Coordination of care is essential to meet the needs of children with a dual diagnosis. Knowledge of each child’s diagnosis by respective team members is key. All specialty areas including education, medical, behavior/ABA, speech, occupational, and physical therapies must understand their targeted impact on each child with a dual/multiple diagnosis. For example, autism and hearing loss might shift the focus of communication by incorporating sign language into all therapeutic and behavioral interventions. Ongoing training and meetings for the interdisciplinary team is key for coordinating services to ensure all areas of need are being addressed.
Service delivery by our interdisciplinary teams requires creation, connection and communication between systems. Every child’s educational plan is formally reviewed with parents and case managers at the 30 day review, and additions/modifications are made accordingly. At this time, a specific interdisciplinary team is identified as well as the types and frequencies of recommended services. Team members then connect on an ongoing basis both informally and during team meetings. Depending on the needs of the child, teams may include a nurse, board certified behavior analyst, occupational therapist, physical therapist, speech pathologist, psychologist, social worker, teacher of the deaf and/or teacher of the visually impaired as well as the special education teacher.
Creation, connection and communication are key components of an effective delivery system for children with developmental disabilities and medical conditions. A child’s educational, medical, behavioral and/or therapeutic needs provide the framework for the identification of appropriate team members. Composition of these interdisciplinary teams may vary depending on the current as well as changing needs of the child. A core team, including a special education teacher and speech pathologist, occupational and physical therapists, may be supported by a school nurse, social worker, board certified behavior analyst/behavior therapist, psychologist and teacher of the deaf. Parents continue as critical members of the team as well. The ability at First Children to draw from a staff of professionals with diverse clinical backgrounds provides the depth of expertise and experience that is required when providing a comprehensive educational program for this population.
Opportunities for team members to connect occur in many ways at First Children School. Formal, as well as informal, team meetings are scheduled daily and as needed. Co-treatments, where two professionals provide intervention together, have been effective in sharing strategies, appropriate positions and/or techniques. Parent connections are critical as well for support and home carry-over. Parents are welcome to observe/ participate in all therapy sessions. School psychologist and social worker are available for support with regard to identifying community resources and coping with ongoing challenges. An integrated system of total communication, established by our speech pathologists, teachers of the deaf and behaviorists, assists all children in accessing and connecting with their environment. Connection with physicians and clinicians outside of the school is facilitated by our nursing staff who maintain a close relationship with our families.
Ongoing communication is critical. In-service programs and trainings are provided so staff from different backgrounds and disciplines can understand not only the role but also the terminology associated with other disciplines. Medical information is shared and explained at neurodevelopmental and physiatry clinics which are scheduled on a regular basis. Staff have ongoing opportunities to share updated information gained from their own experiences and backgrounds. All of the above enhances collaboration which is essential for effective intervention.