum includes teaching programs that facilitate the

development of language and fine and gross motor skills

Programs are implemented by instructional personnel

throughout the day

Pull-out related services are rarely necessary because of

the breadth and comprehensiveness of the curriculum

If services are deemed necessary, appropriate referrals or

consultations are arranged by ALG staff

(Meyer, et. al, 2006)

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The Douglass School each class is supported by a half-time speech-language

specialist who provides individual and group therapy as well

as consultative services to the preschool teachers. Anadaptive physical education professional serves thepreschool children on the three times a week and acts as aliaison for consulting professionals such as physical oroccupational therapists. (Harris, et. al, 2001)

Douglass Outreach Douglass Outreach employs five licensed part-time speech

pathologists for speech-language services. (Harris, et. al,2001)

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Princeton Child Development InstituteStrong emphasis on language development

Does not employ specialists

All intervention personnel are trained to teach receptive and expressivelanguage in everyactivity Toilet training, outdoor play, lunchtime

Language instruction encompasses discrete trials, incidental teaching,time-delay procedures, and video-modeling procedures.

36 of 41 children entered PCDI before 60 months of age and had no

functional expressive language The skills of these children currently range from using sounds as mandsto

age appropriate verbal repertoires.(McClanahan and Krantz, 2001)

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Recommendations for

Continued CollaborationShare treatment efficacy data

Share innovative teaching procedures

Share basic informationShare successful collaboration experiences

Read articles in journals associated with theother profession

Share your concernsShare lunch

(Koenig and Gerenser, 2006)


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Parents / Home /Family PhysicianDentist, Doctor

SiblingsFamily Celebrations

Community

State of New Jersey

Department Of Education

Director of Special Services

STOTPT

ARTMusicBCBA

Teacher

After schoolservices(latch key)

DDDDVR

EmploymentSheltered Living

Department of Human Services

SPAN/COSAC/Autism Society of

America

BOE - Local School /Sending School District

Board of Education(Receiving School)

Child Service Team

Neighborhood,Shops,Restaurants

The Office of Early Careand Education (OECE)

School

PrincipleChildBus


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Collaboration with

AdministrationWho are the possible collaborativepartners?

How can we develop a collaborative

relationship?


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NJDOE Press Release:

February 20, 2007

Approximately 7,400 New Jersey children between

the ages of 5 and 21 have been diagnosed withautism spectrum disorders.

Fifty-five New Jersey school districts will share $15

million in state funds to establish, expand or enhancepublic school programs and services for studentsdiagnosed with Autism Spectrum Disorders..


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Administration

State of New Jersey

Department of Human Services

The Office of Early Care & Education (OECE) Division of Family Development

Department of Children and Families

Build NJ: Partners for Early Learning

Coalition of Infant/Toddler Educators (CITE)


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AdministrationChild care services are coordinated through Department of Human Services' Office of Early Care and Education

for information, policy and resources

the Division of Family Development for child care operations

the Division of Developmental Disabilities

the Office of Licensing in the Department of Children and Families(DCF)

all in cooperation with Child Care Resource and Referral Agenciesin every county

Services include: information and referral to help parents locate child care resources

and to answer typical questions regarding types of child care how to pay for care

how to become family day care and licensed child care providers.


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AdministrationDepartment of Education

Division of Early Childhood Education The Division of Early Childhood Education (DECE) of the New Jersey Department of

Education has programmatic responsibility for preschool through 3rd grade (PK3)programs.

responsible for the development, implementation, and alignment of programcomponents with a focus on standards, curricula, and assessment.

The creation of this division:

Acknowledges that a continuum of developmental stages constitute what is traditionally knownas early childhood,

Protects New Jerseys investment in high quality preschool by providing high qualitykindergarten through third grade educational experiences for young children.

PK3 work will be organized within a framework that includes structural(administration, class size, teacher-child ratio, etc.)

process(quality of classroom environments, teacher-child interactions, etc),

alignment(standards, curriculum, assessments) components that are associated with childrenssocial and academic outcomes.

The DECEs work will be: Research-based, with a series of advisory committees consisting of nationally recognized

experts representing a range of early childhood-related areas

Cross-departmental to align all DOE PK3 initiatives,

Supportive of the efforts of the Division of School Improvement.


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Office of Special Education ProgramsImplements state and federal laws and regulations governing special education toensure that pupils with disabilities in New Jersey receive full educationalopportunities.

Provides statewide leadership through the development of policy and implementationdocuments and provides guidance to school districts and parents regarding theimplementation of special education programs and services.

Responsible for administering all federal funds received by the state for educatingpupils with disabilities ages 3 through 21.

Monitors the delivery of special education programs operated under state authority,provides mediation services to parents and school districts, processes hearings withthe Office of Administrative Law, and conducts complaint investigations requested bythe public.

Funds four learning resource centers (LRCs) that provide schools and parents withinformation services, materials circulation, technical assistance, consultation servicesand production services.

Plans and implements program and personnel development activities in areas such asimplementing the least restrictive environment provision, planning the transition ofstudents with disabilities from school to adulthood, planning programs and servicesfor preschool children with disabilities,developing Individualized Education Programs(IEPs) and accessing individual rights and entitlements.


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LEARNING RESOURCE CENTER - NORTH7 Glenwood Avenue, 2nd Floor, Suite 201

East Orange, New Jersey 07017

Regions served: Bergen, Essex, Hudson,Morris, Passaic, Sussex, and Warren

Counties(973) 414-4491 - LRC General Service(973) 414-4496-FAX (973) 266-1849-TTY(973) 631-6349 - Preschool TechnicalAssistancee-mail:[email protected]


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A collaborative model

The Child Study TeamComposed of teachers, specialists, administrators, and parentsResponsible for identifying and evaluating students aged 3 21 forspecial education programs and services.

Required to conduct both an educational evaluation and apsychological evaluation. (A neurological examination is also requiredbefore a child becomes eligible for special services.)

Develops an Individual Education Plan with parent/child.

Assigns a case manager Visits receiving school or agency with parent/child Organizes placement and transportation

(Walther-Thomas, Korinek, & McLaughlin, 1999)


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IEP Meeting

Who should attend? Student (if appropriate)

Parent

At least one general (or special) education teacher At least one Child Study Team member

Students case manager

School district representatives

Persons invited by parent or school Representatives of agencies providing payment

for services


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Typical School Operations Network

Council of the Borough(duly elected by town)

Board of Education (elected by Council)

Superintendent Hired by the BOE to direct operations

Manage the fiscal year budget Hire all school staff including Child Study

Team members, teachers, andprofessional support staff (ST, OT, PT,BCBA, librarian, etc.)


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SchoolEffective collaboration emerges out of concerns by individualswho are like-minded in some ways and very different in others.Walther-Thomas, Korinek, McLaughlin & Williams (2000)

Principals tend to focus on issues such as achievement trends,financial implications, professional development, studentplacement, professional schedules, and community relations.

Teachers are concerned with individual and group performance,IEP planning, and new responsibilities.

Families care about the impact of new initiatives on theirchildren.


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Improving student bus-riding behaviorthrough a whole-school intervention(Putnam, Handler Ramirez-Platt &

Luiselli, 2003)

Intervention developed through collaboration with

students, school personnel and bus drivers624 students participated during 5 phases of thestudyDisruptive behavior that resulted in referrals orsuspensions was targeted and measured in an ABAB

reversal designResults indicated an overall decrease in bussuspensions


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Parents have power!Parents and children are the service usersParents and children have the most to

gain/lose regarding adequate effective

services

The child is at the center and the parent needs

to learn to collaborate with all the serviceproviders and get them to collaborate with

each other from the time of diagnosis to adult development.

Parents can enlist the work of nonprofit agencies and foundations towork with one another to map the terrain of a problem

They should talk to public officials about providing long-term fundingfor vital programs both in their community and at the State level.

Parents should know their rights and not accept anything less.

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Suggestions for the Future

develop and evaluate new methods of preparingearly childhood special educators whose primary rolenow consists of consultation and collaboration, rather

than teachingUse the case method of instruction

Prepare professionals to become independent andcompetent problem solvers in the role of consultant

personnel training programs must be systemic innature

(Dybvik, 2004)


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Suggestion for the Future, cont

changes in professional roles

create opportunities for interactive learningfor professionals who function in a variety of

roles, including administrative onesensure a shared knowledge and values baseamong all professionals who serve youngchildren and families

Remedy roadblocks

(Skrtic, 1991)


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Suggestion for the Future, cont

21st century changes:

"the entire history of special education is (and should continue to be)one of incremental progress toward more socially inclusive instructionalplacements for students with disabilities"

Efforts aimed at early childhood community integration will continue topresent profound challenges to practitioners in ECSE

Effectively change our roles in response to the changing times, insupport of young children with and without disabilities growing up

together

(Skrtic, 1991)


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ReferencesAble-Boone, H., Crais, E. R., Downing, K., Preparation of Early Intervention Practitioners forWorking with Young Children with Low Incidence Disabilities, Teacher Education and Special

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Allen K. D., Polaha J., Bridging The Disconnection Between Applied Research And Practice: AReview Of Treatments That Work:Empirically Supported Strategies For Managing Child BehaviorProblems by E. Christophersen and S. Mortweet, Journal Of Applied Behavior Analysis 2003, 36,141146

American Speech-Language-Hearing Association. (2004c). 2004 Schools survey report: Caseloadcharacteristics. Rockville, MD: Author.

American Speech-Language-Hearing Association. (2003b).A workload analysis approach forestablishing speech-language caseload standards in the schools: Implementation guide. Rockville,MD: Author.

American Speech-Language-Hearing Association. (2006). Guidelines for Speech-LanguagePathologists in Diagnosis, Assessment, and Treatment of Autism Spectrum Disorders Across the LifeSpan [Guidelines]. Available from www.asha.org/policy.

"APTA Guide for Professional Conduct." American Physical Therapy Association. Jan. 2004.American Physical Therapy Association. 10 Oct. 2007 .

Bellone, Beth, Nicole Conley, and Laura Hutt. Consultative Services for Children with Autism andSevere Developmental Disabilaties. 2005 ASHA Convention, 18 Nov. 2005, New England Center forChildren. 12 Oct. 2007.


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Fawcett, S. B., 1991, Some values guiding community research and action. Journal of appliedbehavior analysis, 24, 621-636

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White Plains, NY: Longman."Foundations of Service Provision in the New Jersey Early Intervention System." New Jersey EarlyIntervention System. 17 Jan. 2005. 21 Oct. 2007 .

Gerenser, Joanne, and Mareile Koenig. "SLP- ABA: Collaborating to Support Individuals withCommunication Impairments." The Journal of Speech Language Pathology - Applied BehaviorAnalysis 1 (2006): 2-10. 23 Oct. 2007 .

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Harchik, Alan. "Children with Autism Benefit From the Expertise of Speech and LanguageSpecialists." News for Parents.Org. 2005. The May Institute. 23 Oct. 2007

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Koenig, Mareile, and Cheryl Gunter."Fads in Speech-Language Pathology." Controversial Therapiesfor Developmental Disabilities. Mahwah: Lawrence Erlbaum Associates,, 2005. 215-234.

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McKeon, John, Kathleen Vuoncino, Rebecca Brenkert, Karen Dinnell-Lopresti, Ellen Doyle, MarkLampert, Michelle Madden-Perez, and Scott Rossig. "The Valley Program." School-Age EducationPrograms for Children with Autism. Austin: Pro-Ed, Inc., 2006. 247-268.

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PPT - Collaboration With a Multi Disciplinary Personnel

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Transcript of PPT - Collaboration With a Multi Disciplinary Personnel