The Power of Alignment in Early Intervention: Effective Teamwork and Why We Need It

Dave Calhoun, M.Ed.Karen Poland, M.S., CCC-SLPKatie Watson, M.A., CCC-SLP

Infant and Early Childhood ConferenceTacoma, WA 2014

Main points we’ll talk about

• Focusing on how you work together • Building relationships• Capacity building

Transdisciplinary teaming

• Sharing of roles across disciplinary boundaries so that communication, interaction, and cooperation are maximized among team members (Davies, 2007; Johnson et al, 1994).

Transdisciplinary teaming

• The transdisciplinary team is characterized by the commitment of its members to teach, learn, and work together to implement coordinated services (Fewell, 1983; Peterson, 1987; United Cerebral Palsy National Collaborative Infant Project, 1976).

Ed., SLP, PT, OT, SW, P

Ed., SLP, PT, OT, SW, P

PC, P

Child

Assessment

Planning

Service

MARSHMALLOW CHALLENGE

✦Build the Tallest Freestanding Structure: The winning team is the one that has the tallest structure measured from the table top surface to the top of the marshmallow. That means the structure cannot be suspended from a higher structure, like a chair, ceiling or chandelier.✦The Entire Marshmallow Must be on Top: The entire marshmallow needs to be on the top of the structure. Cutting or eating part of the marshmallow disqualifies the team. ✦Use as Much or as Little of the Kit: The team can use as many or as few of the 20 spaghetti sticks, as much or as little of the string or tape. The team cannot use the paper bag as part of their structure.✦Break up the Spaghetti, String or Tape: Teams are free to break the spaghetti, cut up the tape and string to create new structures.✦The Challenge Lasts 18 minutes: Teams cannot hold on to the structure when the time runs out. Those touching or supporting the structure at the end of the exercise will be disqualified. ✦Does everyone understands the Rules? Any questions?

And the winning team is….

Questions for the class

• What was challenging?• What worked well for you?

Tom Wujec“Build a Tower, Build a Team”

The Big Idea

As early intervention providers, it becomes our duty to concern ourselves not only

with IFSP outcomes, but with the variables that affect, positively or negatively, those

outcomes.

The Marshmallow

We need a professional system that enables us to address all aspects of the child and family

system.

Teams that focus first on how they work together are more successful than teams that focus first on the task. (Taylor & Greve, 2009)

RELATIONSHIP BUILDING

Relationships are working alliances that build over time…over time you earn confidence and trust through a shared history of interaction.(Weston, Ivins, Heffron & Sweet, 1997)

Relationships

What is the difference between working on a team and relationship based teaming?

Why does it matter?

It Matters Because…

• People are not free to share knowledge or to learn new knowledge unless they are part of a culture that facilitates it.

Strategies to support relationship building

• Providers are on ONE team with ONE team lead – Speech-language pathologist – Occupational therapist– Physical therapist– Educator– Social worker / family counselor

Reflective Supervision

• Individual reflective supervision with the team lead every other week– Because our jobs are difficult! This gives each

team member a chance to check-in about how them and their families are doing and what supports they may need.

Reflective Practice

• …increased awareness, knowledge, and understanding of relationship dynamics and the reasons why others think and act the way they do ….Fosters the ability to step back and consider the thoughts and emotions in oneself and in others (Fonagy, Gergely, Jurist, & Target, 2002)

Access

Structure the office so the team sits together and can easily interact with each other outside of scheduled meetings (i.e., not divided by discipline)

Mandatory weekly team meetings

• Allows for relationship building by…– Team gets to spend time together– Structured for interaction– Provide support for each other around caseload

and work related stressors– Celebrate achievements

Agenda

• Use it consistently • Structure it • Update it • Review its effectiveness• Make it available before the meeting (and

after)• example

CAPACITY BUILDING

Capacity building

Working in groups exposes individuals to a broader set of perspectives, and cross-

fertilization of ideas results in more creative outcomes (Perry-Smith & Shalley, 2003; Tesluk,

Farr, & Klein, 1997)

Oral motorOral structure

Dentition

Safe swallow

Food stage

Oral motor

Oral structure

Dentition

Safe swallow

Food stage

Family culture

Stage of grief/acceptance

Positioning

Adaptive equipment

Developmental level

Sensory organization

Early experiences with food

Muscle tone

Motor planning

Caregiver approach to meal times

Allergies

G.I.

Family routine

What does capacity building allow us to do?

• Allows us to think outside our specific discipline to consider more variables that may influence outcomes.

Teamwork Matters

Teams whose members have and share diverse knowledge obtain higher levels of individual and team creativity.

(De Dreu & West, 2001

Capacity Building

• What is the difference between doing another therapists job and having increased capacity?

• What is the benefit?

What about people outside our teams?

• Continue to use relationships building approach with outside service providers– Open ended-questions– Sharing knowledge vs. telling– Listening – Set the example of how you want to communicate

POWER OF ALIGNMENT

So what is the Power of Alignment…

• Being able to utilize well-established relationships within your team to provide quality support for the whole-child and their family.

…and why do we need it?

• Practicing these concepts with each other allows us to do the same with families

• Stronger relationships lead to more meaningful and lasting outcomes

– the marshmallow!

Thank You!

Dave Calhoun, M.Ed.david.calhoun@childstrive.orgKaren Poland, M.S., CCC-SLPkaren.poland@childstrive.orgKatie Watson, M.A., CCC-SLPkatie.watson@childstrive.org

We want to team with you!