Interdisciplinary Collaboration Training: An Example of a Preservice Training Series

Abstract

In recent years, there has been discussion of the need for training behavior analysts in collaboration skills. There is some consensus that these skills are needed to improve outcomes with clients and with colleagues. Specifically, students of behavior analysis and behavior-analytic practitioners need to learn the skills associated with functioning effectively in interdisciplinary teams. At Melmark, a model of training in this skill set has been developed and integrated into supervision modules for those seeking Board Certified Behavior Analyst certification. In this model, supervisees are exposed to information about the expertise and value of the allied professions of speech-language pathology, occupational therapy, physical therapy, and developmental pediatrics. Rotations are done within these fields to expose trainees to the expertise of these fields and to build skills in collaboration with members of those professions. Trainees are also assigned tasks that require them to identify the contributions of other professions and display appropriate collaborative behavior. Future directions for the model are discussed, including extending it across the organization and developing performance-based assessments and social validity measures.

Professional collaboration is more than simply working on a shared client case with other care providers. To be truly collaborative, one must observe and apply several specific behaviors that embody this concept. Collaboration, by common definition, is the process of working directly with at least one other person toward a mutual goal. In the context of interdisciplinary treatment, collaboration can be defined as a cooperative process among members of a team, requiring trust and respect, clearly defined and equitable roles, with shared responsibility, commitment, and accountability among all team members (Bock et al., 2011). Further, collaboration requires group members to have knowledge of their own, as well as other team members’, roles including training, experience, and professional scopes of practice (Boivin et al., 2015; Brodhead, 2015). Bock et al. (2011) noted that collaboration is not an option, but an expectation in educational settings, particularly between general educators and special education teachers. This expectation can likely be extrapolated to any setting in which multiple service providers are working together to ameliorate socially significant learning and behavioral challenges for an individual. Behavior analysts are increasingly considered essential members of interdisciplinary treatment teams and, as such, are required to develop skills that will enable them to work collaboratively with professionals from a range of other disciplines.

The associated terminology for collaboration across disciplines varies, and each version is associated with a distinctive definition of role and a specific vision for coordination (Choi & Pak, 2006; Cox, 2012). A multidisciplinary approach recognizes the needed expertise of many disciplines but allows for independent functioning. Evaluations, recommendations, and treatments are individually determined and administered. Although the client reaps the benefits of multiple disciplines’ perspectives, the care is delivered in a nonintegrated manner. In an interdisciplinary model, professionals from different fields communicate with one another and coordinate their findings and recommendations. This can increase efficiency and reduce confusion if programming priorities and other issues are coordinated and consistent. However, if the team does not have shared principles and values, it may represent a form of eclecticism. As described in the training example in what follows, the interdisciplinary team was guided by a shared value for assessment and treatment practices from multiple disciplines, definitions of evidence-supported treatment, assessment guiding treatment, and data guiding ongoing treatment decisions to find the best outcomes for individuals (see Schreibman et al., 2015, for an example of identifying shared principles and values across professions).

In recent years, many professionals have been working in transdisciplinary contexts, in which professionals might assess and treat together, and in which reports might be jointly generated. In this model, the coordination of care is intensified, and the recommendations are established from a joint consensus. Although transdisciplinary models can increase the simultaneous provision of expertise applied to the assessment and treatment process, they can be associated with intensity dilution and role blurring (Cox, 2012; Lafrance et al., 2019). Interdisciplinary approaches have major advantages over multidisciplinary approaches, because of the benefits of joint goal development, evaluation of progress, and problem solving. In addition, the term “interprofessional collaboration” has been used to refer to contexts in which members of separate disciplines appreciate and respect the value of other professions in a joint treatment context. For the purposes of this article, we will use the terms “interdisciplinary” and “interprofessional.”

Importance

There are several reasons it is essential for behavior analysts to develop a skill set in the area of collaboration as part of their initial and ongoing professional development. First, a collaborative approach enables interdisciplinary teams to efficiently address multiple presenting needs simultaneously, in addition to addressing specific target behaviors comprehensively. Specifically, collaboration in the context of autism intervention is often compellingly needed to address the complex needs of the individual. Autism is a particularly complex disability, and the impact of autism is often evident in many varied systems, with individuals with autism spectrum disorder potentially presenting with issues in communication, behavioral regulation, cognition, and motor skills (American Psychiatric Association, 2013). Psychiatric and medical comorbidity may further complicate the presenting challenges, requiring additional expertise in many cases (Kroncke et al., 2016). Collaboration optimizes client outcomes (e.g., improved student grades in educational settings) and increases feelings of efficacy among team members (Bock et al., 2011; Brodhead, 2015). Pragmatically, Fulk (2011) suggested that a team’s combined effort toward a mutual outcome is more effective and efficient than multiple members of a team working individually toward a similar goal. Moreover, Brodhead (2015) noted that behavior analysts’ engagement in collaboration can aid in the dissemination of applied behavior analysis (ABA) practices and represent the field of ABA as a collaborative entity among other service professionals.

How Is Collaboration Taught?

Although collaboration is a critical skill for professionals across numerous disciplines to develop, several authors have pointed out that it is rarely directly taught as part of preservice training for teachers, behavior analysts, and other professionals (Bock et al., 2011; Brodhead, 2015). Similar to learning to apply principles and procedures that produce behavior change, direct instruction is required for behavior analysts and individuals working toward certification in this field to develop skills in the area of collaboration. Specifically, individuals must learn how to effectively communicate—for example, by avoiding the use of jargon, acronyms, or obscure terminology; by monitoring their body language; and by practicing active listening. Skills such as goal setting, problem solving, and conflict resolution are all required when working as a member of an interdisciplinary team (Fulk, 2011). Furthermore, direct training and feedback may be required in the areas of structuring, facilitating, and participating in meetings (Fulk, 2011). Brodhead (2015) identified the need for maintaining professional relationships in interdisciplinary settings, offering a decision-making model for behavior analysts to assess nonbehavioral treatments and communicate cooperatively with colleagues from other fields. He further suggested that behavior analysts should consider conducting social validity surveys regarding their interactions as members of interdisciplinary treatment teams (Brodhead, 2015). LaFrance et al. (2019) suggested that more needs to be done to help members of all professions appreciate the expertise and training of other members of the team. In this way, respect may be increased and consultation may be sought when needed, maximizing client outcomes. It has been increasingly clear that additional training and supervision in collaboration skills are needed.

The Behavior Analyst Certification Board (BACB) Task List and Professional and Ethical Compliance Code for Behavior Analysts

Within behavior analysis, there have been some clear indicators of the value placed on collaboration. For example, within the Professional and Ethical Compliance Code for Behavior Analysts (BACB, 2014), Section 2.03 states that behavior analysts arrange for consultations when needed and cooperate with other professionals when indicated. Section 2.09(d) also emphasizes the interest that the behavior analyst has in any intervention that may impact progress on behavioral goals, expanding the scope of interest to all procedures, including those from other disciplines. The concept of professional collaboration is also highlighted in several areas of the BACB’s 5th Edition Task List (BACB, 2017). Most directly, section H-9 explicitly states that behavior analysts are expected to collaborate with other stakeholders who are providing support or services to a shared client. This involves conducting a thorough record review, including medical, educational, and other available records at the initiation of a case (i.e., F-1); conducting assessments to determine a client’s strengths and areas of need (i.e., F-4); prioritizing target behaviors (i.e., F-3); and setting observable, measurable goals (i.e., H-1). Through the fieldwork and supervision process, supervisees learn to operationally define behavior, select appropriate measurement systems, use single-subject experimental designs, and graph and interpret data (BACB, 2017). Data interpretation facilitates decision making regarding treatment effectiveness and the continuation of services, which are also addressed specifically in the Task List. Further, students and professionals in the field of behavior analysis must learn to consider a number of factors when selecting interventions, including the “best available scientific evidence” (BACB, 2017, p. 5), client preferences, supporting environments, and social validity (i.e., H-3; BACB, 2017).

Other Professional Expectations of Teaching

Several other professions identify collaboration as a specific skill set, and behavior analysis has increasingly recognized the utility of such training. Numerous professions have sought to identify and teach components of collaboration, including active listening, empathy, and perspective taking (e.g., Koenig & Gerenser, 2006; Scheibel & Watling, 2016). These “soft skills” are considered essential when navigating differences of opinion about treatment directions and may improve dispute resolution on teams.

In medicine, nursing, occupational therapy, speech pathology, and education, these skills have long been valued and highlighted as explicit expectations for practitioners. Within speech-language pathology, suggestions for bridging with behavior analysts have included learning more about the other discipline, reading articles and attending conferences from the other discipline, creating informal social networks across disciplines, and discussing/translating terminology differences (Gerenser & Koenig, 2019; Koenig & Gerenser, 2006). Within occupational therapy, suggestions have been made for analyzing how activity analysis can be used to clarify tasks and roles and how an approach that uses both disciplines can enhance outcomes (Scheibel & Watling, 2016; Whiting & Muirhead, 2019).

Teaching these soft skills, whether in service provision or collegial contexts, has also been highlighted as important for years across disciplines. In medicine and in nursing, this has been explored for many years, and many skills have been defined and measured. For example, Bonvicini et al. (2009) taught physicians to make empathic statements and to engage in active listening with their patients. Results indicated that training generalized to interactions with real patients. Within educational contexts, collaboration has been valued, especially in inclusive education. Skills emphasized include articulating shared goals, defining roles, working through conflict, and building a community (Davis, 2020).

Recognizing the need for interdisciplinary team readiness is an important direction for behavior analysis. In recent years, several models have been developed to assist practitioners with navigating the expectations of an interdisciplinary team. Brodhead (2015) emphasized the need to evaluate the existing research and potential harm associated with a proposed intervention, to assess whether an objection should be raised based on potential harm. Newhouse-Oisten et al. (2017) suggested that behavior analysts evaluate the extent to which a medical intervention is compatible with ABA and the extent to which it is evidence based. In addition, Critchfield et al. (2017) cautioned behavior analysts against relying on terminology associated with behavior analysis or with science in general, as it may be a barrier to effectively conveying information about ABA. In the context of working with families, behavior analysts have begun to identify common pitfalls that may lessen our effectiveness in partnering with parents of children with autism (Taylor et al., 2018). All of these sources of information have served to highlight the need to identify collaboration as an essential component of our professional work and to begin to identify component skills that compose the collaboration skill set.

Collaboration unquestionably requires an understanding of and an appreciation for the work and contributions of allied disciplines to the treatment context (Gerenser & Koenig, 2006; 2019; Lafrance et al., 2019). In addition, it likely includes the need for the skills of effective communication, judicious navigation of treatment disputes, and systematic team-based assessments of potential treatment paths (Brodhead, 2015; Cox, 2012; Critchfield et al., 2017; Newhouse-Oisten et al., 2017). It also requires an organizational commitment to highlighting the unique expertise of each discipline in an interdisciplinary model.

Behavior Analysis and Collaboration

In recent years, there has been more recognition of the importance of collaboration within the practice of ABA. Brodhead (2015) noted the ways in which behavior analysts might evaluate treatments suggested by other providers. For example, he discussed how a behavior analyst might translate procedures into behavioral principles, and how data might be collected to guide team decisions regarding such approaches. He also emphasized how collaboration presents an opportunity to expose other disciplines to a behavioral view and allows for behavior analysts to learn more about the approaches of other disciplines. Given that the Professional and Ethical Compliance Code for Behavior Analysts (BACB, 2014) Section 2.10d specifies that behavior analysts “review and appraise the effects of any treatments about which they are aware that might impact the goals of the behavior-change program, and their possible impact on the behavior change program,” such communication and collaboration are entirely consistent with the goals of intervention.

In addition to the Professional and Ethical Compliance Code for Behavior Analysts’ inclusion of collaboration, the 5th Edition Task List (BACB, 2017) also supports its relevance. Section E emphasizes behavior analysts’ responsibilities to clients and to colleagues, and Section H-2 emphasizes how the selection of intervention is based on evidence of effectiveness. Section H-9 specifically states that “behavior analysts collaborate with others who support and/or provide services to clients” (BACB, 2017, p. 5).

LaFrance et al. (2019) discussed the importance of understanding the contributions of multiple specialty disciplines to treat complex problems. Developing a respect for the knowledge and expertise of other disciplines, combined with an unwavering commitment to effectiveness and evidence-based interventions, defines the current approach to collaboration within the discipline of ABA.

Purpose Statement

As described previously, there is a need to train behavior analysts to collaborate with other professionals. Little information exists in the behavior-analytic literature regarding examples of training behavior analysts to be collaborators with other professionals. The purpose of this article is to describe a program for training collaboration for preservice behavior analysts that has been used by Melmark for 2 years.

Overview of Melmark

Melmark’s mission is to enhance the lives of individuals with autism and developmental disabilities, and their families, by providing evidence-based and applied behavior-analytic services to every individual, every day. Melmark (also referred to as the “agency”) is a comprehensive multiservice agency providing residential, educational, and therapeutic services for over 300 children and 350 adults across multiple state divisions. The services are often complex and require expertise from professionals across disciplines (i.e., behavior analysis, education, health care, occupational therapy, physical therapy, psychiatry, speech-language pathology). The agency provides behavior-analytic services in a fully interdisciplinary model (i.e., a shared value for assessment and treatment practices from multiple disciplines, definitions of evidence-supported treatment, assessment guiding treatment, and data guiding ongoing treatment decisions to find the best outcomes for individuals). The interdisciplinary model and practices align with behavior-analytic expectations (e.g., Baer et al., 1968; Brodhead, 2015).

Agency professionals maintain the interdisciplinary framework via established systems. Key features include a purposeful system design (e.g., biweekly team progress reviews), defined professional roles (e.g., supervision structure), a defined clinical framework (e.g., curriculum choice), performance-based training (e.g., orientation, on the job), and frequent monitoring of systems and roles (i.e., behavioral skills training; Parsons et al., 2012; Sarokoff & Sturmey, 2004). Professional staff supervise both employees to improve agency-relevant employment skills and employees who are seeking professional credentials. Melmark supports employees by providing tuition reimbursement, a practicum site, and supervision meeting discipline-specific expectations (e.g., Board Certified Behavior Analyst [BCBA], speech-language pathologist).

The agency focuses on the training and development of a highly skilled workforce through evidence-based practices. A tiered system of training has been developed to ensure the competency of the nearly 1,100 staff across the three divisions. Organizational behavior management, with the inclusion of knowledge- and performance-based competencies, is the foundation of training systems across all levels of staff.

The general system of training can be broken down into three phases. Although the content of each phase is specific, the training methods are consistent. All training systems include both didactic and behavioral skills training formats (e.g., Parsons et al., 2012; Sarokoff & Sturmey, 2004). During the first phase, training content includes state regulations, provides staff with a common language specific to the organization’s mission and philosophy, and introduces the principles and terminology of ABA necessary to perform basic job functions. With the first phase consisting of largely didactic trainings, emphasis is on the use of knowledge-based assessments. During presentations, trainees are expected to engage in active student responding and complete guided notes as they follow along. Daily quizzes are also given with the expectation that trainees achieve an 80% or higher to pass. These assessments allow trainers to quickly identify trainees’ retention of knowledge and, if needed, provide additional supports (e.g., one-to-one trainer support).

The second phase of training consists of on-the-job training specific to the setting and clients with whom the employee will directly work. The goal of this phase is to extend the application of learned skills to the respective work site. Over a 30-day training period, employees work side by side with supervisors to learn the specific programming of individuals whom they will support. Assessment methods also shift during this phase from knowledge based to performance based. Supervisors use feedback tools to measure performance and provide feedback on the skills necessary to perform their jobs (e.g., data collection, implementing support plans). This process continues until the employee meets the mastery criteria (dependent on the skill, criteria range from 80% to 100%), at which point training is systematically extended to additional settings.

The third phase of training is the most diverse, with the goal of maintaining current skills, as well as professional development. Examples of professional development areas are leadership (e.g., supervision practices, organizational systems), clinical applications (e.g., functional analysis methodology), and research development. Similar to Phases 1 and 2, training follows a behavior skills training model with periodic skill evaluations to determine drift. This phase continues throughout an employee’s career at Melmark.

Training Behavior Analysts

Demographics

The agency provides opportunities for employees to acquire BACB-supervised experience hours in the supervised independent fieldwork category. On average, the agency has more than 20 BCBAs to provide supervision, with an average caseload of two supervisees per supervisor. The supervisors’ time since certification ranges from newly certified to more than 15 years. The majority of supervisors, more than 75%, reported past working and training experience in the areas of autism spectrum disorder and assessment of challenging behaviors. Of the employees accessing supervision to become BCBAs, approximately 75% of supervisees are enrolled in university/college courses. Supervisee positions held within the agency range from direct support positions to director-level positions.

Overview of “Learning Series”

In line with a behavioral systems analysis approach (e.g., Diener et al., 2009), an organization should state and evaluate training processes, including resources, outcomes, and stakeholders. An evaluation of Melmark’s training for preservice behavior analysts indicated system disconnects such as necessary time resources for supervisors and supervisees, product standards (e.g., lack of promotion of newly certified behavior analysts due to lack of readiness), and alignment of the product and the organization’s mission. The training program described in what follows was developed based on this initial analysis.

Several learning series were developed (there are currently seven completed series) to provide a framework for behavior-analytic training, aligned with the BACB’s 4th and 5th Edition Task Lists. Employed professionals created some learning series solely, whereas external partners developed others contractually. The learning series are 8 to 15 modules with foundational readings and activities for supervisees to learn about behavior-analytic skills in a specific practice area (e.g., autism, aging, challenging behavior). The supervisor evaluates supervisee performance for each content area using multiple-choice pre- and posttests, fluency timings of key terms, written summaries of readings, discussion during supervision, and performance feedback tools for practice activities (see Appendix A for example tools). As outlined in a performance-based training model (Brethower & Smalley, 1998), supervisees who do not meet established performance criteria for activities (e.g., typically set at 80% accuracy) receive remediation supports from the supervisor (e.g., additional practice, altered activities, additional readings).

Each learning series module is expected to be completed in 1–2 weeks depending on the job description of the supervisee (i.e., some job descriptions inherently allow for more experience hours per week). The learning series were developed to reduce the burden on supervisors needing to prepare supervision readings and materials, to ensure supervisees were encountering expected activities on the Task List, to allow for the performance evaluation of supervisees, and to create a system where outcomes of the system could be evaluated (i.e., behavioral systems analysis). Supervisees typically complete three to four learning series to meet the required number of experience hours. There is no particular order for the learning series.

Given that the learning series are applications of behavior analysis to specific practice areas, supervisors are expected to determine their professional scope of competence (see Brodhead et al., 2018, for a discussion) prior to supervising a learning series. Supervisors review the content of the learning series, complete an overall exam specific to the learning series, evaluate coursework and professional experiences, and complete the Competence and Confidence Checklist (Brodhead et al., 2018). Based on the information from these sources, a supervisor self-determines their professional scope of competence for a learning series.

Collaboration Learning Series

Given the need for training on collaboration, a learning series specific to collaboration within behavior analysis was developed. The learning series is composed of 15 weekly modules (see Table 1 for a brief description of each module). The series consists of selected readings, applied projects, pre- and posttests, and SAFMEDS (e.g., Graf & Auman, 2005; Quigley et al., 2017) centering on several key themes critical to working in conjunction with professionals in the fields of speech-language pathology, occupational and physical therapy, and developmental pediatrics. As members of interdisciplinary teams, behavior analysts frequently have the opportunity to share clients with these professionals in educational settings, as well as within home, clinic, and community-based services.

Table 1.

Summary of Collaboration Learning Series Activities

Point in the learning series	Module activity description	Assessment method
Prior to starting the learning series	Pretest to evaluate performance	Multiple-choice pretest
Module 1	Introduction to interdisciplinary strategies	Journal Article Review Form
Module 2	Technical language versus nontechnical language	Journal Article Review Form
Module 3	Collaboration with speech-language pathology: Scope of practice and competence	SAFMEDS (Say all fast minute every day shuffle) check, Journal Article Review Form
Module 4	Collaboration with speech-language pathology: Clinical case review including defining behavior, assessment of behavior, and clinical planning	Journal Article Review Form
Module 5	Collaboration with speech-language pathology: Intervention development including measuring outcomes	Journal Article Review Form, Presenter Feedback Tool
Module 6	Collaboration with occupational therapy: Scope of practice and competence	SAFMEDS check, Journal Article Review Form
Module 7	Collaboration with occupational therapy: Clinical case review including defining behavior, assessment of behavior, and clinical planning	Journal Article Review Form
Module 8	Collaboration with occupational therapy: Intervention development including measuring outcomes	Journal Article Review Form, Presenter Feedback Tool
Module 9	Collaboration with physical therapy: Scope of practice and competence	SAFMEDS check, Journal Article Review Form
Module 10	Collaboration with physical therapy: Clinical case review including defining behavior, assessment of behavior, and clinical planning	Journal Article Review Form
Module 11	Collaboration with physical therapy: Intervention development including measuring outcomes	Journal Article Review Form, Presenter Feedback Tool
Module 12	Collaboration with health care: Scope of practice and competence	SAFMEDS check, Journal Article Review Form
Module 13	Collaboration with health care: Clinical case review including defining behavior, assessment of behavior, and clinical planning	Journal Article Review Form
Module 14	Collaboration with health care: Intervention development including measuring outcomes	Journal Article Review Form, Presenter Feedback Tool
Module 15	Ethical and professional considerations of collaboration	Journal Article Review Form, Presenter Feedback Tool
After completing the learning series	Posttest to evaluate performance	Multiple-choice posttest

The purpose of the learning series is for supervisees to gain knowledge and experience collaborating with professionals in fields that are typically encountered in applied professional practice settings. Further, supervisees are expected to gain behavior-analytic skills relevant to the BACB’s 4th and 5th Edition Task Lists (BACB) and to apply acquired skills in the context of working as a member of an interdisciplinary team. Expected outcomes for supervisees include defining and describing the characteristics of interdisciplinary care, identifying potential problems that may arise within this care model, identifying ways to solve problems when barriers to collaboration are encountered, and disseminating behavior-analytic content to nonbehavioral providers. Further, students learn to effectively communicate in a manner that is professional, cooperative, and transparent.

A combination of assigned and supervisee-selected readings is embedded across the learning series. Assigned reading content includes definitions and examples of professional collaboration, as well as case studies and practical guidance for communicating and working with members of other professions (an annotated bibliography is provided in Appendix B). Further assigned readings provide the supervisee with information regarding the credentialing process and scope of practice for four disciplines frequently encountered in educational and clinical settings (i.e., speech-language pathologist, occupational therapist, physical therapist, developmental pediatrician). The goal of the assigned readings is for supervisees to learn to discuss similarities and differences across practices in the field of behavior analysis and the other respective professions. Additionally, it is anticipated that this knowledge will aid supervisees in developing an understanding of the scope of problems addressed and methods employed to address them by a variety of related fields. Further, readings are designed to foster supervisees’ appreciation for the breadth and depth of training and expertise that their colleagues in other fields possess.

Developing an understanding and appreciation for colleagues in other professions allows behavior analysts to look for ways in which various treatment methods may complement and enhance one another to optimize client outcomes. One way understanding is fostered is through the review of terms regarding collaboration, consultation and foundational terms from other disciplines. These are practiced to fluency in a timed format commonly known as SAFMEDS (Say all fast minutes every day shuffle). In this way supervisees become familiar with how other fields explain deficits and targets for intervention. Moreover, analyzing the assessment and treatment methods employed in other disciplines may also prompt supervisees to identify ways to work cooperatively with colleagues when they encounter differences among professional approaches to the same problem.

In an effort to help expose individuals to content from other fields of study, several modules in the learning series require the supervisee to independently select peer-reviewed articles from journals within the aforementioned fields. Articles must describe specific assessment and/or intervention methods for an identified clinical problem (e.g., skill acquisition, behavior reduction). Supervisees are required to summarize the purpose identified in their self-selected studies; consider such details as participants, setting, and materials; describe the methods employed, including dependent variables, measurement and reliability procedures, treatment integrity, and social validity measures; and summarize the results along with the authors’ conclusions. The structured article review format provides the supervisee with an opportunity to constructively share their opinion and thoughts on the intervention and its peer-reviewed presentation. Finally, supervisees are required to select an article from a peer-reviewed behavior analysis publication and provide two separate summaries: one aimed at a behavior-analytic audience using technical language and terminology from ABA, and one using nontechnical language to describe the concept for professionals in non-behavior-analytic fields.

A hallmark of the learning series is multiple opportunities to collaborate with professionals from each of the four previously identified fields. The supervisees practice collaboration and professional communication skills under the mentorship of their supervising BCBA, who observes and provides feedback regarding the supervisee’s performance of these skills throughout the process. Supervisees are required to collaborate with their colleagues to complete a case study, which includes identifying and operationally defining the behavior targeted for change, analyzing the client’s current skill repertoire and performance levels relevant to the target behavior, and developing learning objective(s) and an intervention for the case.

Knowledge of other disciplines’ scopes of practice and contributions is essential to building a functional interdisciplinary model of care. Supervisees are required to prepare and present (e.g., during an office supervision session) an overview of the scope of practice of behavior analysts and of each of the aforementioned professional roles. The assignment includes a discussion of the similarities and differences of the role and scope of practice for behavior analysts and those of each respective profession, including examples of assessment and intervention methods used in each discipline, areas in which the roles may overlap, and the boundaries of any overlapping practices. The presentation must also identify ways in which the respective providers’ roles complement one another, and include suggested approaches to collaborating with colleagues from other service areas. Supervisees are further responsible for discussing strategies for effective communication and proactively identifying ways to address areas of difference between the disciplines.

Finally, the learning series culminates in the delivery of a summary presentation on the subject of professional collaboration in ABA. In this final presentation, supervisees discuss the integration of socially valid and ethical practices within an interdisciplinary care model grounded in the science of human behavior.

Discussion

Melmark’s Collaboration Learning Series was designed to help trainees in behavior analysis develop an appreciation of the interdisciplinary treatment model. Supervisees are exposed to literature from all disciplines, are mentored through case studies with members from other disciplines, are observed while interacting with members of other professions, and conduct presentations about allied disciplines. These tasks help the behavior analyst in training learn not just about the power of behavior analysis, but also about the power of speech-language pathology, occupational and physical therapy, and medicine. The series is designed to widen the lens through which these supervisees view behavior-analytic intervention, and ensure that their careers will be built on a firm foundation of collaborative intervention and professional respect.

The model is new, and many future extensions are planned. Perhaps most important, activities must be consistently associated with the delivery of performance-based feedback. Toward this end, rubrics are in development to capture the presence of professional behavior in interdisciplinary contexts. Future directions include the consistent collection of social validity data, both to learn what supervisees experienced in the process and to assess how supervisors perceived the value of the experience for supervisees. In addition, it will be crucial to obtain feedback from interaction partners (including professionals from other disciplines) on the nature of the collaboration experience. Additional plans include extending the observations of professional collaboration in the context of supervision, not just for behavior analysts in training, but for all professions and all levels of supervision within the organization. Readers should recognize the lack of experimental evaluation of this model when they consider its implementation.

Example Assessment Tools

Presenter Feedback Tool

Journal Article Review Form

Directions: Upon completion of the article, answer the following questions and consider how the information may apply to you.

Article (list reference in American Psychological Association format for practice writing references):

Appendix B

Annotated Bibliography

Alberto, P. A., & Troutman, A. C. (2003). Responsible use of applied behavior analysis procedures. In P. A. Alberto & A. C. Troutman, Applied behavior analysis for teachers (6th ed., pp. 499–522). Merrill Prentice Hall.

The authors state and discuss common concerns levied against applications of behavior analysis. The chapter includes an exploration and discussion of potential causes for these concerns. The authors conclude with procedural suggestions to mitigate the concerns and provide effective treatment.

Bailey, R. (2011). Speech-language pathologist. In C. G. Simpson & J. P. Bakken (Eds.), Collaboration: A multidisciplinary approach to educating students with disabilities (pp. 105–122). Prufrock Press.

The author provides a comprehensive overview of the role and responsibilities of a speech-language pathologist. The overview includes a description of a speech-language pathologist’s scope of practice. The author concludes with strategies for communicating service delivery information (e.g., assessment results, treatment goals) with parents, teachers, and individuals served.

Bock, S. J., Michalak, N., & Brownlee, S. (2011). Collaboration and consultation: The first steps. In C. G. Simpson & J. P. Bakken (Eds.), Collaboration: A multidisciplinary approach to educating students with disabilities (pp. 3–15). Prufrock Press.

The authors introduce the concepts of collaboration and consultation. Included are definitions, historical perspectives, and the benefits and limitations of collaboration. The authors conclude with steps to build a successful collaborative team.

Boivin, N. E., Blevins, H., Norton, V., Pierce, C., Stone, A., Weiss, M. J., & Whelan, C. (2015). Characteristics of interdisciplinary practice. Southeast Education Network Newsletter (Winter 2015/2016), 106–108.

The authors describe key characteristics of an effective interdisciplinary model. Discussions include treatment planning prior to admission and training for all team members on support plan implementation and strategies for generalization. The authors conclude with examples and benefits of the model’s implementation within an educational setting.

Broadhead, M. T. (2015). Maintaining professional relationships in an interdisciplinary setting: Strategies for navigating nonbehavioral treatment recommendations for individuals with autism. Behavior Analysis in Practice, 8(1), 70–78. 10.1007/s40617-015-0042-7.

The author discusses strategies for behavior analysts to use when nonbehavioral treatments are discussed within an interdisciplinary team. Described are an ethical decision model that assists in determining the purpose of nonbehavioral treatments, ethical considerations for behavior analysts, and strategies for balancing professional relationships.

Choi, B. C. K., & Pak, A. W. P. (2006). Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education and policy: 1. Definitions, objectives, and evidence of effectiveness. Clinical and Investigative Medicine, 29(6), 351–364. http://www.ncbi.nlm.nih.gov/pubmed/17330451.

The authors define and discuss three common terms used to describe teamwork with members from multiple disciplines: multidisciplinary, interdisciplinary, and transdisciplinary. Through a literature review, the authors describe various approaches, the benefits they offer, and the limitations encountered during implementation of the models.

Coben, S. S., Thomas, C. C., Sattler, R. O., & Morsink, C. V. (1997). Meeting the challenge of consultation and collaboration: Developing interactive teams. Journal of Learning Disabilities, 30(4), 427–432. 10.1177/002221949703000409.

The authors describe the similarities and limitations of three team models: consultation, collaboration, and teaming. Research strongly supports the need for special educators to play the dual role of consultant and collaborator. Although there are many models to reference, most share similar goals and processes.

Fisher, W. W., Groff, R. A., & Roane, H. S. (2011). Applied behavior analysis: History, philosophy, principles, and basic methods. In W. W. Fisher, C. C. Piazza, & H. S. Roane (Eds.), Handbook of applied behavior analysis (pp. 3–13). The Guilford Press.

The authors review the history of behavior analysis, including its three branches: behaviorism, experimental, and applied behavior analysis (ABA). Described are the basic tenets that set behavior analysis apart from other areas of psychology. The authors conclude with a discussion of the seven dimensions of ABA.

Friman, P. C., & Piazza, C. C. (2011). Behavioral pediatrics: Integrating applied behavior analysis with pediatric medicine. In W. W. Fisher, C. C. Piazza, & H. S. Roane (Eds.), Handbook of applied behavior analysis (pp. 433–450). The Guilford Press.

The authors discuss the integration of behavioral pediatrics and ABA. This overview covers the four primary domains behavioral pediatricians often treat that also overlap with behavior analysts: bedtime struggles, constipation and retentive encopresis, nocturnal enuresis, and feeding problems. The subsections offer suggestions for treatment, as well as for the interaction between behavior and physiology.

Fulk, B. M. (2011). Effective communication in collaboration and consultation. In C. G. Simpson & J. P. Bakken (Eds.), Collaboration: A multidisciplinary approach to educating students with disabilities (pp. 19–30). Prufrock Press.

The author provides strategies for effectively communicating when collaborating. Strategies described within the chapter include building teams and relationships, understanding communication styles, planning meetings, and solving problems. The author concludes with tips for navigating difficult interactions and cross-cultural communications.

Hayward, L. M., Meleis, W., Mahanna, J., & Ventura, S. H. (2016). Interprofessional collaboration among physical therapy, speech-language pathology, and engineering faculty and students to address global pediatric rehabilitation needs: A case report. Journal of Physical Therapy Education, 30(4), 24–34. https://ece.northeastern.edu/personal/meleis/jpte-2016.pdf.

The authors illustrate the interprofessional collaboration model with students from three separate disciplines: speech-language pathology, physical therapy, and engineering. Tasked with working together, the students incorporated knowledge from their individual disciplines and created low-cost communicative devices for individuals living in Ecuador.

Kerfeld, C. I., Pitonyak, J. S., & Jirikowic, T. (2017). Enhancing student interprofessional teamwork and collaboration through pediatric therapy learning experiences. Journal of Physical Therapy Education, 31(3), 114–120.

The authors evaluated the relationship between the interprofessional education experience for pediatric therapists and student learning outcomes. A description of the model, incorporated with survey data, identified a positive experience with few barriers to implementation. The authors offer several points for readers to discuss regarding the replication and effectiveness of this model.

Li, A., & Poling, A. (2018). Board certified behavior analysts and psychotropic medications: Slipshod training, inconsistent involvement, and reason for hope. Behavior analysis in practice, 11(4), 350–357. 10.1007/s40617-018-0237-9.

This article discusses the role behavior analysts play in regard to the use of psychotropic medications for individuals with autism. Survey data collected show a large number of behavior analysts work with individuals taking medications; however, training around the use of the medications is inconsistent. This inconsistency highlights the need for graduates to have a higher level of training in the use of medication, as well as strategies for collaborating with psychiatrists.

Newhouse-Oisten, M. K., Peck, K. M., Conway, A. A., & Frieder, J. E. (2017). Ethical considerations for interdisciplinary collaboration with prescribing professionals. Behavior Analysis in Practice, 10(2), 145–153. 10.1007/s40617-017-0184-x

While working as part of an interdisciplinary team, behavior analysts may find themselves interacting with team members who can prescribe medications. This article focuses on the ethical issues that can arise when medical interventions are used. To navigate these issues, the article presents a decision-making model that behavior analysts can use when multiple interventions are being proposed.

Ogletree, B. T., Brady, N., Bruce, S., Dean, E., Romski, M., Sylvester, L., & Westling, D. (2017). Mary’s case: An illustration of interprofessional collaborative practice for a child with severe disabilities. American Journal of Speech-Language Pathology, 26(2), 217–226. 10.1044/2017_AJSLP-15-0065.

Set within the context of a case example, this article describes the implementation of the interprofessional collaborative practice. Beginning with the child’s early development and continuing to the current day, the article describes how this model was both effective and ineffective at times during her treatment. Highlighting both these areas allows readers to use the article’s content to evaluate their own interprofessional practices to determine areas of strength and areas to improve.

Parker, R. (1996). Incorporating speech-language therapy into an applied behavior analysis program. In C. Maurice, G. Green, & S. C. Luce (Eds.), Behavioral intervention for young children with autism: A manual for parents and professionals (pp. 297–306). Pro-Ed.

The chapter provides guidance on the integration of the principles of two disciplines: speech-language pathology and ABA. Suggestions for integration include developing common language goals, using common activities to facilitate communication and troubleshoot linguistic issues, and assessing communication skills early in treatment. Mutual participation in the development of goals between disciplines is essential to individuals’ overall progress.

Parnell, A. R. (2011). Physical and occupational therapists. In C. G. Simpson & J. P. Bakken (Eds.), Collaboration: A multidisciplinary approach to educating students with disabilities (pp. 281–307). Prufrock Press.

This chapter provides a comprehensive overview of the roles and responsibilities of physical therapists and occupational therapists. In addition to the roles’ overview, the chapter provides guidance on effective strategies for communicating with both parents and teachers, as well as information on the direct services these professionals provide to the students and teachers they are working with.

Weeden, M., Ehrhardt, K., & Poling, A. (2010). Psychotropic drug treatments for people with autism and other developmental disorders: A primer for practicing behavior analysts. Behavior Analysis in Practice, 3(1), 4–12. 10.1007/BF03391753.

This article provides an overview of the psychopharmacology of developmental disabilities. Many behavior analysts report that the individuals they serve are prescribed at least one medication; however, training on the medication or its effects is rare. Educating oneself on the appropriate use of medications and their effects allows behavior analysts to have a better understanding of how medications can affect behavior-analytic interventions.

Wolf, M. (1978). Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of Applied Behavior Analysis, 11(2), 203–214. 10.1901/jaba.1978.11-203.

Whereas ABA heavily discusses the importance of objective measures, developing rules for measuring social validity is quite the opposite. The author describes how the Journal of Applied Behavior Analysis began defining and measuring social validity and the struggles that came along with the process. This article provides historical examples of how social validity was measured across three areas: the social significance of goals, the social appropriateness of procedures, and the social importance of the effects.

Declarations

Conflict of Interest

There are no conflicts of interest or competing interests for any of the authors.

Ethical approval

Ethical principles were adhered to, and the Professional and Ethical Compliance Code for Behavior Analysts was followed in both the intervention described and in the write-up.

Informed Consent

This is a description of a training module; informed consent is not applicable.