Multi-agency working for children with physical difficulties. An investigation into the processes and effects of joint planning

Context
Children with physical difficulties are increasingly included in mainstream
schools in the United Kingdom. These children are likely to have many agencies
supporting them and helping to meet their needs, for example physiotherapists
and occupational therapists. In recent years the working practice of many
professionals has changed from clinic based practice to a school focused
model.
The purpose of this research is to measure the effectiveness of multi-agency
support for children with physical difficulties who attend mainstream schools.
Current legislation encourages multi-agency working practices but gives little
guidance as to how to do this for the maximum benefit of the children.
Methods
The participants were two groups of children with physical difficulties aged
between six and ten years of age, who attended mainstream schools. For one
group of children the professionals involved jointly developed the child's
individual education plan (IEP). For the other group professional planning was
completed separately. The intervention ran for a period of six months.
The children's progress was measured both before and after the intervention
using the School Function Assessment (SFA), a comprehensive measure of
functional skills. Functional skills are the non-academic skills required for
participation in the academic and related social aspects of an educational
programme. The self-esteem of the children was measured pre- and postintervention
using the Self Image Profiles for Children (SIP-C).
The research also investigated the processes involved in multi-agency working
through focus group discussions. The children's views were collected through
interviews and drawings.
Results
There were small differences between the functional skills scores for the two
groups of children. Although the differences were not statistically significant the
children whose programmes were jointly planned made more progress in
particular for cognitive/behavioural tasks. The gains in self-esteem were statistically significant with the joint planning group attaining increased scores
and the separately planning group showing decreases.
The groups of professionals who planned together communicated more and
with greater specificity and detail. This led to more problem solving and actions
taken to meet the needs of the child. The members of these groups and others
in the wider school demonstrated a sense of responsibility for the child and felt
empowered to contribute to the child's programme of support.
The children who had joint plans demonstrated a clear and realistic
understanding of their needs and they were able to express this through talking
and drawing.
Outcomes
As a result of this research, recommendations are made for professional
practice in a multi-agency framework. The assessment of functional skills is
recommended as a measure of progress and a focus for appropriate target
setting for children with physical difficulties.

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