Professional Collaboration

1
Professional Collaboration

• Adriane Miliotis
• Delia OMahony
• Martine Torriero

2
Organization of the Presentation

• Introduction
• Issues 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

3
Discouraging Search

• Advanced Search
• Search Terms professional collaboration
• Journal Applied Behavior Analysis
• (Searching PsycINFO)  
• No results were found.

4
What is collaboration?

• Working together to enhance the learners
  experience
• Respecting professional expertise

5
What is collaboration? cont

• participation in identifying, designing, and
  developing inclusive program options
• with families and other professionals
• forming partnerships has enhanced professional
  practice
• early childhood special educator's experiences,
  resources, and contacts can be valuable assets to
  communities as they seek to expand and sustain
  community-based service options
• (Allen Polaha, 2003)

6
What are the components of collaboration?

• communication
• decision making
• Goal setting
• organization
• team process
• Nijhuis et. al. (2007)

7
Why collaborate?

• Learners and parents
• How many different people do they see before
  the child receives instruction?
• What happens if parents and learners get
  conflicting information?

8
Why collaborate? cont

• Team Members
• Can we teach effectively in a vacuum?
• Consistent instruction
• Share ideas
• Learn from each other

9
Effective Collaboration

• A basic understanding of
• expertise
• orientation
• terminology
• potential role of the other professionals in the
  collaborating team
• (Geroski, Rodgers and Breen 1997)

10
Helpful to Know

• Qualifications
• Philosophy
• Professional terms
• Possible contribution to the team
• Professional respect

11
Successful Collaborators

• Willing to try strategies
• Interested in using something new
• Quick 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)

12
Roadblocks to Effective Collaboration

• Excessive paperwork
• Difficulties identifying appropriate
  interventions with existing resources
• Lack of financial support
• Inadequate training in problem solving procedures
• No release time for meetings
• Meeting times difficult to arrange
• Meetings last too long
• (Yetter Doll, 2007)

13
Unsuccessful Collaborators

• Moderate and low adopters were less knowledgeable
• took longer to grasp ideas
• did not always implement them well
• some of these teachers needed to have ideas
  explained in detail
• would discard ideas they did not appear to
  comprehend
• (Brownell et. al. 2006)

14
Educating other professionals

• Autism is a low-incidence disorder that has
  received increasing attention as parents have
  organized seeking more effective education
  services for their children with autism 1
• prepare early intervention practitioners to work
  with young children with autism, severe physical
  impairments, and other low incidence disabilities
  1
• The program features joint course work across the
  Schools of Medicine and Education and seminars on
  collaboration and teaming 2
• 1 Shriver, Allen, Mathews, 1999
• 2 Able-Boone, Crais, Downing, 2003

15
Expanding Professional Roles

• Will the shift from direct to indirect roles
  affect
• 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 young
  children and families may be less satisfied with
  roles that are now primarily adult oriented and
  facilitative in nature

16
Ethical Issues

• Before we can collaborate, we need
• Mutual consent form signed by parents and student
• 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 letter
• Indicate an interest in collaboration in this
  letter

17
Collaboration with related service providers
18
Why should we collaborate?

• Coordination between the disciplines is
  important when adding speech-language therapy to
  an applied behavioral program. All objectives
  must reflect a common goal in order to build
  speech, language, play, and social skills.
  (Parker 1996)
• ... SLPs are not the only professionals who
  target communication outcomes within the scope of
  their practice. Teachers, occupational
  therapists, reading specialists, and behavior
  analysts do so as well, either directly or
  indirectly. Therefore, cross-disciplinary
  collaboration is essential. (Koenig and Gunter
  2005)

19
Benefits of Collaboration

• The creation of evidence-based therapeutic
  approaches and practices by individuals with
  combined expertise in ABA and SLP
• The ability to improve the integration of support
  provided by SLP and ABA professionals as
  participants on home-, school-, and center-based
  intervention teams
• A reduction in the number of reinvented wheels
• Discrete trial to establish skills and NET to
  generalize
• (Koenig and Gerenser, 2006)

20
The Role of the SLP

• From the ASHA Position Statement Roles and
  Responsibilities of Speech-Language Pathologists
  in Diagnosis, Assessment, and Treatment of Autism
  Spectrum Disorders Across the Life Span
• Collaboration Speech-language pathologists
  should collaborate with families, individuals
  with ASD, other professionals, support personnel,
  peers, and other invested parties to identify
  priorities and build consensus on a service plan
  and functional outcomes.

21
What do the fields of SLP and ABA have in common?

• ABA and SLP are the treatment components most
  frequently requested by parents
• ABA and SLP therapists are highly focused on the
  individual, his or her unique learning style, and
  the outcomes of treatment
• Both ABA and SLP address skill deficits directly
  by teaching specific language behaviors rather
  than treating the problem indirectly using
  specialized diets or sensory stimulation programs
• Both fields rely on procedures that are supported
  by evidence. Most therapists measure the child's
  performance by collecting data to make decisions
  about progress and potential changes in
  instruction.
• (Harchik, 2005)

22
Coordinating Speech-Language Pathology with an
Applied Behavior Analysis Program (Parker, 1996)

• 1. The SLP should develop language goals similar
  to those developed by the behavior program in
  order to facilitate generalization.
• - Ex. ABA program is working on expressive labels
  with the Sd, What is this? The SLPs goal can
  be to use the same vocabulary to request those
  items in a low structure, play context.

23

• 2. The SLP should help to make the discrete-trial
  goals of the behavior program as communicative
  and functional as possible.
• Ex. Work on requesting programs using objects of
  high interest.
• 3. The SLP can add valuable information about
  speech-language goals that are being addressed 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.

24

• 4. The SLP helps to ensure that all therapists
  are attempting to use similar vocabulary,
  commands, and toys in focusing on their goals.
• 5. The SLP can offer information to the behavior
  team and parents on developmentally appropriate
  linguistic forms and the developmentally normal
  communication sequence.
• Ex. Assists with the periodic reassessment of
  linguistic goals.

25

• 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 specific
  language forms. If the child is working on
  prepositions, the parent can say, First we put
  the water in the pot, then the salt in, then the
  spaghetti in.

26

• 7. The SLP should help develop reinforcers- both
  tangible, such as food, stickers, and toys, and
  social, such as praise, hugs, and tickles.
• 8. The SLP should assess the manner in which
  speech-language skills are used within the
  classroom or 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 to play together.
• - Ex. Encourage the classroom teacher to set up
  activities that require a buddy, and pair the
  child with a peer who is both a strong language
  model and a friendly child.

27

• 9. The SLP can also help troubleshoot specific
  linguistic problems.
• Ex. If the child is having difficulty
  remembering the names of objects, the SLP can
  develop appropriate categorization and world
  knowledge tasks.
• 10. The SLP can also aid in the diagnosis and
  treatment of concurrent disorders (e.g. apraxia
  or dysarthria)

28
Three models for team interaction
29
Component Multidisciplinary Interdisciplinary Transdisciplinary
Philosophy of team interaction Team members recognize the importance of contributions from other disciplines. Team members are willing and able to share responsibilities for services among disciplines. Team members commit to teach, learn and work across disciplinary boundaries to plan and provide integrated services.
Family Role Generally, families meet with team members separately by discipline. The family may or may not be considered a team member. Families may work with the whole team or team representatives. Families are always members of the team and determine their own roles.
Lines of Communication Typically informal. Members may not think of themselves as part of a team. Team meets regularly for case conferences, consultations, etc. Team meets regularly to share information and to teach and learn across disciplines (for consultation, team building, etc.).
Staff Development Generally is independent and within disciplines. Frequently shared and held across disciplines. Staff development is across disciplines and is critical to team development and role transition.
30
Component Multidisciplinary Interdisciplinary Transdisciplinary
Assessment Process Team members conduct separate assessments by discipline. Team members conduct assessments by discipline and share results. The team participates in an arena assessment, observing and recording across disciplines.
Plan Development Team members develop separate plans for intervention within their own disciplines. Goals are developed by discipline and shared with the rest of the team to develop a single service plan. Staff and family develop plan together based on familys concerns, priorities, and resources.
Plan implementation Team members implement their own plan separately by discipline. Team members implement parts of the plan for which their discipline is responsible. Team members share responsibilities and are accountable for how the plan is implemented by one person, with the family.
http//www.njeis.org/NJFoundationsSP.pdf
31
The Consultative Model of Service Delivery
(Bellone, et. al 2005)
32
Why should we use this model?

• For individuals with ASD, exclusive provision of
  services through pull-out services does not
  address the underlying challenge of social
  communication inherent in the disorder, the
  issues of generalization, functional outcomes, or
  the importance of collaborating with significant
  communication partners. (ASHA 2006)

33
Why?, cont

• Research on children with ASD suggests that the
  greatest effects of any direct treatment are
  reflected in the generalization of learning
  achieved by working with parents and classroom
  personnel.(NRC 2001)

34
Traditional SL services are inadequate

• 1-5 hours treatment per week
• SLP is sole instructor
• Isolated setting
• Skill generalization and maintenance difficult to
  achieve given these limitations
• (Bellone, et.al., 2005)

35

• BUT
• The pull-out model of service delivery continues
  to be the most used model for preschool and
  school-age children. (ASHA, 2004)
• EVEN THOUGH
• There is no evidence supporting the long-term
  effectiveness 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)

36
Consultative SL services afford

• Consistent and continuous instruction throughout
  the childs day
• Skill generalization across people and settings
  in childs natural environment
• Skill maintenance through practice in naturally
  occurring and programmed opportunities
• (Bellone, et.al., 2005)

37
The role of the SLP

• Develop curriculum
• Select data collection systems
• Train teachers
• Observe teachers students
• Attend meetings
• Modify teaching procedures

38
The role of the teaching staff

• Provide multiple daily opportunities
• Collect sum data
• Review data w/ SLP
• Initiate questions, concerns
• Troubleshoot w/ SLP
• Incorporate changes into instruction

39
The consultative model in a public school

• School administrator contacted NECCs consulting
  department
• NECC directors met with teachers and
  administrators
• 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
  (n24) selected the consultative model

40
The consultative model in a public school Public
School Contract

• Services were provided in 8 children in 3
  classrooms
• 2 hours/mo of consultative (indirect) services
  from SLP
• 40 hours/mo direct SL instruction from lead
  classroom teacher
• SLP consult with Head teachers
• Head teachers train teaching assistants

41
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)

42
What do other disciplines have to say about
professional collaboration?
43
Guide for Professional Conduct

• PRINCIPLE 11
• A physical therapist shall respect the
  rights, knowledge, and skills of colleagues and
  other healthcare professionals.
• 11.1 Consultation
• A physical therapist shall seek consultation
  whenever the welfare of the patient will be
  safeguarded or advanced by consulting those who
  have special skills, knowledge, and experience.
• 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.

44
Code of Ethics

• Principle 7. Occupational therapy personnel shall
  treat colleagues and other professionals with
  respect, fairness, discretion, and integrity.
  (FIDELITY)

45
Guidelines for Responsible Conduct For Behavior
Analysts

• 9.0 The Behavior Analyst's Responsibility to
  Colleagues.
• Behavior analysts have an obligation to bring
  attention to and resolve ethical violations by
  colleagues, to make sure their data are accurate
  and presented truthfully, and they share 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

46
Are related service providers a necessary
component of an effective program?
47

• A public program serving children in preschool
  through eighth grade diagnosed with Autism and
  related disabilities in Bergen County, NJ
• The speech-language department works
  collaboratively with the classroom teachers to
  promote various communication modes such as the
  Picture Exchange System, computerized voice
  output devices, sign language, and fostering
  expressive language. (McKeon, et.al. 2006)

48

• 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)

49

• 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.
  An adaptive physical education professional
  serves the preschool children on the three times
  a week and acts as a liaison for consulting
  professionals such as physical or occupational
  therapists. (Harris, et. al, 2001)
• Douglass Outreach
• Douglass Outreach employs five licensed
  part-time speech pathologists for speech-language
  services. (Harris, et. al, 2001)

50
Princeton Child Development Institute

• Strong emphasis on language development
• Does not employ specialists
• All intervention personnel are trained to teach
  receptive and expressive language in every
  activity
• 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 mands to age appropriate verbal
  repertoires.
• (McClanahan and Krantz, 2001)

51
Recommendations for Continued Collaboration

• Share treatment efficacy data
• Share innovative teaching procedures
• Share basic information
• Share successful collaboration experiences
• Read articles in journals associated with the
  other profession
• Share your concerns
• Share lunch
• (Koenig and Gerenser, 2006)

52
State of New Jersey
Department Of Education
Department of Human Services
BOE - Local School / Sending School District
Board of Education (Receiving School)
The Office of Early Care and Education (OECE)
Director of Special Services
SPAN/COSAC/ Autism Society of America
Child Service Team
School
ST OT PT ART Music BCBA
Parents / Home / Family Physician Dentist, Doctor
Principle
Child
Bus
Teacher
Siblings Family Celebrations
Community
After school services (latch key)
Neighborhood, Shops, Restaurants
DDD DVR
Employment Sheltered Living
53
Collaboration with Administration

• Who are the possible collaborative partners?
• How can we develop a collaborative relationship?

54
NJDOE Press Release February 20, 2007

• Approximately 7,400 New Jersey children between
  the ages of 5 and 21 have been diagnosed with
  autism spectrum disorders.
• Fifty-five New Jersey school districts will
  share 15 million in state funds to establish,
  expand or enhance public school programs and
  services for students diagnosed with Autism
  Spectrum Disorders..

55
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)

56
Administration

• Child 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 Agencies in 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.

57
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 program components with a focus
  on standards, curricula, and assessment.
• The creation of this division
• Acknowledges that a continuum of developmental
  stages constitute what is traditionally known as
  early childhood,
• Protects New Jerseys investment in high quality
  preschool by providing high quality kindergarten
  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 childrens
  social 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.

58
Office of Special Education Programs

• Implements state and federal laws and regulations
  governing special education to ensure that pupils
  with disabilities in New Jersey receive full
  educational opportunities.
• Provides statewide leadership through the
  development of policy and implementation
  documents and provides guidance to school
  districts and parents regarding the
  implementation of special education programs and
  services.
• Responsible for administering all federal funds
  received by the state for educating pupils 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 with the Office of
  Administrative Law, and conducts complaint
  investigations requested by the public.
• Funds four learning resource centers (LRCs) that
  provide schools and parents with information
  services, materials circulation, technical
  assistance, consultation services and production
  services.
• Plans and implements program and personnel
  development activities in areas such as
  implementing the least restrictive environment
  provision, planning the transition of students
  with disabilities from school to adulthood,
  planning programs and services for preschool
  children with disabilities,developing
  Individualized Education Programs (IEPs) and
  accessing individual rights and entitlements.

59
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
• [phone] - LRC General Service(973)
  414-4496-FAX [phone]-TTY [phone] -
  Preschool Technical Assistancee-mail
  lrcnorth_at_doe.state.nj.us

60
A collaborative modelThe Child Study Team

• Composed of teachers, specialists,
  administrators, and parents
• Responsible for identifying and evaluating
  students aged 3 21 for special education
  programs and services.
• Required to conduct both an educational
  evaluation and a psychological evaluation. (A
  neurological examination is also required before
  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)

61
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

62
Typical School Operations NetworkCouncil 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, and professional support staff
  (ST, OT, PT, BCBA, librarian, etc.)

63
School

• Effective collaboration emerges out of concerns
  by individuals who 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, student placement,
  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 their children.

64
Improving student bus-riding behavior through a
whole-school intervention (Putnam, Handler
Ramirez-Platt Luiselli, 2003)

• Intervention developed through collaboration with
  students, school personnel and bus drivers
• 624 students participated during 5 phases of the
  study
• Disruptive behavior that resulted in referrals or
  suspensions was targeted and measured in an ABAB
  reversal design
• Results indicated an overall decrease in bus
  suspensions

65
Parents have power!

• Parents and children are the service users
• Parents 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 service
  
• providers 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 to work with one another to map
  the terrain of a problem
• They should talk to public officials about
  providing long-term funding for vital programs
  both in their community and at the State level.
• Parents should know their rights and not accept
  anything less.

66
Suggestions for the Future

• develop and evaluate new methods of preparing
  early childhood special educators whose primary
  role now consists of consultation and
  collaboration, rather than teaching
• Use the case method of instruction
• Prepare professionals to become independent and
  competent problem solvers in the role of
  consultant
• personnel training programs must be systemic in
  nature
• (Dybvik, 2004)

67
Suggestion for the Future, cont

• changes in professional roles
• create opportunities for interactive learning for
  professionals who function in a variety of roles,
  including administrative ones
• ensure a shared knowledge and values base among
  all professionals who serve young children and
  families
• Remedy roadblocks
• (Skrtic, 1991)

68
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
  instructional placements for students with
  disabilities"
• Efforts aimed at early childhood community
  integration will continue to present profound
  challenges to practitioners in ECSE
• Effectively change our roles in response to the
  changing times, in support of young children with
  and without disabilities growing up together
• (Skrtic, 1991)

69
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70

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