What is transdisciplinary teamwork around babies and infants who have significant challenges to their development and learning?
It is good that more people are talking about this in the professional effort to avoid fragmentation
I first encountered transdisciplinary teamwork in writings from the USA during last century where some practitioners had decided it was their preferred approach to babies and infants who had cerebral palsy. They had found great advantages for child, family and practitioners in delivering most of their work/play to the child through a single practitioner. This work was informed by other members of the team in the background.
See: Transdisciplinary teamwork gets 'up close and personal'. Is that why we are afraid of it?
Transdisciplinary teamwork has been used in Team Around the Child with some children and families when it was appropriate. This is described in ‘Primary Interventionists in the Team Around the Child Approach’:
See: Primary Interventionists in the Team Around the Child approach. Free PDF of the essay
The aim in this work was to reduce fragmentation by integrating the programmes designed for the infant’s development and learning.
How the infant’s programmes for development and learning can be integrated
An integrated intervention system requires that the main practitioners involved with the infant’s development and learning integrate as appropriate their approaches and goals instead of working separately from each other. The infant’s TAC (Team Around the Child) meetings are the ideal forum for planning this and offer graded opportunities for this integration. The degree of integration is always a TAC decision – not forgetting that parents are full members. Stages of increasing integration are as follows:
Stage 1: Practitioners and parents tell each other what they are working on with the child. This brings the benefit of seeing the pattern of interventions as a whole, resolving contradictory approaches and avoiding wasted time and effort when two people are offering similar work to the child. Judgements can be made about whether the child is being offered too many or too few people and programmes. Similarly, whether parents are being asked to do too many things at home. Parents, typically, are concerned when their infant’s practitioners do not talk to each other, leaving the parent as the go-between. This is disrespectful to the infant and family and puts yet one more demand on the parent.
Stage 2: Practitioners and parents adopt relevant parts of each other’s approaches. This can increase the infant’s opportunities for learning and practising particular tasks and facilitate the interplay between their various activities and abilities. For instance, each can offer the infant practice in the agreed signs, symbols or spoken words, each can incorporate the same postures and movements into their work with the child when it is appropriate.
Stage 3: Practitioners and parents can work towards some degree of actually joining together the infant’s development and learning programmes. This can be helped by agreeing to move from planning a discipline-based ‘physiotherapy programme’ or ‘speech and language therapy programme’ to a child-based ‘getting dressed programme’, a ‘mealtime programme’ or ‘a playing on the floor and moving around the room programme’. In this way the infant gets whole-child learning opportunities in relevant situations and times and with natural opportunities to join abilities together. One outcome of this sharing process is ‘collective competence’ as explained below.
Stage 4: It might be decided that one person could take on the work of another using the ‘consultant model’ in which one person hands over some part of their work with an infant to another TAC member who is competent to take it on with necessary support. This will reduce the number of people doing regular hands-on work with the child. This has direct advantage to the child, reduces the number of necessary sessions at home or in clinics, and supports service providers in their efforts to make the best use of their limited resources.
Stage 5: The consultant model described above can progress, by TAC decision, into agreeing one of the team as the single primary interventionist who becomes for an agreed period of time the one practitioner doing most of the regular hands-on work with the child.
These stages are extracted from ‘Early Childhood Intervention without Tears’, page 35:
In my view, Stage 5 represents a valid and achievable UK version of transdisciplinary teamwork. I have found that this fully integrated approach requires the people in the TAC to share a high level of honesty, trust and respect – between practitioners and between practitioners and parents. The approach will not work unless all involved are very willing to collaborate closely. It also requires that practitioners have training in the approach. This is essential.
Peter Limbrick,
October 2024
