Dr Irina Roncaglia, Chartered Practitioner Psychologist and Clinical Lead at the National Autistic Society, discusses transdiscplinary teams and their benefits when supporting autistic pupils.

Transdisciplinary teams (TDT) and approaches are well known in health care. They have been developed to enable providers of multiple disciplines to collaborate and share ideas when creating a total health care plan that identifies and meets an individual’s support needs.

This differs from a multidisciplinary team, in which members use their individual expertise to first develop their own answers to a given issue, and then come together afterwards. 

Multidisciplinary approaches to assessment and support are less effective for both short and long-term outcomes. Not having a shared goal and clear direction at the start can mean the process becomes fragmented, increasing the likelihood of: 

• miscommunication
• unclarity of purpose
• disciplinary silos
• potential conflicts. 

The National Autistic Society has introduced TDTs within our educational settings, with the aim of improving children and young people’s (CYPs) access to learning and development. TDTs do this by working together to understand the CYP and any difficulties they may experience with day-to-day tasks, cognitive, emotional and social development and their overall well-being.

This approach means professionals from a range of disciplines can identify barriers to education through joined up thinking, recognising and understanding CYPs strengths and interests, and their wishes and aspirations.

TDTs can involve a range of professions including:

• psychologists
• speech and language therapists
• occupational therapists
• teachers
• other therapists.

It involves a sharing of knowledge, skills and decision-making, and the significant inclusion of multiple stakeholders. At the centre of this are the CYPs, their families and communities.

Research evidence

Transdisciplinary approaches have been long recognised as best practice for early intervention (Bruder, 2000; Gularnick, 2001) and many of these programs adopt some level of transdisciplinary approaches (Berman et al. 2000). There is also evidence that TDTs (Carpenter, 2005; Davies, 2007):

• reduces fragmentation of service delivery;
• reduces confusion (and conflicts) in reports and communication with families;
• promotes cooperation and coordination. 

Anxiety and learning

A TDT approach within schools can help pupils in many ways, for example supporting them to manage their anxieties and therefore reduce the barriers to learning. Autistic individuals experience high levels of anxiety which can significantly impact on their daily functioning and life (van Steensel et al. 2011).

Autistic people may experience anxiety through (Kerns 2014):

• difficulties with uncertainty and unpredictability (intolerance of uncertainty);
• sensory sensitivities;
• difficulties recognising and regulating emotions of self and others;
• performance anxiety.

Joyce et al. (2017) suggest that autistic people may respond to anxiety by increasing repetitive patterns of behavior, as these can provide a level of predictability and security to counterbalance the experienced anxiety. These experiences of, and responses to, anxiety can affect a person’s ability to access education and learning. 

Why use a TDT model

Transdisciplinary teams work seemlessly together, sharing teams‘ skills. Goals are aligned for better short and long-term positive outcomes. The benefits include (King et al. 2009): 

• team members around the CYP use strategies and approaches from all different disciplines;
• team members develop greater awareness and understanding of different disciplines through sharing of information and best practice;
• team members learn theories and methods from different disciplines; 
• team members learn to use all the above to embed the recommendations from different disciplines into the support for the CYP.   

It is not about taking the CYP out of the classroom to access therapeutic support. Instead, that embedded therapeutic support is delivered throughout the school day and beyond. Skills acquisition, resilience, emotional self-regulatory skills, communication skills, and sensory adaptations are embedded throughout the whole day.   

Results of using a TDT approach

There are several ways in which transdisciplinary embedded approaches positively impact on education practice and provision. 

Shared understanding of the issue

Understanding what causes a pupil’s anxiety, and what skills they need to manage these feelings, becomes a shared responsibility for the whole team. Different views are explored, explained and challenged, requiring an ability to respect each other’s professional expertise and yet also develop a shared common vision for short and long-term outcomes. 

Working in partnership with all involved

We work with all agencies such as social care and health, and follow the Educational and Health Care Plans (EHCPs). Transdisciplinary approaches through regular meetings with external agencies and professionals, provide an opportunity to support and empower the pupil and their families to achieve their goals, not just in a school setting but across different contexts and throughout their lifespan. 

Resilience building

Transdisciplinary approaches can promote greater resilience, acceptance and shared purpose. They encourage an ability to focus together on solutions, and support everyone to move forward despite setbacks. The process is shaped together - rather than an intervention or a program being done to, it is embedded within the process. 

Embedded transdisciplinary approaches can have a positive impact on the wider education practice and provision. Improving pupils‘ access to other community-based activities means improving their engagement, accomplishments, enjoyment and ultimately, their wellbeing.