Magazine article National Association of School Psychologists. Communique

Facilitating Relationships between Pediatricians and School Psychologists

Magazine article National Association of School Psychologists. Communique

Facilitating Relationships between Pediatricians and School Psychologists

Article excerpt

Pediatricians and other family healthcare providers are critical in working to address many behavioral, academic, and/or social difficulties children experience at home and school. Effective communication and collaboration between school psychologists and healthcare providers is essential to fully understand the child's problems and design interventions that will address the child's needs.

School psychologists have several important areas of expertise that can facilitate communication between physicians and the school:

* Understanding chronic health difficulties

* Understanding school system dynamics

* Translating information across settings

* Identifying and addressing barriers

* Utilizing a problem-solving framework

* Focusing on prevention programs

Given ongoing changes in the provision of healthcare to children, school psychologists are an increasingly essential link in collaborating across the complex school, health, and family systems. However, school psychologists may experience many challenges to effective communication with the healthcare field. This article addresses these challenges and recommends simple strategies to facilitate collaboration.

UNDERSTANDING THE DIFFERENT MODELS

Schools and healthcare providers use different models in order to identify and treat various "problems." As noted in the table below, differences occur in the basis for diagnostic decision-making, the link between diagnosis and intervention, and perspectives about confidentiality. Working collaboratively with the school nurse, the school psychologist may need to educate members of the multidisciplinary team on these differences in order to reframe perspectives on various roadblocks that are bound to occur when working across systems.

The different diagnostic models are often confusing to parents and may create tension in communication across systems. For example, a physician may diagnose a child with ADHD and indicate to the parent and school that the child requires special educational programming. However, in schools, the presence of ADHD alone would not qualify a child for special education services unless the team finds that the child's academic performance is also impaired by ADHD. Thus, what appears to the physician as the school ignoring his or her recommendation based on a medical assessment is really a lack of full understanding by the physician as to what constitutes eligibility for special education.

Treatment options for the healthcare provider are determined directly from the diagnosis. Medical treatments often include the use of prescribed medication and other health-related interventions. From a physician's perspective, a child found to have a diagnosis of a learning disability needs to receive a treatment matched to the disability, which from their perspective maybe special education services. However, the school may already be providing individualized interventions to the student as a prereferral intervention or as part of a response-to-intervention model. Yet, these interventions are not necessarily special education or related to a diagnosis, which can be confusing to physicians and healthcare providers.

CONFIDENTIALITY

The issue of confidentiality must be addressed before a school psychologist is able to work collaboratively with a physician. Typically, consent to release information forms are required from both the school and physician's office. The school psychologist must take an active approach to ensure that parents have signed all consent forms and understand the purpose of the collaboration. As a medical office is typically very busy, it is important to follow up by phone after faxing information to ensure that all forms have been received. In addition, school psychologists should attach a signed copy of the consent form when mailing or faxing information to the physician. This will decrease the demands on the physician and likely expedite the response time. …

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