University of Edinburgh

Cerebral Palsy and Visual Impairment in Children: Experience of Collaborative Practice in Scotland

Appendix I

Yorkhill Audit Project

by Nicola Tennant

This study examined the working relationship between physiotherapists and teachers in schools for children with learning difficulties in the Greater Glasgow Area.

Unfortunately the mere presence of professionals, regardless of their individual competencies, does not guarantee that children with learning difficulties receive educationally relevant services. The effective provision of services to these children depends on effective collaboration among professionals. Few other aspects of a child’s education have such long-term implications as the results of interactions among those responsible for the design, implementation and evaluation of Individualised Educational Programmes (IEP). It is this co-ordination of related services that allows children access to the curriculum and the necessary number of practice opportunities to acquire skills. Where interaction is poor among professionals, understanding and awareness of other team members is reduced, opportunities for communication lost, and care is fragmented.

For some time there has been concern about inter-professional and inter-agency co-operation, and ultimately the education of children with learning difficulties is compromised when input from related service professionals is not adequately synthesised.

Professional collaboration has evolved as a result of the frustration of parents and teachers at the inability of children to carry over skills from the treatment room to everyday situations.

The initial multi-disciplinary team where professionals functioned independently of one another progressed to the interdisciplinary method where individual assessment and treatments were still performed but exchange of information across disciplines improved. A further progression to effective collaboration produced the transdisciplinary approach where professionals of different disciplines not only exchanged increasing amounts of information and expertise across traditional boundaries but also exchanged methods. In this case the whole team shares responsibility for assessment, setting of joint goals, the process involving the transfer of skills and joint evaluation. This method of service delivery has been recognised as ´best practice═ for several decades.

This study carried out in Greater Glasgow took the form of a questionnaire to both physiotherapists and teachers examining issues such as communication, setting of joint goals, attending meetings, exchange of methods and willingness to work together.

The main issues highlighted by the study were that both teachers and physiotherapists had similar beliefs about best practice, spent little time communicating with one another, thought that it was important to set joint goals and attend meetings, but very few did so. There was a willingness to work together and to exchange methods in the form of role release but all professionals felt that they did not receive enough training to do so effectively. Both teachers and physiotherapists stated that lack of time and the inflexibility of their timetables was the main barrier to effective collaboration and that better communication was essential.

To complete the audit cycle, transdisciplinary groups have been set up in one school where regular meetings are held to set joint goals, plan transdisciplinary group sessions involving as many professionals and parents as possible. This project, although progressing well, has not yet been evaluated.