Journal of Autism and Developmental Disorders

https://doi.org/10.1007/s10803-020-04413-7

ORIGINAL PAPER

Transdisciplinary Approach Practicum for Speech‑Language Pathology

and Special Education Graduate Students
Deborah Weiss1   · Barbara Cook1 · Ruth Eren2

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract
Speech-language pathology and special education graduate student teams participated in an intensive summer practicum
for social communication skills with children with autism spectrum disorders, utilizing a transdisciplinary approach that
aligned to the frameworks utilized for implementation science. Questionnaires measuring transdisciplinary approach knowl-
edge and comfort level were administered pre/post-practicum. Results of the questionnaires, written daily team reflections,
course evaluations, and a focus group interview indicated an increase in all measures, including an increased knowledge of
TA, increased understanding and comfort level with the other discipline, and a higher level of confidence and openness in
working collaboratively utilizing a transdisciplinary approach.

Keywords  Autism spectrum disorder · Transdisciplinary · Speech-language pathology · Special education ·

Interprofessional collaboration · Collaborative teaming · Implementation science

Introduction development (Casanova 2014). Research indicates that

Autism spectrum disorder (ASD) is a complex neurodevel-
opmental disorder characterized by impaired social interac-
tion, impaired verbal and non-verbal communication, and
stereotyped, repetitive behaviors evident from an early age
(American Psychiatric Association 2013). Autism preva-
lence has been consistently rising, with the most recent
estimate by the Centers for Disease Control and Preven-
tion (2018) of 1 in 59 children presenting with ASD, an
increase of 15% from 2 years prior. Causality appears to
be multi-faceted and complex. The previous assumption of
autism as being highly heritable has given way to a more
balanced conclusion which recognizes the interaction of
both genetic and environmental factors during neurological
Dr. Ruth Eren has retired from Southern Connecticut State
University.
* Deborah Weiss
weissd1@southernct.edu
1
Department of Communication Disorders, Southern
Connecticut State University, 501 Crescent Street,
New Haven, CT 06515, USA
2
Professor Emeritus, Department of Special Education,
Southern Connecticut State University, New Haven, CT,
USA
several hundred loci probably contribute to the genetic het-
erogeneity of ASD (Schaaf and Zoghbi 2011). The broad
heterogeneity and range of symptomatology and disabilities
within this population pose special challenges to the profes-
sionals who work with children with ASD (Klin et al. 2005).
Due to the complexity of the disorder, no one member
of a child’s educational team is expected to have in-depth
knowledge in all of the impacted areas; collectively how-
ever, a team would presumably have this breadth and depth
of knowledge (Connecticut State Department of Education
2005). Under the Individuals with Disabilities Education
Act (2004), a multidisciplinary team is mandated to assess,
plan, and implement educational programs for individuals
with disabilities. Close interprofessional collaboration and
specialization among teachers, speech-language patholo-
gists, special education teachers, other service providers,
and family members is necessary given the complexity of
the disorder (Paul and Wetherby 2005). The consequences of
not utilizing a collaborative approach include development
of separate, discipline-specific goals as opposed to shared
goals, increased utilization of pullout approaches rather than
provision of related services in a less restrictive general edu-
cation environment, isolated decision making, less effective
coordination and communication overall, and confusion on
the part of family members (Giangreco 2000).

13
Vol.:(0123456789)

Collaborative Teaming
The terms interprofessional collaboration and collaborative
teaming are often used interchangeably in the literature. This
article will utilize the term collaborative teaming; however,
will preserve the terminology utilized in the literature by the
various authors when citing them. D’Amour et al. (2005)
presented a comprehensive review of the literature on inter-
professional collaboration in an attempt to arrive at a defi-
nition of the term and identify its conceptual frameworks.
In their review of 17 articles, they found a great deal of
diversity in the way the authors conceptualized and utilized
different interpretations of the word ‘collaboration’ and term
‘interprofessional collaboration’ in their research. However,
D’Amour et al. were able to identify five underlying concepts
of collaboration that many articles had in common, namely;
sharing, partnership, interdependency, power, and process.
In the educational setting, collaborative teaming refers to
a dynamic process in which a group of individual team mem-
bers, e.g., teachers, parents, related service providers, and
others with diverse, but complementary skills and areas of
expertise work with students to collaboratively troubleshoot
problems a child is experiencing in order to find solutions
and plan services to address these challenges through mutu-
ally agreed upon goals. Collaborative teaming is a derivative
of “communities of practice,” which is grounded in situated
and relational theories of learning in which individuals are
bound by what they do together (Wenger et al. 2002). Col-
laborative teaming has, as its ultimate goal, the improvement
of teaching and learning (Eren and Brucker 2011). There is a
rich body of literature that demonstrates the strong relation-
ship between effective collaborative teaming and learning
(e.g., Berninger 2015; Ebersöhn et al. 2007; Handley et al.
2006; Havnes 2009; Kaczmarek et al. 2000; McSheehan
et al. 2008). The collaborative teaming process is especially
critical in addressing the needs of students with disabilities
in the inclusive educational setting in which many profes-
sionals are involved in a child’s total program (Hunt et al.
2003). There are some generally agreed-upon essential com-
ponents in the collaborative teaming process. First, there
must be a structure in place to monitor and address team
performance and issues that arise that includes treating all
team members with respect. In addition, there should be
regularly-scheduled, face-to-face meeting time, as well as
clearly assigned, agreed-upon responsibilities of the team
members with built-in accountabilities. Although the roles
and responsibilities of team members should be identified,
there should also be flexibility in the role boundaries (Hunt
et al. 2003; King et al. 2009; Nevin et al. 1990; West and
Idol 1990).
D’Amour et al. (2005) found that many of the articles
in their review did not discuss collaborative processes, but
13
Journal of Autism and Developmental Disorders
rather focused on the structure of the teams and settings and
described varying degrees of collaboration within a team.
The qualifiers that were often utilized were multidiscipli-
nary, interdisciplinary, and transdisciplinary; however, the
authors found that the terms were often used interchangeably
and were rarely defined in a clear manner. The first distinc-
tion between these terms is credited to Piaget (1972), as
is coinage of the term ‘transdisciplinarity,’ which was first
used at a seminar on interdisciplinarity in universities that
took place at the University of Nice in 1970 (López-Huertas
2013; Nicolescu 2010). Piaget (1972) described distinctions
between interdisciplinary collaborations and the ‘neighbor-
ing concepts’ of multidisciplinary and transdisciplinary. The
first level, multidisciplinary, was described as the ‘lower’
level, which occurs when information is needed from two
or more sectors of knowledge. In this case, there is little or
no enrichment that occurs between the sectors. The second
level, interdisciplinary, was described as a cooperative effort
in which there is mutual enrichment due to cooperation that
takes place between disciplines. Finally, Piaget described
as the highest level, the stage of ‘transdisciplinarity’ which
“would not only cover interactions or reciprocities between
specialized research projects, but would place these rela-
tionships within a total system without any firm boundaries
between disciplines” (Piaget 1972, p. 138).
Despite this clear differentiation by Piaget, it appears that
over the years, researchers have utilized disparate definitions
of these terms. Lethard (1994), described the problem as a
‘terminological quagmire’ and stated as one goal of her pub-
lication, the redefining and clarifying of terminology. How-
ever, more than 10 years after Lethard’s book was published,
Choi and Pak (2006) decried ambiguity in the literature for
the terms multidisciplinary, interdisciplinary, and transdis-
ciplinary and noted that the terms were often used inter-
changeably in research. They exhaustively researched the
terminology through searches of dictionaries, Google, and
MEDLINE for the years between 1982 to 2006. Although
Piaget (1972) was not cited by the authors, they arrived at
working definitions for these terms that largely aligned with
those proposed by him.
Transdisciplinary Approach in Education
Transdisciplinarity, or the transdisciplinary approach (TA) is
recognized as a best practice in the early intervention and edu-
cational settings and has been the focus of articles by many
authors (e.g., Carpenter et al. 1998; Davies 2007, Down-
ing and Bailey 1990; Fewell 1983; Foley 1990; Limbrick
2007; Orelove and Sobsey 1991; Peterson 1987; McGonigel
et al. 1994). Some advantages of TA include coordination
of services (Fewell 1983; Peterson 1987), maximized com-
munication and cooperation (Davies 2007), and develop-
ment of shared vision (Davies 2007; McGonigel et al. 1994).
Journal of Autism and Developmental Disorders
Furthermore, TA enhances communication with families,
reducing confusion that may arise from multiple, potentially
conflicting reports (Carpenter et al. 1998; Klin et al. 2005).
King et al. (2009), outlined three essential features of
TA: arena assessment, teamwork, and role release. In arena
assessment (Foley 1990), the child is assessed by profes-
sionals from multiple disciplines. One person serves as the
facilitator for the assessment while the other team members
observe and provide input during a discussion that follows
the assessment. The second feature, teamwork, includes
ongoing interaction among team members that facilitates the
exchange of knowledge, cooperation, and planning (Foley
1990). The third feature is role release, in which members of
the team share expertise from their individual practices with
the goal of the other team members providing some of these
interventions. This feature is perhaps the most challenging
one in that professionals may fear a loss of professional iden-
tity and control over their areas of expertise (Davies 2007;
Downing and Bailey 1990). There are a number of factors
that are related to the successful implementation of these fea-
tures, including holding regular team meetings, identifying
team members’ roles and responsibilities, and establishing
common goals (Hunt et al. 2002). Given the diversity of dis-
ciplines, personalities, and knowledge of the team members
that may be involved, it is essential that members be able to
effectively share their skills and information so that the group
may collectively arrive at solutions and treatments generaliz-
able across people and settings. As a rule, team members who
are more experienced and have a higher level of expertise
in their disciplines appear to be more comfortable with TA
while novice professionals, especially those without univer-
sity training in collaborative teaming may feel overwhelmed
(King et al. 2009). Likewise, in a recent study, Pfeiffer et al.
(2019) surveyed 474 practicing speech-language pathologists
(SLPs) to explore their utilization of interprofessional col-
laborative practice in schools. They discovered that only 8%
engaged in collaborative practice during initial evaluations,
and only 14% during intervention sessions. The three predic-
tive factors for higher engagement were training in collabo-
rative practice, working in the field for a greater number of
years, and working in elementary schools (as opposed to sec-
ondary schools). Among other recommendations, the authors
indicated a need for collaborative learning opportunities at
the university level. Therefore, an educational strategy at the
preservice level would likely increase the up-take and imple-
mentation of TA by professionals.
Further, given the complex needs and challenges exhib-
ited by individuals with ASD, TA has the potential to be an
extremely effective collaborative teaming process to address
the multiplicity of needs among this population. There have
been several studies that have focused specifically on providing
TA assessment, treatment, or services to children with ASD.
Klin et al. (2005) described an overview of psychological
assessment for children with ASD within the framework of
a transdisciplinary approach. The authors stressed the need
to utilize a comprehensive developmental approach as well
as involve professionals with multiple areas of expertise in
order to provide a uniform and coherent picture of the child.
An adherence to several core principles was advocated, e.g.,
assessing multiple domains of functioning in an integrated
manner, gathering information from multiple sources with an
emphasis on naturalistic settings, and being cognizant of con-
ditions that may diminish or optimize performance.
Ranjan et al. (2014) utilized a transdisciplinary approach
for group therapy for five male children with ASD, ranging
in age from 8 to 10 years, that incorporated occupational and
speech/language therapies. Goals of the study were three-
fold; measure impact of TA in the development of social
interaction skills, measure effect of the occupational and
speech therapies in group therapy sessions, and measure
impact of standardized treatments in the improvement of
social interaction skills. Following six, 3-h sessions, results
indicated significant improvements for the children as a
group as rated by the therapists and parents. The authors
concluded that TA was useful in the group therapy setting.
Lau (2017) studied the developmental gains and parental
stress levels of a group of children in Hong Kong with ASD,
five of whom received home-based TA in addition to other
interventions they were already receiving, versus a control
group of four children with ASD who did not receive home-
based TA, but continued to receive other interventions. One
goal of TA utilization was an increase in efficiency and
potential subsequent reduction in the median waiting time
of about 19 weeks to receive services, due to a shortage
of professionals. Results indicated some improvements in
developmental gains, but contrary to expectation, there was
an increase in parental stress levels. The author concluded
that the study might assist policymakers in reflecting on how
to streamline services and reduce waiting time.
Finally, in a single-subject study, Roncaglia (2018),
explored the effectiveness of TA with a 13-year-old male
who was being educated at an autism-specific day school.
The transdisciplinary group, which met at regular intervals,
was comprised of psychologists, speech/language patholo-
gists, occupational therapists, teachers, and teaching assis-
tants. Data were collected on qualitative outcomes, quantita-
tive academic progress, and impact on educational practice
and provision over a period of 9 months. Improvements were
noted on a number of different measures.
Preservice Training for Teachers
and Speech‑Language Pathologists
The relative paucity of studies that have focused specifi-
cally on providing TA assessment, treatment, or services
to children with ASD may be attributed, at least in part, to
13

the inadequacy of preservice training available for teachers
and other professionals, including SLPs. Eren and Brucker
(2011) stressed the importance of preservice training in ASD
for general and special education teachers; however, stated
that such programs often appeared to be inadequate. This
was the case despite the estimated high prevalence of ASD
and the likelihood that professionals working in school sys-
tems will encounter children with the disorder. For example,
during their careers, most SLPs will work with individuals
who have ASD. Fifty-three percent of SLPs are employed in
schools (American Speech-Language-Hearing Association,
n.d.-a); between the years 2014 and 2018, 90% of these SLPs
worked with individuals with ASD (American Speech-Lan-
guage-Hearing Association 2018). Of the SLPs who worked
with pediatric populations in healthcare settings, 17% of
their time was spent working with children who have ASD
(American Speech-Language-Hearing Association 2017).
Based upon a variety of measures, research in the United
States and abroad indicates a lack of preparation and knowl-
edge among teachers, preservice teachers, and SLPs regard-
ing ASD. Upon surveying 87 institutions of higher educa-
tion in the United States, Barnhill et al. (2011) concluded
that most undergraduate teacher preparation programs for
special education provided only generalist special educa-
tion training. For example, Morrier et al. (2011) described
the inadequacy of personnel preparation programs for 185
teachers of students with ASD in one southern state. Like-
wise, in a study that examined autism knowledge among 148
pre-service Birth to Five teachers, Johnson et al. (2012) con-
cluded that better teacher preparation in ASD was needed for
Birth to Five training programs. Finally, in a comprehensive
literature review, Strong (2014) concluded that nationally
there was a lack of depth and consistency in preparation of
licensed teachers and personnel in the area of ASD as well
as concern for trends in professional development.
These challenges are not limited to the United States. Three
studies, completed in different countries, that measured the
knowledge of preservice teachers regarding ASD indicated
inadequate preparation. A study done in Turkey (Rakap et al.
2016) investigated knowledge of ASD among 504 teacher
candidates in their final semester who would be likely to have
contact with children with ASD in the public-school system.
Results indicated a limited knowledge of autism among the
candidates. Sanz-Cervera et al. (2017) investigated knowl-
edge, misconceptions and gaps regarding autism among 866
preservice teachers at the University of Valencia in Spain.
Results indicated that fourth-year students were more knowl-
edgeable than first-year students, however, had more miscon-
ceptions regarding autism. Special education students were
more knowledgeable and had fewer misconceptions than gen-
eral education students; however, the authors concluded that
university preparation for all future teachers was inadequate.
Finally, another recent study in Queensland Australia (Coates
13
Journal of Autism and Developmental Disorders
et al. 2017) that investigated ASD preservice training informa-
tion provided in teacher and teacher aide education programs
indicated the absence of vital information. The authors stated
an urgent need to redesign programs for preservice educators
in order to deliver best practices for ASD.
It is more common for Master’s degree programs in
special education to offer specialized preparation (Eren
and Brucker 2011). In order to fully understand ASD, the
authors advocated for advanced training that would include
both coursework and supervised clinical experiences. The
authors stated, “As important as course work is in advanced
levels of teacher preparation, nothing enhances a student’s
program more than supervised clinical experience with chil-
dren with ASD. A clinical experience in a controlled set-
ting conducted under the direction of professors allows the
graduate student to acquire the ability to translate knowledge
into practice” (p. 315).
According to the American Speech-Language-Hearing Asso-
ciation (n.d.-b), SLPs have a pivotal role to play in diagnosing,
assessing, and treating ASD. Among the appropriate roles listed
for SLPs are educating other professionals, diagnosing, man-
aging, treating, and measuring progress, developing treatment
plans, serving as members of the school planning team, coun-
seling on communication-related issues, and serving as members
of an interdisciplinary team. However, research has indicated that
many SLPs displayed a lack of confidence regarding evidence-
based practices with this population (Cascella and Colella 2004;
Price 2013), were not knowledgeable regarding diagnostic cri-
teria, and did not feel comfortable determining treatment goals
(Price 2013; Schwartz and Drager 2008). Plumb and Plexico
(2013) compared SLPs who graduated pre/post 2006 on a num-
ber of measures. One positive trend indicated that the more recent
graduates received more academic and clinical training on ASD;
however, the pre-2006 graduates reported a greater familiarity
with the research on prognostic indicators and a greater level of
confidence in service delivery factors, pointing to the importance
of experience and post-graduate continuing education.
More recently, Stockstad (2016) surveyed 46 program
directors and 21 clinical coordinators of ASHA-certified
Master’s programs in speech-language pathology. Results
indicated a lack of training in ASD and evidence-based prac-
tices both academically and clinically, i.e., fewer than half
of the respondents reported being taught how to administer
standardized autism evaluations. Despite this, the surveyed
program directors and clinical coordinators expressed a high
level of confidence in their graduates’ level of preparation to
work with individuals with ASD. The author recommended
that a specified, minimal foundational training be provided
to all students and that an optional concentration or spe-
cialization in ASD be available. Finally, given the multi-
ple providers that work with individuals with ASD, it was
recommended that students be taught to work as part of an
interdisciplinary team.
Journal of Autism and Developmental Disorders
SED teachers and SLPs require a high level of col-
laborative interaction and partnership when working in
schools. Despite this, collaborative university training pro-
grams, courses, and/or practica for these two professions
are uncommon. The pull-out model is still a widely-used
service delivery model for SLPs; however, current recom-
mended practice is for a flexible service delivery model
(American Speech-Language-Hearing Association, n.d.-c;
National Research Council 2001). ASHA recognizes the
importance of supported social interactions and a focus on
functional outcomes. Service delivery models that provide
relevant contextual support and include interdisciplinary col-
laboration, family involvement, and significant communica-
tion partners are imperative across the life span (American
Speech-Language-Hearing Association, n.d.-b; n.d.-c).
Contributing to the challenges cited above is the fact that
evidence-based practices that are recommended by research
are rarely applied, unless the research is either conducted in
real-world settings or with consideration for application in
real-world settings (Douglas and Burshnic 2019). A poten-
tial solution to this problem is implementation science (IS),
which provides a systematic approach for analyzing effective
strategies of intervention in real world settings, resulting in
an increased understanding of how to enhance and increase
consistency in their use as routine practice. Essentially, IS
allows for examination of research-based practices in real-
world settings and increases the opportunity to identify
strengths and challenges of implementation of these proven
strategies, including potential barriers such as lack of knowl-
edge, skills, resources, or competing demands (Bauer et al.
2015). A critical outcome of utilizing IS methodology is
the ability to provide quantitative and qualitative informa-
tion to guide up-take and use of evidence-based practices in
an effective and efficient manner, likely leading to use and
sustainability of the proven practice (Powell et al. 2012).
Although literature demonstrates the effectiveness of TA in
supporting students with ASD, routine instruction at the pre-
service level in the use of TA that includes both professions
is uncommon. In addition to identifying the most effective
practices at the preservice level to instruct in the use of TA, it
is also important to identify the factors that support or impede
its subsequent implementation. A focus on IS methodology
can provide a lens to consider evidence from real-world appli-
cation of practices that leads to effective implementation of
TA by students during their preservice learning experience
(Powell et al. 2012). The focus of this study is teaching stu-
dents how to utilize TA through instruction, mentoring, and
hands-on supervised experience. A variety of measures have
been incorporated in the training program in order to provide
data that will help us better understand the factors that might
influence implementation of TA by preservice practitioners
and identify the potential adjustments needed in utilizing this
approach in order to teach use of TA in the future.
Methods
Given the potential benefits of employing a transdisciplinary
approach in working with children with ASD, as well as evi-
dence that points to the relative complexity of its implemen-
tation, training at the preservice level in a real-world set-
ting should facilitate comfort and skill in its utilization and
provide greater understanding of the potential challenges
presented in using this approach. An existing practicum for
Master’s students in special education, with a concentration
in ASD and other developmental disabilities (SED), was
enhanced to include Master’s students in speech-language
pathology (SLP). The enhanced practicum was designed
to support a context for use of TA and was aligned to the
IS framework by including the service provider, the identi-
fied student/client, and the natural context. The practicum
focused on the development of social interaction skills for
children with autism when interacting with peers and adults.
The purpose of the experience was exploration of the utility
of using TA during a short, intensive practicum in achiev-
ing the following goals: (1) increase knowledge of TA, (2)
increase comfort/attitude levels in the utilization of TA, (3)
increase exposure to children with ASD in an educational
setting, (4) afford an opportunity to work together as equal
partners and increase knowledge of each other’s professions,
and (5) identify benefits and challenges of implementation of
TA for preservice practitioners in a natural context.
Participants
There were eight participants in the practicum, four SLP and
four SED students, all at the graduate level. Informed con-
sent was obtained from all individual participants included
in the study and Institutional Review Board (IRB) approval
was obtained (SCSU IRB #14-111) prior to commencing
the study. The SLP students were in their final semester of
their program and had completed a school-based practicum
that included at least 100 h of treatment. They had been
exposed to information on ASD as part of their coursework,
but none had taken a dedicated course in ASD. They had
varying levels of exposure and experience working with
individuals with ASD in their on-campus and off-campus
practica. The SED students were all certified special educa-
tion teachers who had been exposed to individuals with ASD
in their teaching and had completed a significant amount of
dedicated coursework in ASD as part of their Master’s pro-
gram in special education. Four transdisciplinary teams were
formed, each comprised of one SLP and one SED student.
Procedure
Each team was assigned to work with a group of four-five
elementary school-age children in a Connecticut public
13

school system, who had been identified as having ASD. The
practicum took place over 3 weeks within the framework of
an intensive, educationally-based summer program focused
on social communication skills. Service was provided to the
children on a 5-day per week basis. All four teams were
supervised by the same two faculty members who had exper-
tise in ASD and TA. Supervisors were full-time faculty at
the university, one from the Department of Communication
Disorders and one from the Department of Special Educa-
tion/Reading. Both had extensive knowledge and experience
in their respective fields as well as extensive knowledge and
experience with evidence based practice for individuals with
ASD. All teams followed the same rigorous course syllabus
which included clearly stated course content, methodology,
evaluation procedures, and outcomes. The practicum experi-
ence incorporated three essential TA elements: arena assess-
ment, role release, and intensive ongoing interaction among
team members. Prior to beginning the practicum, students
were assigned three articles to read on TA (Chapman and
Ware 1999; King et al. 2009; York et al. 1990), followed by
a meeting between all teams and supervisors to discuss the
articles. Given the intent of providing a uniform approach to
increase social interaction, thus allowing a primary focus on
use of TA, Pivotal Response Training (PRT) was the selected
intervention approach; this was also in keeping with the orig-
inal framework of the practicum. Students were assigned the
PRT Pocket Guide: Pivotal Response Treatment for Autism
Spectrum Disorders (Koegel and Koegel 2012) as required
reading material. Although PRT was not formally imple-
mented, the core underlying element of PRT that is critical
for children with ASD, motivation to engage in social com-
munication, was the focus throughout the practicum. It was
expected that components of PRT would be incorporated
into daily lesson plans including motivational activities, self-
initiation, choice, stimulus materials, use of natural reinforc-
ers, reinforcement of attempts, interspersion of maintenance
and acquisition tasks, and task variation.
The teams worked with their groups for 90 min per day.
An additional 90 min per day were spent in planning, col-
laborative meetings with supervisors and peers, debriefing,
and setting up and cleaning the rooms. All sessions were
directly supervised on a daily basis and written and oral
feedback were provided during the planning and meeting
sessions, also on a daily basis. The first tasks of the teams
were to speak with families and complete an assessment
of the children in the groups. This was done following the
principles of arena assessment, utilizing the incorporation
of various informal assessment tools and tasks. Following
the assessments, the teams and the supervisors met to dis-
cuss the results and formulate goals for the children. The
team members collaboratively wrote the assessment reports,
decided on goals, and wrote the daily lesson plans for the
duration of the practicum. Following each session, the team
13
Journal of Autism and Developmental Disorders
members met for debriefing and planning for the next day
and completed a daily reflection. The intensive nature of the
program as well as the generous amount of time dedicated
to daily team meetings facilitated application of TA and
assisted in team building.
Prior to the practicum (and prior to reading the TA arti-
cles), all students completed two questionnaires, the first
designed to establish a baseline of their TA knowledge (KN)
(Appendix 1) and the second to establish a baseline of their
comfort level (CO) in engaging in TA (Appendix 2). The
knowledge questionnaire consisted of ten true/false state-
ments regarding TA. The comfort questionnaire consisted
of ten opinion statements which the students rated using a
1-5 Likert scale, with 1 indicating strong disagreement and
5 indicating strong agreement. During the three weeks of
the practicum, students completed a written daily reflection.
Upon conclusion of the practicum, students completed the
two questionnaires for a second time, completed an evalua-
tion of the course (Appendix 3), and participated in a focus
group discussion with the supervisors.
It was hypothesized that following participation in the
practicum, pre/post-test results on the questionnaires would
indicate that students’ scores had increased significantly in
both of the dependent measures, KN and CO. It was also
expected that positive changes towards the goals would be
demonstrated in the qualitative measures of daily reflection,
course evaluation, and focus group discussion. The focus
group discussion following the practicum was led by the
supervisors. Discussion was facilitated by asking students to
share any comments they wanted to provide regarding the
practicum. Based upon the comments, several directed ques-
tions were asked by the supervisors, e.g., How did you feel
about your traditional discipline-specific roles? Following this
experience, would you feel increased confidence in reaching
out to someone from another discipline in a work setting?
Data Analysis
All data collected from the completed questionnaires were
analyzed to compare participant change in knowledge and
comfort with TA from pre-practicum to post-practicum
experience using descriptive and t test parametric statis-
tics. The qualitative data were reviewed and coded using
‘action’ terms to support possible future recommendations
and identify the development of themes within the responses
(Charmaz 2006). Primary coding of the responses was com-
pleted by one of the authors with independent corroboration
by the two other authors and indicated a very high level of
intercoder reliability. Through a process of grounded the-
ory, the responses were further defined and categorized into
descriptive or in vivo codes, resulting in additional themes to
reveal participant perspectives regarding the broader themes
of the research questions (Saldana 2009). The quantitative
Journal of Autism and Developmental Disorders
data were compared and contrasted with the themes derived
from the qualitative data; students’ written daily reflections,
responses on the course evaluations, and responses to ques-
tions from the focus interview in order to further reveal the
impact of the preservice experience on their knowledge and
future use of TA.
Results
Questionnaire Quantitative Analysis
No significant within-group differences were found on
KN between the SLP and SED participants on either the
pre- or the post-tests [(CMD pre-test, M = 6.5, SD = 1.0;
CMD post-test, M = 7.00, SD = 0.82) (SED pre-test,
M = 5.25, SD = 1.26; SED post-test, M = 7.75, SD = 0.96)
(two-tailed t-tests, p = 0.31, p = 0.06, pre- and post-tests
respectively)]. Likewise, no significant within-group differ-
ences were found on CO between the SLP and SED par-
ticipants on either the pre- or the post-tests [(CMD pre-test,
M = 3.43, SD = 0.52; post-test, M = 3.80, SD = 0.69) (SED
pre-test, M = 3.93, SD = 0.27; post-test, M = 4.23, SD = 0.69)
(two-tailed t-tests, p = 0.60, p = 0.72, pre- and post-tests
respectively)]. Therefore, participants were analyzed as one
group for the questionnaire analyses for KN and CO.
Significant positive differences were found for the stu-
dents between pre- and post-test results for the depend-
ent variable KN (pre- and post-tests respectively M = 5.9,
SD = 1.2, M = 7.4, SD = 0.92; one-tailed t-test, p = 0.02),
Fig. 1, and CO (pre- and post-tests respectively M = 3.6,
SD = 0.39; M = 4.0, SD = 0.51; one-tailed t-test, p = 0.04),
Fig.  2. Significantly increased knowledge in TA was
Fig. 1  Pre- and post-test com-
parisons of knowledge (KN)
prior to beginning practicum
and upon completion of practi-
cum
10
9
8
7
6
5
4
3
2
1
Pre-test
demonstrated, as was a significantly increased level of com-
fort in working collaboratively in TA with a professional
from another field.
Qualitative Daily Team Reflection Responses
Following each daily session, team members met in order to
discuss the session as well as plan for the next day. The stu-
dents were also required to write a daily team reflection. The
reflections demonstrated understanding of TA, comfort and
belief in engaging in TA, and recognition of peers’ expertise
and how to benefit from this. Emerging themes that reflected
behaviors indicative of TA engagement included: working
together effectively, engaging in reciprocal learning, maxi-
mizing expertise, and releasing roles to share implemen-
tation of intervention strategies (Davies 2007; King et al.
2009; Downing and Bailey 1990). A majority of the reflec-
tions spoke to both comfort and benefit of releasing roles
to share implementation of intervention strategies, further
demonstrating achievement of practicum goals. Many of the
reflections described comfort and benefit related to working
together effectively and engaging in reciprocal learning. A
few examples of comments included: “truly maximized…,”
“continuously learning…,” “interesting insights…,” and
“feel comfortable….” Although there were only three com-
ments that related to the maximizing of expertise, all were
positive. There was only one instance of unease, evident
in the reflection, “I am a little nervous to take on the role
of SLP…;” however, the rest of the statement revealed a
willingness to try: “I’m sure the role release will be com-
pletely successful and a great opportunity for both teachers
and students.” (See Fig. 3 and Appendix 4 for table of coded
statements to themes.)
Knowledge
(p=0.02)
Post-test
13

Fig. 2  Pre- and post-test
comparisons of comfort levels
(CO) prior to beginning practi-
cum and upon completion of
practicum
5
1
Pre-test
Select portions of one of the teams’ daily reflections are
presented below:
SED partner reflection—Day #3 As the first week of the
practicum comes to an end, I am finding that the overall
effectiveness of our lessons is truly maximized by our dif-
ferent areas of expertise—in my opinion, we have already
begun releasing our specific roles, and allowing each other
to bring unique ideas to the table. I believe that not only are
we are working effectively together to create engaging and
meaningful lessons for our students, but my partner and I
are continuously learning from each other throughout the
process. I think I can speak for both of us when I say that
we genuinely value each other’s knowledge and ideas—not
only in our specific areas of study, but also when it comes to
Fig. 3  Pie chart analysis reflect-
ing percentage of statements per
TA themes
13
Journal of Autism and Developmental Disorders
Comfort
(p=0.04)
Post-test
brainstorming new strategies, interventions, activities, etc.
that we implement daily within our class.
SLP partner reflection—Day #4 Overall, I believe that the
partnership between the two disciplines working in the class-
room has provided some interesting insight. I feel that our
personalities and styles complement each other very well,
and our ideas, creativity, and ability to plan lessons reflect
similarly. I respect all that my partner has to offer to these
students and am confident that she feels the same about my
skill set. I’m beginning to think of our roles as more unified
than I initially expected, while also understanding that we
each have our own specific skill sets.
SED partner reflection—Day #5 For O, we utilized a
pacing board and began collecting data about his speech
Journal of Autism and Developmental Disorders
intelligibility and the number/intrusiveness of prompts
required to get him to slow down and focus on his speech
through use of the pacing board. This is an example of just
one of the many areas that I can say I am extremely grateful
to work on with my SLP partner as part of the study on the
effectiveness of the transdiciplinary approach. My partner
has both directly and indirectly taught me many strategies
and interventions that I now effectively utilize on a daily
basis with our kids. I have not had much experience work-
ing with nonverbal students before, and I’m starting to feel
comfortable when it comes to promoting purposeful and
meaningful speech and communication in our classroom.
SLP partner reflection—Day #6 Overall, my SED partner
and I are continuing to learn from each other and continue
to collaborate professionally and creatively.
SED partner reflection—Day #7 Overall, my SLP partner
and I continually learn from each other and transition from
our normal roles in the classroom—I, for one, have learned
various strategies to encourage and appropriately reinforce
specific vocalizations and uses of language (especially with
K and B) by working with my partner on a daily basis. In my
opinion, I believe that it would be difficult for an outsider
to initially point out the SLP and the SED teacher in our
classroom, as we take on other roles and switch roles when
appropriate and/or required. My partner and I continue to
communicate effectively on a daily basis to reflect on previ-
ous lessons, plan new lessons, and create/modify goals, both
within and outside of the classroom to ensure that our class
is running as smoothly as possible in order to provide the
best learning experiences for our students.
SED partner reflection—Day #9 We discussed the idea
of role release while reflecting on today’s lesson this after-
noon—normally, my SLP partner works with B with encour-
aging meaningful vocalizations and social interactions (bub-
bles, beads, “It’s my/your turn!”) each day, but we decided
that I will take over that portion of the lesson tomorrow
while she works with the other students on their individual
goals. We are both extremely excited to fully switch our
roles in the classroom, and we are excited to see if our stu-
dents will generalize their newly-learned skills when work-
ing with the other teacher. I am also a little nervous to take
on the role of a SLP for a portion of tomorrow’s lesson, but
based on everything I have learned both directly and indi-
rectly from my partner, as well as my growing relationship
with each student in the class, I’m sure the role release will
be completely successful and a great opportunity for both
teachers and students.
SED partner reflection—Day 10 I’ve found that it is
almost an instinct for me to now encourage any purposeful
vocalizations from B, K and O after observing and working
with my SLP partner for the past few weeks. I’ve seen such
an increase in functional language use and speech intelligi-
bility from B and O since the beginning of our time spent
together, and my partner and I both constantly reinforce their
purposeful language by saying things such as “I hear you
talking, B!” and when O slows down his speech, “I under-
stand now, O!” I am beginning to feel extremely comfort-
able (and almost natural) leaving my typical role as a SED
teacher and taking on the role of a SLP in the classroom.
Qualitative Course Evaluation Responses
All participants either agreed or strongly agreed that the
readings on TA were helpful in increasing their knowledge
of TA and the behaviors required to engage in it. Addition-
ally, they reported an increased understanding of the value
of TA as a result of the practicum. There was a consensus
that it would have been helpful to have had a formal lecture
on TA prior to beginning the practicum. Most responses
to the questions, similar to the themes noted in the weekly
written reflections, reflected positivity on the benefit of the
experience in facilitating TA utilization. Although some
statements suggested apprehension and concern regarding
how the experience would encourage use of TA beyond their
graduation, closing statements revealed agreement on the
benefits of this real-world experience in supporting the abil-
ity to engage in all of the expected behaviors and actions
representative of TA. Of note was the report of potential use
of TA in a future work experience.
Below is a compilation of the responses to these
questions:
Did you believe that the practicum met your expecta-
tions? By and large, the participants agreed that their expec-
tations had been met. They felt that it had been an intense
and demanding practicum, but very rewarding.
Did your perception regarding working closely with a
professional from another discipline change from the begin-
ning to the end of the practicum? Four participants stated
that their perceptions and expectations from the beginning
had been positive and they had not been disappointed. The
other four, stated that their perceptions had changed; ini-
tially they had been nervous and/or hesitant, but had a very
positive experience with the collaborative program and had
gained tremendously from working with a professional from
another discipline.
How do you think the skills that you learned in working
with a professional from another discipline might be use-
ful to you in the future? All participants felt that they had
learned a great deal from their teammates. The SED stu-
dents, in particular, cited the value of learning strategies to
encourage speech and language production in the classroom
in order to improve the learning environment. The SLP stu-
dents, in particular, cited the value of working closely with
a person who had behavioral and classroom management
skills and could assist them in improving their skills in work-
ing with groups and in the classroom environment. Some
13

participants felt that the experience would assist them in
working with individuals from other professions in the future
and/or bring additional skills to a prospective employer that
would give them an edge in the hiring process.
What could have been done differently to make this a
more worthwhile experience? Nearly all participants felt
that it would have been helpful to have had more training
prior to the practicum in TA, e.g., a lecture on the topic. In
particular, the SLP students, who had less experience that
the SED students in ASD, felt that it would have been help-
ful to have taken a course dedicated to ASD.
Qualitative Focus Group Responses
The themes from the focus group discussion reinforced
the themes revealed in the course evaluations and the daily
reflections. As a group, the SLP students felt more over-
whelmed initially by the experience due to less experience
working with children with ASD, whereas, the SED students
did not express feeling overwhelmed due to their greater
level of experience. Most of the SED students were cur-
rently employed as special education teachers at the time of
the practicum, whereas the SLP students were not employed
professionally and had gained any prior experience only via
volunteer activities or practicum experience. The experi-
ence of partnering and gaining practice in utilizing TA was
reported as extremely positive by all students, while their
different backgrounds were lauded as adding value to the
children as well as to their own learning experiences, pro-
viding further evidence of reciprocal learning. Reiterating
what had been expressed in the course evaluations, the SLP
students reported learning a great deal about classroom man-
agement, while the SED students reported learning a great
deal about continuously promoting and reinforcing commu-
nication within the classroom. All students reported gaining
a valuable level of comfort in working with each other and
confidence in the collaboration process. One SLP student
who interviewed for a job while the practicum was taking
place, reported that she felt that the experience assisted her
in obtaining the job since she was able to speak about her
collaborative experience and describe how she could imple-
ment a similar program in her future work setting.
The focus discussion indicated that role release was chal-
lenging for all students; this differed from what was described
in the written reflections. This difference may have been due
to the nature of the reflections and the opportunity to reflect
more holistically during the focus interview discussion. They
reported that initially they gravitated towards their typical
roles and had to exert effort to consciously release responsi-
bilities to their partners. This seemed to happen around the
end of the first week or the beginning of the second week of
the practicum, when they naturally began to assume some
of the roles of the other professional. They initially learned
13
Journal of Autism and Developmental Disorders
techniques and strategies from each other and then gradually
felt comfortable implementing them. It was also felt that the
collaboration facilitated goal writing which became much
more holistic as opposed to being compartmentalized accord-
ing to discipline. Generalization of goals was more natural as
was infusing the goals throughout the entire session.
Some sample comments from the focus group discus-
sion, that have been paraphrased for clarity and conciseness,
appear below:
SED Student: I had an amazing partner! I had never
worked with a child who was non-verbal. Some students
in the group were totally verbal. We brainstormed back
and forth and would say, “Oh, this is not working” or
“This was awesome!” We implemented strategies that I
would not have used if the SLP hadn’t shared them.
CMD Student: It was good to work with a SED student.
I had no idea what a morning circle was! She had really
good ideas on how to organize the day.
SED Student: I have picked up on some things that I
didn’t learn in class, for example, increasing wait time
for the child to communicate. Now I know that I can reach
out to the SLP to figure out what to do.
CMD Student: When I did my school experience, I did all
pullout. The SED student taught me how to use language
to engage all the students in the classroom setting.
SED Student: TA makes writing goals more natural and
practical. We included both of our disciplines in all of our
goals, weaving communication throughout.
CMD Student: I gained a lot of comfort working with my
SED partner through seeing her perspective and helping
her to generalize what we wanted to do with communica-
tion. I now have confidence to collaborate more. Having
both perspectives helped each child we worked with make
progress.
Discussion
Results of this study provided information on the effects
of a practicum experience in a natural context that trained
Master’s level SLP and SED students in the utilization of a
transdisciplinary approach with children with ASD. It had
been anticipated that it would be feasible to provide students
with TA skills in this intensive program in which the SLP
and SED students worked together on a five-day per week
basis for a period of 3 weeks. This indeed proved to be the
case. Three essential TA elements were incorporated into
this real-world experience, arena assessment, role release,
and intensive ongoing interaction among team members.
Arena assessment was utilized by the teams as the initial
step in the practicum. Since all children participating in the
program had previously been identified as having ASD, the
Journal of Autism and Developmental Disorders
purpose of the assessment was to identify current levels of
performance with an emphasis on communication and social
skills, identify strengths and areas of concern, and propose
goals and a treatment plan for the duration of the program. One
team member served as the facilitator for the assessment, while
the other team member observed. Following the arena assess-
ment, the team collaborated on the results, report writing, and
establishment of goals and treatment plan. Although the logis-
tics of the program did not allow for parent involvement in the
arena evaluation itself, all parents were interviewed by one of
the team members and provided input prior to the assessment.
The comfort questionnaire, administered prior to beginning
the program and at its conclusion, indicated that students’ level
of comfort towards utilizing TA increased and/or became more
positive. A number of the questions were strongly related to
role release. Measures on this questionnaire that demonstrated
an increased score included level of trust towards a profes-
sional from another discipline, confidence in knowing how to
handle conflict that might arise with that professional, knowl-
edge regarding the other discipline, broader understanding
of children with ASD, and openness to another professional
providing intervention in one’s own area of specialty. Results
of the questionnaire also demonstrated that fears of loss of pro-
fessional identity decreased. Another indicator of role release
could be found in the daily reflections. Based upon these, it
appeared that significant comfort with role release occurred
around the end of week one or the beginning of week two of
the program. Among the most powerful student comments in
the daily reflections and course reviews were those that indi-
cated the high levels of satisfaction and accomplishment the
team members experienced as they assisted their partners in
acquiring the skills of each other’s professions and in expand-
ing their own skill set. There was agreement that the model
provided a significantly improved learning environment for
the children. This outcome demonstrated that implementation
of TA resulted in role release in a natural context; thus, similar
outcomes can be expected in similar contexts. The positive
change in perspective across the practicum, particularly regard-
ing comfort in shared roles and clear agreement of the effec-
tive impact in the use of TA, reveals the likelihood of students
engaging in the evidence-based practice of TA in the future.
The benefits of a preservice practice that intentionally includes
multiple disciplines engaging in TA supports implementation
at the university level.
Interaction among the team members was intensive and
ongoing throughout the program. For each 1.5 h of class-
room time in a given day, at least 1.5 h of non-classroom
interaction time were allocated for the purposes of plan-
ning, debriefing, classroom organization, problem solving,
and team building and reflection. The high levels of col-
laboration and role release, as measured by comparisons of
the pre/post questionnaires, daily reflections, course surveys,
and focus group discussion are attributed, in large part, to
the students’ intensive and ongoing interactions as well as
the intensive level of input from the supervisors. Implemen-
tation of instructional strategies to support knowledge and
skill in the use of TA to support students with ASD appears
to require this time allocation as indicated by the positive
outcomes reported. University programs interested in engag-
ing students in a similar practicum may use these data to
substantiate the accommodation of time. However, this
ample provision of non-classroom time was indeed a luxury.
It is recognized that it would be nearly impossible to provide
this amount of non-classroom time for these purposes in the
typical classroom setting, leading to a potential implemen-
tation barrier that requires deeper investigation. Nonethe-
less, although this amount of time is typically not available
for collaboration in a classroom setting, more experienced
professionals should be able to create successful TA teams
that benefit children and families in a more efficient manner
that would require less meeting time. Additional research
utilizing an implementation science framework may have the
potential to assist in identifying the required time needed to
engage in TA in other, more typical real-world settings. The
results of this real-life setting research can then be used to
further inform and refine preservice practices in order to pre-
pare students for the actual time available in a typical setting.
There was an increase in students’ TA knowledge, as
measured by pre/post questionnaires; however, input pro-
vided in the focus group interview indicated that students felt
that it would have been beneficial to have had more infor-
mation on TA prior to beginning the practicum. Although
students were provided with three articles on the subject
following administration of the initial questionnaire, this
appears to have been insufficient in their estimation, and stu-
dents suggested a formal lecture presentation and discussion.
This information could also be incorporated into coursework
as part of the Master’s degree programs. Despite this, the
data contradicted this perceived need for prior information
which may be an indication of lower perception of self-
efficacy than is substantiated through observed behaviors.
Despite the fact that the SLP students were in the final
stages of their Master’s programs, they felt inadequately pre-
pared for this practicum in terms of their knowledge of ASD.
This is noteworthy, given the previously mentioned statistics
that indicated that the majority of SLPs will work with indi-
viduals with autism in their careers. This implies that many
students graduating from SLP Master’s programs are not
being adequately prepared to work with the ASD population.
Additionally, despite the fact that the SLP students had already
completed their school practicum at the time they participated
in this practicum, they reported struggling with behavior and
classroom management techniques. SLPs are expected to be
competent in a variety of service delivery models in schools,
including classroom-based models, e.g., co-teaching, class-
room based collaborative services, and direct pullout services
13

(American Speech-Language-Hearing Association, n.d.-c).
Although the students in this practicum had already completed
a school practicum that consisted of a minimum of 100 h of
hands-on treatment, they did not feel completely comfortable
in the classroom setting or in dealing with behavioral issues,
suggesting a need for further study to understand the lack of
knowledge translation and implementation of strategies likely
taught or observed during these experiences. The students
were not surveyed regarding their school practicum to deter-
mine the extent of their classroom experience so it cannot be
determined whether this lack of confidence stemmed from
insufficient experience or from other reasons. The reported
growth of the SLP students in their classroom and behavior
skills due to the TA experience in this practicum was highly
encouraging and another indication of the relevance of imple-
mentation of TA and its’ reported effect on learning. It can
also be inferred that the instructional practices used in this
study to teach TA resulted in incidental increase in knowledge
of ASD and effective behavior supports.
The SED students were more confident in working with
the children with ASD in this practicum than were the SLP
students which was to be expected given that they were
already working as certified SED teachers and were close to
completion of a Master’s degree program in SED with a con-
centration in ASD. These students, however, reported a lack
of knowledge, experience and confidence in knowing how to
encourage purposeful vocalizations among non-verbal chil-
dren, increase speech intelligibility, utilize a pacing board to
slow down speech rate, etc., and apply these techniques dur-
ing small groups to assist children in their social interactions
with peers. This is also noteworthy, given that the primary
problem among children with ASD is social communica-
tion and the SED students had not yet developed a comfort-
able level in teaching and reinforcing these skills. Likewise,
the reported growth of the SED students in management of
classroom speech and language skills during this practicum
was highly encouraging. The varied strengths of the students
and reported knowledge gained from each other when dis-
cussing shared roles suggest a greater likelihood of engaging
in TA beyond this practicum experience. These outcomes
indicate that the provision of direct instruction and practice
in TA provided through this practicum experience is likely
to lead to up-take and use of this evidence-base practice.
Limitations and Future Directions
While this  study provides preliminary insights into the
benefits and challenges of pre-service education in TA,
the researchers note the limitation of the small number of
participant groups. Although a variety of methods of data
collection were triangulated to understand the participant
groups’ outcomes and perspectives, interpretation of results
and generalization to the greater population should be done
13
Journal of Autism and Developmental Disorders
with caution. Expanding the program to a larger number of
students in the future should assist in determining whether
the data from the current study will prove to be robust. It is
also recognized that there is a limitation in using a single
question format as the only assessment of transdisciplinary
approach knowledge. This could be expanded to include
other measures in a future study, such as surveying specific
experiences that participants have had with the model.
Future iterations should include teams comprised of more
than two disciplines. For example, in a natural context, the
team in a school setting includes additional members such
as the general education teacher, social worker, psychologist,
occupational therapist, physical therapist, etc. A potential
barrier, requiring further analysis, is the coordination of TA
among an expanded group of disciplines in a pre-service set-
ting. In the context of this project, the parents were provided
with daily updates of the activities completed, yet data were
not collected from the parents to determine their perspective
on the use of TA as part of the intervention for their children
during this project. A future study may develop a similar
preservice practicum and include graduate students from
various relevant disciplines as well as parents in order to
further understand the feasibility of utilizing TA in practice
implementation in the university setting.
Conclusions
In sum, the progress in learning to utilize TA as well as the
changes in KN and CO that were achieved within a period
of only 3 weeks were highly beneficial to these graduate stu-
dents and support the utility and promise of such a program
at the preservice level. Based on the results of this study, it
can be concluded that including training of TA in preservice
programs for SLP and SED students, in a collaboratively
taught course, has the potential to ensure a greater level of
comfort in future collaborative endeavors among these pro-
fessionals as well as increase the likelihood that these col-
laborations will take place.
Author Contributions  All authors contributed to the study concep-
tion and design, material preparation, and data collection. Analysis
and theoretical frame for analysis were developed, implemented and
reviewed by all authors. The first draft of the manuscript was written
by Deborah Weiss and all authors commented on previous versions of
the manuscript. All authors read and approved the final manuscript.
Funding  This research was supported in part by a grant from the Con-
necticut State University Research Grant Program.
Compliance with Ethical Standards 
Conflict of interest  The authors declare that they have no conflict of
interest.
Journal of Autism and Developmental Disorders

Appendix 1 6. Presumed benefits of the transdisciplinary approach

Questionnaire: Transdisciplinary Approach Knowledge
True/False
1. In the transdisciplinary model, environment referenced
assessment identifies the context and functional targets
of instruction.
2. Transdisciplinary team members reach a consensus to
select multiple sets of priority goals for each student,
one per discipline.
3. In the transdiciplinary approach, therapy in the class-
room is always “integrated” therapy.
4. In the transdiciplinary approach, therapists maintain
direct, hands-on interaction with learners, offering learn-
ers more “therapeutic” input than direct models over time.
5. In arena assessment, professionals assess a child in a
staged setting utilizing only informal methods.
include service efficiency, cost-effectiveness or ser-
vices, and more coherent intervention plans and holis-
tic service delivery.
7. In arena assessment, parents may or may not be pre-
sent, depending on their wishes.
8. Three essential elements of the transdisciplinary
approach are arena assessment, role release, and occa-
sional, intensive interaction among team members.
9. Role release is the most crucial and challenging com-
ponent in transdisciplinary team development.
10. In the transdisciplinary approach, more children can be
served because fewer providers routinely see a given
child.

Appendix 2
Questionnaire : Transdisciplinary Approach Comfort Level

1. I have a strong understanding of the transdisciplinary team process.

Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

2. Only a speech-language pathologist should deliver effective intervention to a child with

speech language difficulties.
Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

3. Only a special education teacher should manage a classroom group of children and
establish behavioral goals and curriculum content.
Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

4. I trust a professional from a discipline other than my own to develop goals and objectives
in my discipline for a child with ASD.
Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

5. I am comfortable in allowing another professional to address goals in my discipline.

Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

6. I am comfortable in handling conflict when it arises when working with a professional

from another discipline.
Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

7. A major risk of transdisciplinary teaming is a loss of professional identity.

Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

8. Transdisciplinary teaming allows me to become more knowledgeable about other

disciplines and develop a more comprehensive understanding of the child.
Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

9. The special education teacher should always defer to the speech-language pathologist in
matters related to communication.
Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

10. The speech-language pathologist should always defer to the special education teaching in
the classroom setting.
Strongly disagree (1) Disagree (2) Neither agree nor disagree (3) Agree (4) Strongly agree (5)

13
 Journal of Autism and Developmental Disorders

Appendix 3

Course Evaluation

Date:

Please indicate: CMD SED

I feel that I have gained an increased understanding of the value of transdisciplinary

teaming from this practicum.
Strongly disagree Disagree Neither agree or disagree Agree Strongly agree

The articles on transdisciplinary teaming were helpful to me.

Strongly disagree Disagree Neither agree or disagree Agree Strongly agree

It would have been helpful to have had a formal lecture on the transdisciplinary process
prior to beginning the practicum.
Strongly disagree Disagree Neither agree or disagree Agree Strongly agree

Did the practicum meet your expectations? Please elaborate below:

Did your perception regarding working closely with a professional from another
discipline change from the beginning to the end of the practicum? Please elaborate
below:

How do you think the skills that you learned in working with a professional from another
discipline might be useful to you in the future?

What could have been done differently to make this a more worthwhile experience?

13
Journal of Autism and Developmental Disorders

Appendix 4 Working together Engaging in Maximizing Releasing roles to

effectively reciprocal learn- expertise share implementa-
ing tion of strategy

Working together Engaging in Maximizing Releasing roles to We utilized a My SED partner I respect all that We utilized a
effectively reciprocal learn- expertise share implementa- pacing board and I are con- my partner has pacing board
ing tion of strategy and began tinuing to learn to offer to these and began
collecting from each other students and collecting data
I think I can I believe that not As the first week We have already data about his and continue am confident about his speech
speak for both only are we of the practi- begun releasing speech intel- to collaborate that she feels intelligibility
of us when I are working cum comes to our specific ligibility and professionally the same about and the number/
say that we effectively an end, I am roles, and allow- the number/ and creatively my skill set intrusiveness of
genuinely value together to finding that ing each other intrusiveness prompts required
each other’s create engaging the overall to bring unique of prompts to get him to
knowledge and and meaningful effectiveness ideas to the table required to get slow down and
ideas—not only lessons for our of our lessons him to slow focus on his
in our specific students, but is truly maxi- down and focus speech through
areas of study, my partner and mized by our on his speech use of the pacing
but also when I are continu- different areas through use board. This is
it comes to ously learning of expertise of the pacing an example of
brainstorming from each other board. This is just one of the
new strategies, throughout the an example of many areas
interventions, process just one of the that I can say I
activities, etc. many areas am extremely
that we imple- that I can say I grateful to work
ment daily am extremely on with my SLP
within our class grateful to partner as part of
I believe that the My partner has I believe that the I’m beginning to work on with the study on the
partnership both directly partnership think of our roles my SLP partner effectiveness of
between the and indirectly between the as more unified as part of the the transdicipli-
two disciplines taught me two disciplines than I initially study on the nary approach
working in many strategies working in expected, while effectiveness of
the classroom and interven- the classroom also understand- the transdicipli-
has provided tions that I now has provided ing that we each nary approach
some interest- effectively uti- some interest- have our own My SED partner My SLP partner My SLP partner
ing insight. I lize on a daily ing insight. I specific skill sets and I are con- and I continu- and I continually
feel that our basis with our feel that our tinuing to learn ally learn from learn from each
personalities kids. I have not personalities from each other each other and other and transi-
and styles com- had much expe- and styles and continue transition from tion from our
plement each rience working complement to collaborate our normal normal roles in
other very well, with nonverbal each other professionally roles in the the classroom—
and our ideas, students very well, and creatively classroom. I, I, for one, have
creativity, and before, and I’m and our ideas, for one, have learned various
ability to plan starting to feel creativity, and learned various strategies to
lessons reflect comfortable ability to plan strategies to encourage and
similarly when it comes lessons reflect encourage and appropriately
to promoting similarly appropriately reinforce specific
purposeful and reinforce spe- vocalizations and
meaningful cific vocaliza- uses of language
speech and tions and uses (especially with
communica- of language K and B) by
tion in our (especially with working with
classroom K and B) by my partner on a
working with daily basis
my partner on a
daily basis

13
 Journal of Autism and Developmental Disorders

Working together Engaging in Maximizing Releasing roles to Working together Engaging in Maximizing Releasing roles to
effectively reciprocal learn- expertise share implementa- effectively reciprocal learn- expertise share implementa-
ing tion of strategy ing tion of strategy

My partner and I’ve found that I believe that it I’ve seen such an
I continue to it is almost would be difficult increase in func-
communicate an instinct for for an outsider to tional language
effectively on me to now initially point out use and speech
a daily basis encourage any the SLP and the intelligibility
to reflect purposeful SED teacher in from B and O
on previous vocalizations our classroom, as since the begin-
lessons, plan from B, K we take on other ning of our time
new lessons, and O after roles and switch spent together,
and create/ observing and roles when and my partner
modify goals, working with appropriate and/ and I both con-
both within and my SLP partner or required stantly reinforce
outside of the for the past few their purposeful
classroom to weeks language by say-
ensure that our ing things such
class is running as “I hear you
as smoothly talking, B!” and
as possible when O slows
in order to down his speech,
provide the “I understand
best learning now, O!” I am
experiences for beginning to
our students feel extremely
We discussed comfortable (and
the idea of role almost natural)
release while leaving my
reflecting on typical role as
today’s lesson a SED teacher
this afternoon— and taking on the
normally, my role of a SLP in
SLP partner the classroom
works with B I’ve found that
with encourag- it is almost an
ing meaningful instinct for me to
vocalizations and now encourage
social interac- any purposeful
tions (bubbles, vocalizations
beads, “It’s my/ from B, K and O
your turn!”) after observing
each day, but and working with
we decided that my SLP partner
I will take over for the past few
that portion of weeks
the lesson tomor- I am beginning to
row while she feel extremely
works with the comfortable (and
other students on almost natural)
their individual leaving my
goals. We are typical role as
both extremely a SED teacher
excited to fully and taking on the
switch our roles role of a SLP in
in the classroom, the classroom
and we are
excited to see if
our students will
generalize their
newly-learned
skills when References
working with the
other teacher American Psychiatric Association. (2013). Diagnostic and statistical
manual of mental disorders (5th ed.). Arlington, VA: American
Psychiatric Publishing.
American Speech-Language-Hearing Association. (2017). SLP health
care survey 2017. Retrieved from https​://www.asha.org/uploa​
dedFi​les/2017-SLP-Healt​h-Care-Surve​y-Casel​oad-Chara​cteri​
stics​.pdf.

13
Journal of Autism and Developmental Disorders
American Speech-Language-Hearing Association. (2018). Schools
survey report: SLP caseload characteristics trends 2000–2018.
Retrieved from https​://www.asha.org/uploa​dedFi​les/2018-Schoo​
ls-Surve​y-Casel​oad-Trend​s.pdf.
Barnhill, G., Polloway, E., & Sumutka, B. (2011). A survey of person-
nel preparation practices in autism spectrum disorders. Focus on
Autism and Other Developmental Disabilities, 26(2), 75–86.
Bauer, M. S., Damschroder, L., Hagedorn, H., Smith, J., & Kilbourne,
A. M. (2015). An introduction to implementation science for
the non-specialist. BMC Psychology, 3(1), 1–12. https​://doi.
org/10.1186/S4035​9-015-0089-9.
Berninger, V. W. (2015). Using the interdisciplinary frameworks in
practice. In V. W. Berninger (Ed.), Interdisciplinary frameworks
for schools: Best professional practices for serving the needs of all
students (pp. 17–47). Washington DC: American Psychological
Association. https​://doi.org/10.1037/14437​-002.
Carpenter, S. L., King-Sears, M. E., & Keys, S. G. (1998). Counse-
lors + educators + families as a transdisciplinary team = more
effective inclusion for students with disabilities. Professional
School Counseling, 2(1), 1–9.
Casanova, M. (2014). Autism as a sequence: From heterochronic ger-
minal cell divisions to abnormalities of cell migration and cor-
tical dysplasias. Medical Hypotheses, 83(1), 32–38. https​://doi.
org/10.1016/j.mehy.2014.04.014.
Cascella, P. W., & Colella, C. S. (2004). Knowledge of autism spectrum
disorders among Connecticut school speech-language patholo-
gists. Focus on Autism and Other Development Disabilities, 19(4),
245–252.
Centers for Disease Control and Prevention. (2018). Autism. Retrieved
from http://www.cdc.gov/ncbdd​d/autis​m/data.html.
Chapman, L., & Ware, J. (1999). Challenging traditional roles and
perceptions: Using a transdisciplinary approach in an inclusive
mainstream school. Support for Learning, 14(3), 104–109. https​
://doi.org/10.1111/1467-9604.00113​.
Charmaz, K. (2006). Constructing grounded theory: A practical guide
through qualitative analysis. Los Angeles, CA: Sage Publications
Ltd.
Choi, B. C. K., & Pak, B. C. K. (2006). Multidisciplinarity, interdis-
ciplinarity, and transdisciplinarity in health research, services,
education and policy: 1. Definitions, objectives, and evidence of
effectiveness. Clinical and Investigative Medicine, 29, 351–364.
Coates, M., Lamb, J., Bartlett, B., & Datta, P. (2017). Autism Spectrum
Disorder coursework for teachers and teacher-aides: An investi-
gation of courses offered in Queensland. Australia. Australian
Journal of Teacher Education, 42(11), 65–80.
Connecticut State Department of Education. (2005). Guidelines for
identification and education of children and youth with autism.
Division of Teaching and Learning Programs and Services,
Bureau of Special Education (Eds.). Hartford, CT.
D’Amour, D., Ferrada-Videla, M., San Martin Rodriguez, L., & Beau-
lieu, M. (2005). The conceptual basis for interprofessional col-
laboration: Core concepts and theoretical frameworks. Journal
of Interprofessional Care, 19(S1), 116–131.
Davies, S. (2007). Team around the child. Working together in early
childhood education. Wagga Wagga, New South Wales: Kurra-
jong Early Intervention Service.
Douglas, N., & Burshnic, V. (2019). Implementation science: Tackling
the research to practice gap in communication sciences and disor-
ders. Perspectives of the ASHS Special Interest Group, 4(1), 3–7.
https​://doi.org/10.1044/2018_PERS-ST-2018-0000.
Downing, J., & Bailey, B. R. (1990). Sharing the responsibility: Using
a transdisciplinary team approach to enhance the learning of
students with severe disabilities. Journal of Educational & Psy-
chological Consultation, 1(3), 259–278. https​://doi.org/10.1207/
s1532​768xj​epc01​03_4.
Ebersöhn, L., Ferreira-Prévost, J., Maree, J., & Daleen, A. (2007).
Exploring facilitation skills in transdisciplinary teamwork. Inter-
national Journal of Adolescence and Youth, 13(4), 257–284. https​
://doi.org/10.1080/02673​843.2007.97479​80.
Eren, R. B., & Brucker, P. O. (2011). Practicing evidence-based prac-
tices. In B. Reichow, P. Doehring, D. V. Cicchetti, & F. R. Volk-
mar (Eds.), Evidence-based practices and treatments for children
with autism (pp. 309–341). New York, NY: Springer.
Fewell, R. R. (1983). The team approach to infant education. In S. G.
Garwood & R. R. Fewell (Eds.), Educating handicapped infants:
Issues in development and intervention (pp. 299–322). Rockville,
MD: Aspen.
Foley, G. M. (1990). Portrait of the arena evaluation: Assessment in
the transdisciplinary approach. In E. Biggs & D. Teti (Eds.), Inter-
disciplinary assessment of infants: A guide for early intervention
professionals (pp. 271–286). Baltimore, MD: Paul H. Brookes.
Giangreco, M. F. (2000). Related services research for students with
low-incidence disabilities: Implications for speech-language
pathologists in inclusive classrooms. Language, Speech, and
Hearing Services in Schools, 31(3), 230–239.
Handley, K., Sturdy, A., Fincham, R., & Clark, T. (2006). Within
and beyond communities of practice: Making sense of learning
through participation, identity and practice. Journal of Manage-
ment Studies, 43(3), 641–653.
Havnes, A. (2009). Talk, planning and decision-making in interdis-
ciplinary teacher teams: A case study. Teachers and Teaching,
15(1), 155–176.
Hunt, P., Soto, G., Maier, J., & Doering, K. (2003). Collaborative
teaming to support students at risk and students with severe dis-
abilities in general education classrooms. Exceptional Children,
69(3), 315–332.
Hunt, P., Soto, G., Maier, J., Muller, E., & Goetz, L. (2002). Collabora-
tive teaming to support students with augmentative and alternative
communication needs in general education classrooms. Augmen-
tative and Alternative Communication, 18, 20–35.
Johnson, P., Porter, K., & McPherson, I. (2012). Autism knowledge
among pre-service teachers specialized in children birth through
age five. American Journal of Health Education, 43(5), 279–287.
Kaczmarek, L., Pennington, R., & Goldstein, H. (2000). Transdiscipli-
nary consultation: A center-based team functioning model. Educa-
tion and Treatment of Children, 22(2), 156–172.
King, G., Strachan, D., Tucker, M., Duwyn, B., Desserud, S., & Shil-
lington, M. (2009). The application of a transdisciplinary model
for early intervention services. Infants & Young Children, 22(3),
211–223.
Klin, A., Saulnier, C., Tsatsanis, K., & Volkmar, F. R. (2005). Clinical
evaluation in autism spectrum disorders: Psychological assess-
ment within a transdisciplinary framework. In F. R. Volkmar, R.
Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and per-
vasive developmental disorders (3rd ed., Vol. 2, pp. 772–798).
Hobokin, NJ: Wiley.
Koegel, R. L., & Koegel, L. K. (2012). The PRT pocket guide: Pivotal
response treatment for Autism Spectrum Disorders. Baltimore,
MD: Brookes.
Lau, H. (2017). Evaluation of a home-based, transdisciplinary inter-
vention for Autism Spectrum Disorder in Hong Kong, ProQuest
Dissertations and Theses.
Lethard, A. (1994). Going interprofessional: Working together for
health and welfare. London: Routledge.
Limbrick, P. (2007). Team around the child: Principles and practice.
In P. Limbrick (Ed.), Family-centered support for children with
disabilities and special needs: A collection of essays (pp. 1–9).
UK: Interconnections.
López-Huertas, M. (2013). Reflections on multidimensional knowl-
edge: Its influence on the foundation of knowledge organization.
Knowledge Organization, 40(6), 400–407.
13

McGonigel, M. J., Woodruff, G., & Roszmann-Millican, M. (1994).
The transdisciplinary team: A model for family-centered early
intervention. Meeting early intervention challenges: Issues from
birth to three (2nd ed., pp. 95–131). Paul H. Brookes: Baltimore,
MD.
McSheehan, M., Sonnenmeier, R., & Jorgensen, C. (2008). Member-
ship, participation and learning in general education classrooms
for students with Autism Spectrum Disorders who use AAC. In P.
Mirenda & T. Iacono (Eds.), Autism Spectrum Disorders and AAC​
(pp. 413–439). Baltimore, MD: Paul H. Brookes.
Morrier, M. J., Hess, K. L., & Heflin, L. J. (2011). Teacher training for
implementation of teaching strategies for students with Autism
Spectrum Disorders. Teacher Education and Special Education,
34(2), 119–132.
National Research Council. (2001). Educating children with autism.
Washington, DC: National Academy Press, Committee on Educa-
tional Interventions for Children with Autism, Division of Behav-
ioral and Social Sciences and Education.
Nevin, A. I., Thousand, J. S., Paolucci-Whitcomb, P., & Villa, R. A.
(1990). Collaborative consultation: Empowering public school
personnel to provide heterogeneous school for all. Journal of
Educational and Psychological Consultation, 1, 41–67.
Nicolescu, B. (2010). Methodology of transdisciplinarity: Levels of
reality, logic of the included middle and complexity. Transdisci-
plinary Journal of Engineering & Science, 1, 17–32.
Orelove, F. P., & Sobsey, R. (1991). Educating children with multiple
disabilities: A transdisciplinary approach (2nd ed.). Baltimore,
MD: Paul H Brookes.
Paul, R., & Wetherby, A. (2005). New autism collaboration develops
practices in communication assessment for SLPs. ASHA Leader.
https​://doi.org/10.1044/leade​r.FTR7.10032​005.11.
Peterson, N. (1987). Early intervention for handicapped and at-risk
children: An introduction to early childhood special education.
Denver, CO: Love.
Pfeiffer, D., Pavelko, S., Hahs-Vaughn, D., & Dudding, C. (2019). A
national survey of speech-language pathologists’ engagement
in interprofessional collaborative practice in schools: Identify-
ing predictive factors and barriers to implementation. Language,
Speech, and Hearing Services in Schools, 50(4), 639–655. https​
://doi.org/10.1044/2019_LSHSS​-18-0100.
Piaget, J. (1972). The epistemology of interdisciplinarity relationships.
In L. Apostel, G. Berger, A. Briggs, & G. Michaud (Eds.), Inter-
disciplinarity: Problems of teaching and research in universities
(p. 138). Paris, France: Organization for Economic Cooperation
and Development.
Plumb, A. M., & Plexico, L. W. (2013). Autism spectrum disorders:
Experience, training, and confidence levels of school-based
speech-language pathologists. Language, Speech, and Hearing
Services in Schools, 44, 89–104.
Powell, B., McMillen, C., Proctor, E., Carpenter, C., Griffey, R.,
Bunger, A., et al. (2012). A compilation of strategies for imple-
menting clinical innovations in health and mental health.
Medical Care Research Review, 69, 123–157. https ​ : //doi.
org/10.1177/10775​58711​43069​0.
Price, J. (2013). Preservice knowledge and training in autism spec-
trum disorders. Perspectives on Issues of Higher Education, 16(2),
71–80.
13
Journal of Autism and Developmental Disorders
Rakap, S., Balikci, S., Parlak-Rakap, A., & Kalkan, S. (2016). An
analysis of Turkish pre-service teachers’ knowledge of autism
spectrum disorder: Implications for teacher preparation programs.
SAGE Open, 6(3), 1–11.
Ranjan, R., Pradhan, K., & Wong, J. (2014). Effect of transdisciplinary
approach in group therapy to develop social skills for children
with Autism Spectrum Disorder. Theory and Practice in Lan-
guage Studies, 4(8), 1536–1542.
Roncaglia, I. (2018). Transdisciplinary approaches embedded through
PERMA with autistic individual: A case study. Psychological
Thought, 11(2), 224–233. https:​ //doi.org/10.5964/psyct.​ v11i2.​ 306.
Saldana, J. (2009). An introduction to codes and coding. In J. Saldan
(Ed.), The coding manual for qualitative researchers (3rd ed.).
London: Sage Publications.
Sanz-Cervera, P., Fernández-Andrés, M. I., Pastor-Cerezuela, G., &
Tárraga-Mínguez, R. (2017). Pre-service teachers’ knowledge,
misconceptions and gaps about Autism Spectrum Disorder.
Teacher Education and Special Education, 40(3), 212–224.
Schaaf, C., & Zoghbi, H. (2011). Solving the autism puzzle a few
pieces at a time. Neuron, 70(5), 806–808.
Schwartz, H., & Drager, K. D. R. (2008). Training and knowledge in
autism among speech-language pathologists: A survey. Language,
Speech, and Hearing Services in the Schools, 39, 66–77.
Stockstad, M. (2016). An evaluation of coverage of autism spectrum
disorders in speech-language pathology, (Master’s thesis). Appa-
lachia State University. Retrieved from https​://libre​s.uncg.edu/ir/
asu/f/Stock​stad,%20Mar​issa%20201​6.pdf.
Strong, J. E. (2014). Preparing teachers of students with Autism
Spectrum Disorders: Evidence-based practices and teacher self-
efficacy. Doctoral dissertation. Retrieved from https​://schol​arsco​
mpass​.vcu.edu/cgi/viewc​onten​t.cgi?artic​le=4685&conte​xt=etd.
Wenger, E., McDermott, R. A., & Snyder, W. (2002). Cultivating com-
munities of practice: A guide to managing knowledge. Boston,
MA: Harvard Business Press.
West, J. F., & Idol, L. (1990). Collaborative consultation in the educa-
tion of mildly handicapped and at-risk students. Remedial and
Special Education, 11, 22–31.
American Speech-Language-Hearing Association. (n.d.-a). Employ-
ment Settings for SLPs. Retrieved from https​://www.asha.org/
Stude​nts/Emplo​yment​-Setti​ngs-for-SLPs.
American Speech-Language-Hearing Association. (n.d.-b). Autism
(Practice Portal). Retrieved from https​://www.asha.org/Pract​ice-
Porta​l/Clini​cal-Topic​s/Autis​m/.
American Speech-Language-Hearing Association. (n.d.-c). School-
based service delivery in speech-language pathology. Retrieved
from https:​ //www.asha.org/slp/school​ s/school​ -based-​ servic​ e-deliv​
ery-in-speec​h-langu​age-patho​logy/.
York, J., Rainforth, B., & Giangreco, M. F. (1990). Transdisciplinary
teamwork and integrated therapy: Clarifying the misconceptions.
Pediatric Physical Therapy, 2(2), 73–79.
Publisher’s Note Springer Nature remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations.