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approach in the opinion of the Association. Jacquie further notes that the support for practice based evidence and E3BP advocated by the Association (SPA, 2010) requires her to integrate the considerable clinical expertise that she gathered from her colleagues in the Early Intervention team into her findings, in balance with her consideration of the

Although Jacquie feels that this practical application of the IPCP will be appropriate for her clients and a useful framework for her to relay to her managers, she notes that, in parts, the paper generalises the benefits of an IPCP approach after describing a single case study, and she evaluates that it ultimately overstates the benefits of IPCP. Overall, Jacquie concludes that the Bruce and Bashinski (2017) paper has several limitations. While the authors identify that future research must focus on training for IPCP teams, they do not provide practical guidance around how this can be achieved. Jacquie also feels that the support of families using AAC within an IPCP service needs to be further investigated, as empirical evidence illustrating how IPCP principles integrate with the trifocus framework across contexts would be instructive for clinical teams. Implications for practice Overwhelmingly, interdisciplinary practice is described in the literature that Jacquie considers as balancing the coordinated, holistic, client- and family-inclusive approach of transdisciplinary practice with a well-defined scope of practice and professional boundaries for each clinician (Rokusek, 1995). Jacquie notes that the benefits of interdisciplinary practice are suggested to be: a united purpose of all interventionists and the utilisation of the specific strengths of individual team members to maximum benefit (Ogletree et al., 2017; Sylvester, Ogletree & Lunnen, 2017). Clinical skill development of interdisciplinary team members is also mentioned as a likely outcome (Ogletree, 2017); this specific claim is, however, not supported by research evidence. In contrast, some of the issues noted to arise within interdisciplinary practice include: possible tensions within team relationships due to differences in opinion or therapeutic approach, as well as areas of crossover within the clinical scope of practice of two or more team members (Zwarenstein, Goldman & Reeves, 2009). Jacquie’s broader reading also suggests that coordinating the availability of a team can result in longer waiting times for children to access intervention, and that lack of funding for multi-member outreach services may limit access to services in community settings, especially for children from lower socioeconomic backgrounds (Majnemer, Shevell, Rosenbaum & Abrahamowicz, 2002). Additionally, clinicians report that while they value interdisciplinary collaboration, practically, lack of time and access to other professionals can present barriers to collaboration (Muncy, Yoho & McClain, 2019). Jacquie also notes that qualifying and measuring the components of successful interprofessional collaborative practice appears to present a challenge for researchers (Zwarenstein et al., 2009). Thus, meta-analyses of the outcomes and nature of IPCP have not been possible, and so there is no formal, robust, consolidated effect size that Jacquie can report on. Finally, Jacquie considers the guidance provided in the SPA documents. Taken together, the documents support interdisciplinary practice as an evidence-based approach to clinical practice (SPA, 2015; SPA 2010), and advocate that a multi-professional, collaborative team is indicated for optimum, holistic service delivery in AAC (SPA, 2020). The Association also cautions speech pathologists to carefully consider the specific activities that can be delegated to other professionals (SPA, 2016), indicating to Jacquie that interdisciplinary practice, with its emphasis on clear professional boundaries, is a well-supported clinical

research evidence. Conclusion

Jacquie’s concluding summary for Karen states that although interdisciplinary practice in community-based allied health services is well supported by both the broader research evidence and her profession’s clinical guidelines, a body of research specifically focusing on models of clinical service provision in AAC is still emerging. A low level of evidence to support the case that interdisciplinary collaboration can facilitate successful communication outcomes for children with disabilities can be found in the literature, however, at the time of Jacquie’s search she finds that there is a need to establish a robust evidence base around interdisciplinary, person- and family-centred intervention in AAC. This would support a more convincing case for service managers and funding providers of the benefits of interprofessional collaboration within this specific context. True interdisciplinary collaboration requires purposeful, continuous and reflective collaboration between professionals of diverse clinical disciplines (Ogletree, 2017). For many community-based services providing disability and AAC intervention in Australia, facilitating this level of interprofessional collaboration would require a significant adaptation in the structure of service delivery, which could be a challenge for many services within the current funding climate. As such, overall, Jacquie concludes that the low level of summative evidence she has collated does not provide strong enough support for a transition in the delivery model of her service at this time. She decides, however, that she will take on board the clinical expertise and practice based evidence provided by her colleagues, and will integrate interdisciplinary collaboration into her practice in AAC to the best of her ability with the time that she has available under the current service structure. References Bruce, S. M. & Bashinski, S.M. (2017). The trifocus framework and interprofessional collaborative practice in severe disabilities. American Journal of Speech-Language Pathology , 26 (2), 162–180. Giladi, N., Manor, Y., Hilel, A., & Gurevich, T. (2014). Interdisciplinary teamwork for the treatment of people with Parkinson’s disease and their families. Current Neurology and Neuroscience Report s, 14 (11), 493–499. Majnemer, A., Shevell, M.I., Rosenbaum, P., & Abrahamowicz, M. (2002). Early rehabilitation service utilization patterns in young children with developmental delays. Child: Care, Health and Development , 28 (1), 29–37. McNeilly, L. G. (2018). Using the International Classification of Functioning, Disability and Health Framework to achieve interprofessional functional outcomes for young children: A speech-language pathology perspective. Pediatric Clinics of North America , 65 (1), 125–134. Muncy, M.P., Yoho, S.E., & McClain, M.B. (2019). Confidence of school-based speech-language pathologists and school psychologists in assessing students with hearing loss and other co-occurring disabilities. Language, Speech and Hearing Services in Schools , 50 (2), 224–236.

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