Why is She Calling Me?

Written by Christine Milano, LMHC, Mecklenburg County CDSA

I was 22 years old when I sat around a large conference room table at Bellevue Hospital in NYC as part of the treatment team on the Psychiatric Unit. The room was filled with every discipline imaginable, from the Chief Resident to the Art Therapist. We met every week to discuss each and every patient on the floor at the time. As a first year graduate student, I was quite intimidated by the setting. However, I quickly learned that this was the way to go! I gained so much insight about our patients by listening to everyone who worked with them. That insight translated into more effective ways to treat our patients. The team was much better able to see the patient as a whole. We could understand different aspects of a patient’s day, personality and symptoms simply by communicating with each other. I continued to work primarily for teaching hospitals over the next 15 years. No matter what the setting, inpatient or outpatient, the treatment teams met weekly.

So, it came as quite a surprise for me that we didn’t have more communication between the evaluation staff at the Children’s Developmental Services Agency (CDSA) and our early intervention provider agencies that provide ongoing support and services for families. Single discipline assessments are usually requested by the IFSP team when there is a lingering concern or a new concern. The team, always including the family, may be having trouble meeting an outcome, or maybe they need more guidance to help make a specific routine more successful.  A Service Coordinator’s role is generally to connect with families about once a month. While they often connect more than that with each family, they also gain valuable information from talking with the providers in the home. I love connecting with other early interventionists who see a family more frequently. In addition to the service coordinator, providers have the richest information about the family and can paint the best picture of the child and the family from a week to week basis.  As early intervention providers, it is helpful when you can relay if the family is stressed, how they are coping, if the child is making typical progress, what technique you find helpful with the child…the list goes on and on. While finding the time to call and connect with all IFSP team members can be challenging at times, the information can be invaluable when I am preparing for a single discipline assessment. Typically a 10 minute call or 1 solid email is all that is needed to relay valuable information to an evaluator that is completing an assessment for the family. By not communicating with each other, our assessments occur in a vacuum because we may miss important details that give more perspective and result in better suggestions or services and activities. We all fill in the missing pieces for each other when we work as a team.

Any evaluator can benefit from connecting with a treating therapist prior to heading out to a home. For example, let’s take my role as a Licensed Mental Health Clinician. Not always, but very often, I am asked to complete a single discipline assessment when a team or family is questioning Autism as the underlying reason when children are struggling to meet IFSP outcomes. My role is then to figure out if this child, whom I may or may not have met at their initial evaluation, has Autism. It helps me tremendously to get feedback from providers who see the child regularly for treatment sessions. I am not looking to see if you think the child has Autism, I am looking for week-to-week functioning, behavior, regressions, improvements, etc. I am looking for your observations so I can incorporate them into my knowledge base and make further suggestions that are more useful to the family. Another example may be if a treating Speech Therapist is having challenges getting a child’s attention during sessions, and the team suspects sensory processing differences are impacting the child. An Occupational Therapist may want to observe the session to help provide more information.

We are talking a great deal about teaming and coaching as an interaction style with families at the CDSA. The time has come to open up the lines of communication between the evaluation staff and early intervention providers that are seeing families on a regular basis to help get a more complete picture of what’s going on. So, do not be surprised if you get an email or a phone call from one of the evaluators. Share your knowledge of the family and the child. In the end, we will have a more valuable experience for the family and as professionals.