Interprofessional or Transdisciplinary Practice

This section aims to investigate the literature concerning collaboration efforts between educators and SLPs. By doing so, this section explores the ideas of integrated services, interprofessional practice and multidisciplinary, interdisciplinary and transdisciplinary models.

There is evidence to suggest that collaborative practices between educators and speech pathologists is essential in improving language support for young children (Robertson & Ohi 2016). For example; Overby et al., (2007) discusses a need for increased interactions between SLP’s and teachers regarding the needs of students with SLI, as some children were referred

for speech therapy because of teacher expectations and not because of student performance. This study asked teachers to listen to recordings of second-grade students speaking (n=6) and indicate if they felt the student had typically developing speech and language or need to be referred for assessment. From this, their study revealed teacher’s academic, social, and behavioural expectations for students with moderate intelligible speech were significantly lower than their expectations for their peers with normal or typically developing intelligibility of speech. Furthermore, an Australian study by McIntosh, Crosbie, Harrison and McAllister (2007) consisting of 97 preschool child participants who undertook a 10-week program developed to increase phonological awareness and language skills. The results from this study suggested that implementing programs which are developed collaboratively between educators and speech therapists, may lead to a significant improvement in young children’s speech and language skills.

Another term that is widely used throughout the literature, referring to a range of professionals who work together in teams, is integrated services. Policies to support integrated services within early childhood settings have emerged internationally (Wong et al., 2012). A core feature of integrated services is interprofessional work, which involves collaboration, and cooperation by professionals from different disciplinary backgrounds (Press et al., 2010). The concepts and ideas of interprofessional practice are commonly incorporated in the professional practices within the health industry (WHO, 2010). Interprofessional work is said to encompass the meaning of multidisciplinary, interdisciplinary and transdisciplinary service delivery models (Malin and Marrow, 2008).

Multidisciplinary models are described as individuals assuming a permanent role based on their discipline. Interdisciplinary models expect that roles overlap enabling the blur of disciplines. In transdisciplinary models, the roles of each discipline may dissolve, resulting in one discipline performing the role of another (Hillier et al., 2010).

Transdisciplinary approaches were initially conceived for professionals to share valuable information and skills with primary caregivers of children with disabilities (Hutchinson, 1978). More recently this approach is referred to as the primary provider model, requiring team members from different disciplines to address, coordinate, and implement developmental

domains from all disciplines. Therefore, interventions are delivered primarily by one service provider, who then receives consultation from others (Bruder, 2010) King et al., (2009) describe a transdisciplinary model as having three essential operational features. The first is where professionals for multiple disciplines assess the child simultaneously. The second is intensive ongoing interaction among team members from different disciplines. And the third is ‘roll release’, when members give up or release intervention strategies from their discipline and under the supervision and support of team members, “let go” of one’s specific role when necessary. Bruder (2000) and Gurlanick (2001) have acknowledged transdisciplinary models as the best practice for early intervention.

The present study aims to fill a gap in the literature concerning this very complex phenomenon of interprofessional or transdisciplinary practice within an early childhood context. Preceding literature discusses the limited understanding of the complexity of relationships between professionals (in the health services), who throughout their education are socialised to adopt a discipline-based vision of the services they offer (D’Amour et al., 2005). Bucci and Reitzammer (1992) bring into question whether any undergraduate teacher or allied health training program formally offers experience in multidisciplinary or interdisciplinary practice? The results from Hillier et al.’s., (2010, pg 9) review of literature confirm that the skills and attitudes necessary for effective teamwork in the educator and health professionals should be introduced at the undergraduate level.

There is growing evidence to suggest an overwhelmingly positive reaction to interprofessional working between early childhood practitioners (Wong et al., 2012). Furthermore, interviews from 115 multi-agencies concluded that although professionals thought highly of various sectors (health and education) working together and being able to provide a more efficient service to their families, there was concern that the overall impact of multi-agency working with disabled children may be limited (Abbot, 2005). Hillier et al., (2010) suggest this may reflect their relatively isolated training. Abbot's (2005), study also revealed the willingness of professionals to expand their role may be contingent on how secure of confident they feel in their own roles. The present study aims to explore if a professional’s confidence may have a direct influence on; or be directly influenced by interprofessional collaboration. The concept of collaboration between education and health provided services for children has been supported

by policy but remains rare in practice (Aspery & Nash, 2006). Restrictions to this can be due to limited training for teachers and difficulties scheduling time for collaborative planning (Hillier et al., 2010). Finally, there is evidence to suggest a gap between the notion of knowing what we should be doing, and what we are doing in early childhood intervention programs (Dunst & Trivette, 2009a; Odom, 2009).