Transdisciplinary teamwork in early childhood intervention. What is it?
Peter Limbrick writes: I was recently asked for a definition of this and I realised I have never written one as such – except for saying that if members of a child's TAC (Team Around the Child) integrate their work to the fullest extent it becomes a transdisciplinary approach. So here is my definition of transdisciplinary teamwork as I see it now. I have added explanatory notes. Your comments are very welcome.
Transdisciplinary teamwork for infants who have a multifaceted condition represents the extreme of programme integration in which the close team of people (practitioners and parent) around the child (TAC) agree to deliver their interventions through one of them chosen as the primary interventionist (PI).
The child, parent and PI work together as a threesome on a whole-child programme designed to promote the child's enjoyment of life, general wellbeing, development and learning – and with consideration of the needs, situation and wellbeing of the family.
This work includes: exploring learning and development needs (assessment); creating a single integrated programme (planning); offering it to the child as a meaningful and enjoyable part of his or her normal everyday activity (intervention); regular checks on progress (review).
A multifaceted condition
An infant's multifaceted condition can include such diagnostic labels as cerebral palsy, autism, sensory impairment and learning disability. The term 'multifaceted condition' is used in preference to such phrases as 'multiple disabilities' because the infant's various development and learning impairments and disabilities interact with each other at the neurological level to create a single unique condition.
The extreme of programme integration
The people comprising a child's TAC must decide to what extent their programmes ought to be integrated. At the lesser end of the integration spectrum practitioners and parent will all share with each other what their approach is and why they have chosen it. Each can then continue offering their approach to the child separately from the others – with the advantage that they now know what the others are doing.
Choosing a PI for a transdisciplinary approach comes at the other end of this spectrum of integration and means the infant and family have fewer practitioners to relate to on a regular basis. The infant has the opportunity to relate closely to one familiar practitioner rather than to a group, some of whom might be less familiar and even unwelcome. The PI has the privilege of getting to know child and family 'in the round'.
The whole-child programme
This integrates all necessary work on the infant's posture, hand function, mobility, vision, hearing, perception, communication, understanding, etc. A single multifaceted programme is the appropriate response to an infant's single multifaceted condition.
Infant, parent and PI as a threesome
This becomes an interconnected and interdependent whole in which each learns from the others in a safe and non-threatening environment. Hands-on work for the youngest or most fearful infants can be delivered through the parent. The threesome sits within the infant's TAC and the TAC sits within the wider network of people around the infant and family.
The infant's enjoyment of life and general wellbeing
The whole programme promotes the infant's right to the maximum possible happiness, wellbeing and freedom from anxiety and pain and is designed and delivered accordingly.
The needs, situation and wellbeing of the family
Each infant exists in a social situation and cannot ever be treated as a separate entity. The whole programme is designed to fit well with the family and with their aspirations, living space, routines and present situation.
A meaningful and enjoyable part of the infant's normal everyday activity
The whole programme is designed to fit within and add pleasure and value to the infant's normal activity, play and routines. Development and learning interventions are made relevant and meaningful to the infant and parent.
Assessment of needs, planning, intervention and review
This logical sequence of work on development and learning is largely carried out by the threesome of child, parent and PI. The PI has the other TAC practitioners supporting her and PI and parent can opt to refer to other practitioners with different or deeper disciplines when it is felt appropriate.