Home-based Team Meetings

I had a team meeting tonight for a child that is receiving almost 40 hours of services per week. I thought it might be helpful to provide guidelines or at least a broad format for a home-based team meeting.

Frequency: For a child with many therapists working together, monthly team meetings are advisable. We meet for this child once a month.

Attendance: Everyone who works with the child should make an effort to attend the monthly meetings. At our meeting, in attendance were myself, five therapists, two speech therapists, an occupational therapist and mom.

Purpose: The purpose of the team meeting is to review the student's progress, identify any difficulties that the entire team has encountered over the past month, to update programs, and identify if there are new areas that the child may be ready to develop. Additionally, it gives the team an opportunity to get together and discuss overall ideas. ABA teams in a home-based environment can often be very isolating for the therapists and the family. A team meeting gives everyone an opportunity to collaborate and rejuvenate the "team" feeling. This is important, as sometimes, getting excited about a program when you feel like you are on your own, is more difficult. I find that after a team meeting, everyone, family and therapists included, are a little more excited for their next few sessions. Its like a booster shot.

Agenda:

Overview: At the start of the meeting, a brief overview helps the team point out any major concerns. It gives the family an opportunity to give an overview "feel" for how the child is progressing. Do we feel he is overall progressing? Is there a regression? No progress? This will guide the program over the course of the meeting, and help focus discussion.

Pressing Concerns from Family: I like to ask the parent at the start of the meeting to share any concerns that are affecting the family. This is usually a behavior that is interfering, and is very important to focus. If there is a concern in the family, this should take precedence over the meeting. While academic programs may not get reviewed, this should be priority and a plan should be put in place to help the family.

Behavior: If it hasn't been brought up until now, a brief discussion of the students behavior and progress should ensue. This is important in order to ensure that not only the ABA therapists are implementing consistent behavior support plans, but that the related service providers are on the same page.

New programs to be added: Any new ideas from programs should then be discussed. For example, tonight, we discussed four new programs that were probed and added by the team coordinator (myself) over the week. I had probed programs, and identified if they appeared to be appropriate. At the meeting, I posed them to the team and we discussed the appropriateness of the programs.

Book Review: Programs and graphs are reviewed. If the program is moving along nicely, the point does not need to be belabored. If there is a concern, the team will discuss the program and identify if it needs modification or additional supports.

Occupational therapy Review: The ABA programs are reviewed first in order to give the speech and OT an opportunity to hear the programs run and to give input. The entire process is collaborated on by the entire team, however usually, the ABA programs review all of the domains and often touch on the other domains.

After ABA program review, the occupational therapist discusses how the programs can me supported to include an OT perspective, and what additional goals can be addressed. The OT at this meeting had created a list of strengthening activities that should be followed by the team and progress on these goals were reviewed.

Speech Review: Much like OT, speech therapists discuss the goals as well throughout the meeting and provide feedback. If there are areas of development and programming that hadn't been discussed, the speech therapists would address it and provide suggestions and modification for how the team could support pacing, articulation and additional language development. This is not the only time that the related service providers collaborate, but having an opportunity to "have the floor" provides the therapists with time to cover what may have been missed (and there is always something missed).

Re-cap: Highlight any changes that will be implemented based on the meeting.

Schedule Next Meeting: Scheduling over email and phone calls is all but impossible. The best way is to schedule it at the meeting to ensure a day and time that everyone can make.

Time: These meetings tend to run about 2 hours. This may seem a bit extreme, but it also allows for the occasional digression which happens, and breaks up the meeting a little. If there is a significant concern, the meeting may run longer, but this is usually not the case. It is also rarely the case that the meeting is short.

Food and drink: While it may not seem important, having a little something at the meetings helps, and goes a long way to make the therapists feel appreciated. Some families go overboard with a full meal and dessert ensemble, which is lovely, but parents shouldn't feel the need to cook. It also depends on the time of the meeting. Coffee is always good. Anything else is supplemental. If the meeting is at a meal time (like tonight, 7:30-9:30) I find parents want to provide dinner, but this can get expensive and difficult to prepare if you have a family to take care of.

I find that meetings are very important. In earlier years, I have worked with teams that said they were "so consistent" they didn't need to meet. I found this ludicrous and arrogant. Everyone is different, and the diversity should be embraced. Out of this diversity may come some great ideas and successful strategies.