Transdisciplinary Team Approach FIT FOCUS - TTA 05-11-17

Agenda Transdisciplinary Team Approach (TTA) - History in NM Key Resources Used Key Terminology in NM Defining Transdisciplinary teaming Literature, Research and Background on TTA Key TTA Practices in NM Role of the Family Role of the Family Service Coordinator (FSC) FOCUS TQRIS TTA Practices Other Professional Development Opportunities and resources FIT FOCUS - TTA 05-11-17

TTA History in FIT Program Pilot with 4 providers in FY11 Launch statewide in FY12 – FY13: Webinar Agency Self Assessment Onsite 2 day - planning and training (staff & contractors) Ongoing support to core teams to implement plan with 1 year Changes to Service Definitions & Standards Up to 12 hrs of consultation included if service listed IFSP “Co-treatment” changed to “co-visits” FIT FOCUS - TTA 05-11-17

Key Resources used: The Early Intervention Teaming Handbook – The Primary Service Provider Approach - M’Lisa Shelden & Dathan Rush (2013) Early Intervention Workbook - Essential Practices for Quality Services - Lynda Cook Pletcher and Naomi Younggren (2013) FIT FOCUS - TTA 05-11-17

Key Resources used: Nuts And Bolts for Transdisciplinary Teams – A collocation of Key Questions… - Larry Edelman et al (2006) FIT FOCUS - TTA 05-11-17

Key TTA Terminology in NM: Sheldon & Rush: TTA in NM: Primary Service Provider (PSP) Lead practitioner Team members coach the PSP Team members provide consultation to the lead and each other Joint visits Co-visits Team membership based on geographical area served Team members are practitioners on the IFSP FIT FOCUS - TTA 05-11-17

Defining Transdisciplinary teaming: Members of a transdisciplinary team cross professional discipline boundaries to achieve service integration by consulting… one another. They do not abandon their discipline, but blend specific skills with other team members to focus on achieve integrated outcomes …team members accept and build upon each others knowledge and skill (Pletcher & Younggren 2013) FIT FOCUS - TTA 05-11-17

Defining Transdisciplinary teaming: An operation definition of a Primary Service Provider approach: An established team consisting of multiple disciplines that meets regularly and selects one member as the primary service provider who receives coaching and support from other team members, and uses coaching as an interaction style with parents and other care providers to support and strengthen their confidence and competence in promoting child learning and development and obtaining desired supports and resources in natural learning environments (Sheldon & Rush, 2010) FIT FOCUS - TTA 05-11-17

Defining Transdisciplinary teaming: Using this “….approach to teaming does not equate to only one practitioner supporting child and family nor does it imply any prescription for frequency and intensity of services provision. In this approach to teaming, the child and family have access to any and all team members as needed via joint visit with the PSP [lead] and team meetings. The Primary Service Provider [Lead] is not asked to engage in role release and take on the role of practitioners from other disciplines involving specific techniques targeted at skill development, but rather become an expert on a family’s and child’s activities, routines, and interests in order to promote the parent mediation of child participation in everyday activities (Sheldon & Rush, 2013) FIT FOCUS - TTA 05-11-17

Literature, Research and Background on TTA Rush and Sheldon (2013) include research foundations that support the PSP / TTA approach, including: Multiple disciplines implementing decontextualized, child-focused, and deficit based interventions has not proven effective (Dunst, Bruder et al., 2004; McWilliam, 2000; Dunst, Trivette et al., 2001) Parents reported less stress and developmental outcomes were greater when receiving services from a primary provider compared to multiple providers (Shonkoff et al., 1992) The more services a family received the less family centered they viewed early intervention (Dunst et al., 1998) 96 % of parents having 1 provider rated them as helpful; 77% having 2 providers rated them as helpful; and 69% having 3 or more provider rated them as helpful (Bruder and Dunst 2004) FIT FOCUS - TTA 05-11-17

Literature, Research and Background on TTA Rush and Sheldon (2013 ) found in their pilot study where one of the group of children and families received services through a PSP approach, results indicated that: IFSP outcomes were met more often IDEA Part C timelines were more met Less disruption to family life FIT FOCUS - TTA 05-11-17

Literature, Research and Background on TTA National organizations recognize / have endorsed PSP / Transdisciplinary team approach: American Speech and Hearing Association (ASHA) American Occupational Therapy Association (AOTA) American Physical Therapy Association (APTA) Division of Early Childhood (DEC) – Recommended Practices (2014) + National Early Childhood TA Center (NECTAC) – Key Principles and Practices FIT FOCUS - TTA 05-11-17

National Early Childhood TA Center – 7 Key Principles (2007) Infants and toddlers learn best through every day experiences and interactions with familiar people and familiar contexts. All families, with the necessary supports and resources, can enhance their children’s learning and development. The Primary role of the service provider in early intervention is to work with and support the family members and caregivers in a child’s life The early intervention process, from initial contacts through transition, must be dynamic and individualized to reflect the child’s and family members’ preferences, learning styles and cultural beliefs IFSP outcomes must be functional and based on children’s and families needs and priorities. The family’s priorities needs and interests are addressed most appropriately by a primary provider who represents and receives team and community support. Interventions with young children and family members must be based on explicit principles, validated practices, best available research ad relevant laws and regulations. FIT FOCUS - TTA 05-11-17

Key Transdisciplinary team Approach (TTA) Practices in NM “Lead” practitioner identified and listed on the IFSP who will work most frequently with the family Consultation* Regular team meetings between members of the IFSP team, in order to promote: Alignment of strategies Coordinated approach Collaboration among team members Co-visits between members of the IFSP team *Up to 12 hours per year per discipline is billable for consultation between team members (without the family present) FIT FOCUS - TTA 05-11-17

Role of Family Family members can be invited to a TTA meeting as needed to share information and participate in conversations regarding strategies, e.g. a targeted conversation regarding sleep Any decisions regarding proposed changes to the frequency, intensity, method, mx of services, which would involve changing the IFSP FIT FOCUS - TTA 05-11-17

Role of the Family Service Coordinator A person in a dedicated FSC role would not be designated as the lead – as the lead is an early intervention practitioner FSC attends the TTA meeting if possible Lead and FSC need to work closely together, especially when there are proposed changes to the frequency, intensity, method, mix of services, which would involve changing the IFSP and working with the family. The FSC can also help with access to other supports and services identified by the team e.g. assistive technology, nursing consult, audiology appointment, etc. FIT FOCUS - TTA 05-11-17

FOCUS TTA Practices TTAP1. The Early Intervention Team and the family work together to identify a Lead Practitioner who serves as the primary liaison between the family and the team. TTAP2. Early Intervention Team members meet on a regularly scheduled basis to: assist families in achieving desired child and family outcomes; share disciplinary expertise and knowledge with one another; and assist each other to know about and access informal and formal services and resources available to meet family-identified TTAP3. Early Intervention Team members meet on a regularly scheduled basis to assist the Lead Practitioner to support the family by systematically exchanging expertise, knowledge and information to jointly solve problems, and to plan, align, and implement strategies. TTAP4. Early Intervention Team members coordinate practices and activities using strategies such as working through the Lead Practitioner and using co-visiting when more than one practitioner is required. TTAP5. Early Intervention Team members consistently use communication strategies that enhance team functioning, interpersonal relationships, and build team capacity. FIT FOCUS - TTA 05-11-17

TTAP1. The Early Intervention Team and the family work together to identify a Lead Practitioner who serves as the primary liaison between the family and the team. A Lead is specified on the IFSP within 90 days of the initial IFSP. The criteria used to select the Lead includes but is not limited to discussions on: Coaching skills sets needed to support the family Linguistic and cultural needs of the family Service needs of the family Rapport/compatibility with family The family is informed of the role of the Lead and has had an opportunity to ask questions and give input. FIT FOCUS - TTA 05-11-17

TTAP2. Early Intervention Team members meet on a regularly scheduled basis to: - assist families in achieving desired child and family outcomes; - share disciplinary expertise and knowledge with one another; - assist each other to know about and access informal and formal services and resources available to meet family-identified EI practitioners and families meet to discuss child’s current abilities and progress Team Members are exchanging expertise and/or knowledge, and/or information to meet child’s current level of performance Team Members assist each other to know about and access relevant informal and formal services and resources FIT FOCUS - TTA 05-11-17

TTAP3. Early Intervention Team members meet on a regularly scheduled basis to assist the Lead Practitioner to support the family by systematically exchanging expertise, knowledge and information to jointly solve problems, and to plan, align, and implement strategies. Meet regularly, as specified on the IFSP, to modify and/or align strategies to meet child’s current level of performance. Team member are prepared to share information during the team meetings, including: bringing in video or pictures of home visits and other relevant print material or web-based resources to assist in planning and/or implementing strategies. Additional expertise is brought to the team when appropriate. FIT FOCUS - TTA 05-11-17

TTAP4. Early Intervention Team members coordinate practices and activities using strategies such as working through the Lead Practitioner and using co-visiting when more than one practitioner is required. Obtain identified resources that include support and coordination from appropriate Team members Co-visiting and/or consultation are listed as strategies on the IFSP Co-visits and consultations lead to integrated and coordinated strategies. FIT FOCUS - TTA 05-11-17

TTAP5. Early Intervention Team members consistently use communication strategies that enhance team functioning, interpersonal relationships, and build team capacity. Use communication strategies that enhance team functioning, interpersonal relationships, and build team capacity e.g., active listening, offering effective feedback, working through conflict Hold effective, structured team meetings occur e.g. developing meeting ground rules and agenda, taking minutes, ensuring equal opportunity to participate, evaluating meetings. Roles are shared across meeting E.g. facilitator, recorder, time keeper) in an effort to build team capacity FIT FOCUS - TTA 05-11-17

Other Professional Development Opportunities and resources Training and resources on New Mexico’s Transdisciplinary Team Approach (TTA) are available on the UNM portal: http://cdd.unm.edu/%5C/ecln/FIT/inde x.html We will make available other resources on the FIT FOCUS TQRIS page http://cdd.unm.edu/ecln/FIT/FIT- FOCUS.html E.g. Sample meeting agenda FIT FOCUS - TTA 05-11-17