Collaborating with Other Disciplines

Chances are, if you choose to work in a multidisciplinary setting, you value the opportunity to collaborate with other professionals. In today's post, I am going to discuss why collaboration is so vital to our client's progress and how best to communicate with a patient's entire team to ensure continuity of care and progress.

As rehab providers (SLPs, OTs, PTs), we have limited access to our patients. We see them for one hour at a time, at best several days a week. How are we able to ensure that our patients are getting the communication opportunities they need throughout the day and that everyone the child interacts with has the same expectations for them? Collaboration! Imagine if a patient leaves your speech session, where he is expected to use 2 words to request, goes to OT, where the therapist also knows to expect that, and then the child has 3 hours of ABA with the same expectations. That's 5 hours of speech therapy for the price of 1. Progress would sky-rocket!

To be effective, speech therapy, occupational therapy, physical therapy, or ABA can't be done in a vacuum. It is not only important to share our personal clinical knowledge, it is necessary to seek out others' clinical knowledge to ensure you are treating the patient holistically. In order to be effective collaborators, we must first know who is on a patient's team. The team includes all the clinical professionals involved in the patient's care (PT, OT, SLP, BCBA, Psychologist), the patient's educational team if applicable (teacher, related service team), and of course, the parents. It is more challenging to communicate with outside providers, but initiating those conversations is so impactful for your patient's care. Here are some steps to initiating and maintaining communication with the entire team:

• Ask parents to complete Release of Information (ROI) Forms for all professionals the child works with. This can be done at the initial evaluation or first session.
• Once those releases are on file, send an introductory email to all parties, including the parents. I like to include the ROIs that were signed as attachments so that everyone is aware that you have permission to speak with them. Other clinics and schools may have policies that require their own release, so be mindful that it may take some time for the team to respond.
• Once everyone is able to communicate, share your goals and ask for what others have been working on.
• These don't need to be ongoing conversations that are time-consuming. I recommend checking in at progress note and re-evaluation time. Ask for their input with checklists and standardized assessments when applicable.
• If an outside professional initiates a conversation with you, include the entire clinical team in your response.

If the child's team is all on-site, utilize multidisciplinary team meetings. Any major changes to a patient's treatment plan should be communicated to the entire team, for example: potty training, a new behavior plan, starting to use AAC, starting to use a chewy for mouthing, etc. If you have an impromptu discussion in the hallways with one member of a patient's team, a follow-up email to the entire team is very helpful to share the information. Because ABA is structured differently than rehab services, make sure that you are only discussing treatment planning with the BCBA and that you do not instruct an RBT to change what they are doing, as they must follow the BCBA's treatment plan.

Whether you are new to a multi-disciplinary setting or have years of experience, collaborating in a mutually respectful and inclusive way takes practice. As long as you seek out other professional's perspectives and are open to implementing their strategies, your patients will drastically benefit from the effort. Collaboration isn't always easy or convenient, but it is always worth it!