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“If everyone is moving forward together, then success takes care of itself” Henry Ford
Many individuals with complex communication needs require multiple forms of assistive technology in addition to their augmentative and alternative communication tools. Whenever we work with children who use AAC or other assistive technologies, teamwork among providers is essential. Interdisciplinary teamwork provides many potential benefits to our clients and their team members, whereas practicing in a silo is known to result in overuse, misuse, or underuse of services that would benefit the children we work with. Teamwork across all providers may sound as simple as getting a quick meeting, yet many barriers exist which prevent a strong level of collaboration. Engaging in teamwork can vastly improve the care we provide to our children, and the benefits far outweigh the demands. How many of us in the Community regularly reach out to the providers who see our children?
To illustrate the benefits of teamwork, here is the story of Laura (pseudoname). Laura was a young girl with autism spectrum disorder requiring substantial support in the areas of social communication and restricted and repetitive interests. She used primarily unconventional forms of communication (e.g., hand-guiding) to express her wants and needs. At the age of 7, she had no form of communication which allowed her to express a variety of messages besides guiding others to objects of interest. A former therapist made her several picture symbols, but these were reportedly unsuccessful as Laura would tear them off a Velcro strip and throw them. At our initial evaluation, she demonstrated a strong interest in turning the light switch on and off, and we were able to teach her how to exchange a “light” picture symbol to switch the light. Our department was able to meet virtually with her school team (SLP, Special Educator, Paraprofessionals) to discuss potential strategies of communication, and we collectively decided a PECS-like approach may benefit her. Our department provided a brief training, and we reached a shared vision of where we hoped she would be in the future. Through e-mail exchanges, we consistently updated each other on progress. In her school setting, she was able to achieve hundreds of successful picture exchanges with a variety of partners in various settings; this is something that we could never have achieved in the private one-on-one setting.
I write this piece in hopes of inspiring some and reminding others why teamwork is so critical to the success of our students. Professionals establish goals and envision their 5 year plan to create change that truly make a difference in the child’s future. However, with so many professionals in each of our clients’ lives there may be competing visions for the future. Think of a child you work with who has complex communication needs; now imagine if all of the professionals in that child’s life were on a boat in the middle of a sea. Each individual has a paddle in their hands, and in the distance there are many islands. If each individual paddled towards a different island, they may never reach land. Even if a few chose to work together, they would expend extravagant effort to achieve their vision. Imagine rather if we work together as a full team under a single shared vision, perhaps we could actually achieve our goal faster and with less demand placed on individual team members.
Interdisciplinary teamwork is crucial for a variety of reasons. As Rogers and Nunez (June, 2013) suggest, engaging in interdisciplinary teamwork has the potential to prevent avoidable errors, duplicate services, missed referrals, and overuse/misuse/underuse of services. Copley & Ziviani (2004) suggest that lack of interdisciplinary teamwork in assistive technology evaluations may result in less than comprehensive assessment of individual needs and piecemeal equipment acquisition without consideration in how the equipment will be integrated. Through interdisciplinary teamwork, we have the potential to engage in shared learning experiences to maximize our knowledge of others’ professions while providing education about the scope of our own practice.
In theory this sounds like an easy dream to achieve; simply get all the professionals in the same room at the same time and hash it out, much like an IEP meeting. Yet often missing from those IEP meetings are the private providers and clinical specialists (e.g., ophthalmology, pediatric specialists, audiologists, etc.). Given clinic and teaching loads, administrative barriers, and other time constraints, often one professional assumes the role of liaison between team members. As a result, the entire team loses the opportunity to have an informed interactive discussion, and greater burden falls on the liaison. Even worse, we may fail to achieve a shared vision among all providers.
Interdisciplinary teamwork can be a challenging task, and there are many barriers we must overcome to implement this successfully. Members of the Community have likely experienced these barriers first-hand. What barriers do you feel exist that prevent all relevant stakeholders from being at the table? How is your team planning for five years in the future, and how do you ensure each member of your shares the same vision?
Resources: Copley, J. & Ziviani, J. (2004). Barriers to the use of assistive technology for children with multiple disabilities. Occupational Therapy International, 11(4), 229-243.
Teamwork is such a valuable tool to prevent barriers for communication. It is important to maximize student potential by meeting with staff to reflect on student progress and to identify areas of need to explore ways to promote student growth. Thanks for your valuable feedback on the importance of teamwork!!
dmertzlufft - 5/16/2017
Assessment
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Many teachers require their college students in communication disorders
or child development classes to complete a Communication Matrix
online. Please have your students use the Test Drive site for this
purpose. You may ask them to print out the Profile and Communication
Skills List as proof of their work.
My child doesn't seem to have real control over his body yet.
The only way I know that he wants something is because he fusses or whines when he's unhappy or uncomfortable, and he smiles, makes noises or calms down when he's happy and comfortable. Does this statement describe your child?
My child has control over her own behaviors, but she doesn't use them to try to communicate to me.
She doesn't come to me to let me know what she wants, but it's easy for me to figure out, because she tries to do things for herself. She knows what she wants, and her behavior shows me what she wants. If she runs out of something to eat, she will just try to get more, rather than trying to get me to give her more.
The remainder of the Communication Matrix is not applicable to your child based on your response to the last question. You have completed this assessment.
Each question you will see is related to a certain message that
your child might be able to express using a variety of behaviors.
Read the question and decide whether your child is able to
express the message described using any of the listed behaviors.
If the answer is YES, then you must also decide whether your child
has mastered the use of each behavior or whether it is still at an
emerging stage. Check either the mastered or emerging box next
to any behaviors your child uses to express the message. Use the
following definitions to decide whether a behavior is mastered or
emerging
Mastered
– Does this independently most of the time when the opportunity arises – Does this in a number of dierent contexts, and with dierent people
Emerging
– Does this inconsistently
–
Only does this when prompted or encouraged to do so. Only does this in one or two contexts or with one person.
Tips on Communication Devices
Each question you will see is related to a certain message that your child might be able to express using a variety of behaviors.Read the question and decide whether your child is able to express the message described using any of the listed behaviors.If the answer is YES, then you must also decide whether your child has mastered the use of each behavior or whether it is still at an emerging stage. Check either the mastered or emerging box next to any behaviors your child uses to express the message. Use the following definitions to decide whether a behavior is mastered or emerging
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