Online publication date: 18 February 2010

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1 This article was downloaded by: [Trepanier-Street, Mary L.] On: 23 February 2010 Access details: Access Details: [subscription number ] Publisher Taylor & Francis Informa Ltd Registered in England and Wales Registered Number: Registered office: Mortimer House, Mortimer Street, London W1T 3JH, UK Journal of Early Childhood Teacher Education Publication details, including instructions for authors and subscription information: Education and Medical Professionals Collaborating to Prepare Early Childhood Teachers for Inclusive Settings Mary Trepanier-Street a a School of Education, University of Michigan-Dearborn, Dearborn, Michigan, USA Online publication date: 18 February 2010 To cite this Article Trepanier-Street, Mary(2010) 'Education and Medical Professionals Collaborating to Prepare Early Childhood Teachers for Inclusive Settings', Journal of Early Childhood Teacher Education, 31: 1, To link to this Article: DOI: / URL: PLEASE SCROLL DOWN FOR ARTICLE Full terms and conditions of use: This article may be used for research, teaching and private study purposes. Any substantial or systematic reproduction, re-distribution, re-selling, loan or sub-licensing, systematic supply or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.

2 Journal of Early Childhood Teacher Education, 31:63 70, 2010 Copyright National Association of Early Childhood Teacher Educators ISSN: print / online DOI: / Education and Medical Professionals Collaborating to Prepare Early Childhood Teachers for Inclusive Settings UJEC Journal of Early Childhood Teacher Education, Vol. 31, No. 1, Jan 2010: pp. 0 0 Education M. Trepanier-Street and Medical Professionals MARY TREPANIER-STREET School of Education, University of Michigan Dearborn, Dearborn, Michigan, USA Best practice in the early childhood special education field supports the inclusion of young children with special needs in natural learning environments, that is, in programs where children without disabilities of the same age and their families participate. Consequently, early childhood teacher education programs must prepare professionals to teach children who are diverse in physical, social, emotional, and cognitive abilities and needs. This article describes the first 3 years of collaboration between a university s early childhood teacher education program and a hospital s program for families of children with special needs. Using a transdisciplinary model, the mission of this partnership is to prepare a new generation of teachers who excel in helping children with and without disabilities thrive. There is a growing need for quality early childhood programs for all children, typically developing children and children with special needs and their families. Recommended practice in the early childhood special education field supports the inclusion of young children with special needs in natural learning environments, that is, in programs where children without disabilities of the same age and their families participate (Sandall, Hemmeter, Smith, & McLean, 2005). Children enrolled in early childhood programs vary widely then in physical, social, emotional, and cognitive abilities and needs and are diverse in linguistic, cultural, and socioeconomic backgrounds. To meet the needs of young children with disabilities in the regular early childhood classroom, transdisciplinary teaming has been suggested as an appropriate strategy for inclusive services (Kilgo, 2006). Teaming among a general early childhood educator, early childhood special education educator, physical therapist, occupational therapist, speech-language therapist, nurse, physician, social worker, and critically important, the parents/family would be utilized to provide quality services to young children with disabilities in inclusive classrooms. This transdisciplinary team approach would permeate all aspects of service delivery from assessment to program delivery (Kilgo). Teacher education programs must prepare quality early childhood professionals who are ready to work effectively on a transdisciplinary team. Guidelines set by both the National Association for the Education of Young Children (Hyson, 2003) and the Division of Early Childhood of the Council for Exceptional Children (Miller & Stayton, 2000) emphasize that early childhood professionals need appropriate coursework and field Received 1 February 2009; accepted 16 June Address correspondence to Mary Trepanier-Street, School of Education, University of Michigan- Dearborn, Hubbard Dr., Dearborn, MI 48126, USA. mtrepani@umd.umich.edu 63

3 64 M. Trepanier-Street placements at the undergraduate and graduate level to meet the diverse needs of all young children with and without disabilities and their families. Within the teacher education program, general education early childhood teachers must have the opportunity to observe and gain an understanding of the roles and skills of special education and health care professionals and work with children with disabilities in an inclusive setting. Few early childhood teacher education programs provide students with such learning opportunities. The following is a description of how one teacher education program and its Early Childhood Education Center have begun, over the course of 3 years, to collaborate with a hospitalbased program for children with disabilities and their families to provide children with and without disabilities with developmentally appropriate educational and social experiences as well as training opportunities for early childhood teacher preparation students in inclusive settings. University of Michigan-Dearborn Early Childhood Center The University of Michigan-Dearborn (UM-D) Early Childhood Education Center (ECEC) serves as a teacher preparation site for both preservice and in-service teachers enrolled in undergraduate and graduate early childhood education programs and is an education and child care center for children 1 through 6 years of age. Currently, the ECEC provides preschool, kindergarten and child care for over 190 children of students, faculty, staff, and community families; it also provides field experiences and internship placements for approximately 200 undergraduate and graduate students in Education at UM-D (UM-D ECEC, 2009, para. 1). The ECEC has been nationally and internationally recognized as a model site for the adaptation and American interpretation of the Reggio Emilia approach to early childhood education (Saltz, 1997; Trepanier-Street, 1999, 2000). Consistent with the philosophy of Reggio Emilia, the ECEC views all children, with and without disabilities as unique, strong and full of potential. All children construct their knowledge and develop skills through exploration, self-expression, and collaboration with their teachers and peers. The ECEC views education as a cooperative, collaborative interactive process among the children, teachers, families, school, and community. While the ECEC has been an inclusive education site since its establishment in the 1970s, the need for expansion of services for children with disabilities and the corresponding expansion of training opportunities for early childhood teachers became evident. In addition there was a substantial need for additional quality care for typically developing children. Therefore, the University desired to acquire a new facility, which would substantially increase its capacity to educate young children with and without special needs and their teachers. Oakwood Healthcare Center for Exceptional Families The Oakwood Healthcare System s Center for Exceptional Families (CEF) provides comprehensive, coordinated, culturally competent health care for children with multiple disabilities or chronic complex disorders. These conditions include diagnoses such as cerebral palsy, muscular dystrophy and autism as well as congenital/developmental disabilities, chronic illnesses, acquired disabilities, and orthopedic conditions. Children at the CEF benefit from the care delivered by a multidisciplinary team consisting of a physician, psychologist, social worker, physical therapist, speech and language pathologist, occupational therapist, dietician, nurse, and orthotist. By housing specialized staff and a multidisciplinary team at one site, young children may get their complex medical and health maintenance needs

4 Education and Medical Professionals 65 addressed in a single visit rather than in multiple visits to different specialists. In the years since its inception, the program has served over 1,000 children through office medical consultations and multidisciplinary team consultations (Oakwood Health System, 2008, para. 1, 2, 5). Like the ECEC, a major goal of the CEF was to expand their services and acquire a new facility, a pediatric medical home for families. Such a facility would meet national health care goals ahead of other pediatric providers both nationally and locally with expanded health care and therapy services. How the Collaboration and Inclusion Began Both the ECEC and CEF had as its major goal acquiring a new facility and expansion of programs. Both programs had at their core, philosophically and in practice, a child and family centered approach to the care and education of young children and their families and were also committed to the inclusion of young children within the regular classroom setting. Staff in both programs were particularly committed to the preparation of future professionals who engaged in best practices for young children with and without disabilities and their families. Fortunately a member of the local community and advocate for children and their families was actively involved with both institutions. Recognizing the quality of the educational experience provided by the ECEC for children, families, and university students, the high quality care and services provided by the CEF, and the common need of both the CEF and ECEC to acquire a new facility, this community activist brought the significant players from each institution together. The end result was a formal agreement of collaboration between the university and the hospital, signed by the University Chancellor and hospital CEO. Collaborative Mission and Goals Professionals from both the university and hospital programs prepared a mission statement for the partnership based on the individual missions of each institution, but more importantly, a shared philosophy and vision. As stated in the mission, the partnership prepares a new generation of teachers who excel in helping children with and without disabilities thrive. It creates and takes great pride in an environment of inclusion. From the building entrance to the classroom to the playground, clinicians, faculty, staff, and University students learn about a transdisciplinary model of inclusion, which helps children of diverse talents and varying abilities grow to be perceptive, accepting, appreciative, and successful together. (UM-D ECEC, 2009). The transdisciplinary model was chosen because it best reflected the philosophy of families and professionals from a variety of professions working together to best serve the development of the whole child. In this model professionals make a commitment to teach, learn, and work together across discipline boundaries (Kilgo, 2006). Program goals for the collaborative relationship for the first 3 years were established. Goals for the ECEC and CEF children were to provide children from both programs opportunities to interact, play, and enjoy activities together and to increase the inclusive educational opportunities of CEF children by enrollment in the ECEC. For the ECEC and CEF families, the goals were to provide opportunities for support and interaction through collaborative family events and parent educational meetings and workshops. University students in the teacher education program would have opportunities to: 1) observe and interact with children with and without disabilities and increase their level of comfort with

5 66 M. Trepanier-Street children with special needs; 2) design and implement activities developmentally appropriate for these children and their families; 3) observe and learn about the various roles of a transdisciplinary team. Finally, the goals for the ECEC and CEF staff and faculty included: 1) developing a transdisciplinary team by understanding the various roles and practices of each individual member of the team and by working together on collaborative projects; 2) increasing professional knowledge of early childhood, special education, and teacher education, and appropriate educational and medical practices by sharing expertise and professional development opportunities; 3) developing a research program and disseminating the learning from the collaborative experience; and 4) increasing public awareness of the ECEC and CEF programs and the collaborative relationship. The First Year During the first year numerous meetings at the higher administration level and at the program level occurred. A Steering Committee, chaired by the hospital CEO and University Provost, was formed and met regularly to discuss a multitude of issues such as acquiring and leasing a new facility, fund-raising activities, public relations and media, and collaborative program events. To meet the program goals, the ECEC and CEF staff and faculty met regularly to plan events and educational experiences for children, families, and university students and the transdisciplinary team. Several enjoyable and educational experiences for the ECEC and CEF children, their families, and the University students in the teacher preparation program occurred during this first year. An inclusive event for 4-to-6-year-old ECEC and CEF children and their families was collaboratively planned by early childhood teacher education students enrolled in the Young Children with Special Needs course, by the ECEC children, and by the staff and faculty of the ECEC and CEF programs. At this event, children with and without disabilities and their families enjoyed a number of activities such as dancing to music, playing basketball and bowling, doing an art project, and sharing dinner. This inclusive event gave children and families the opportunity to interact and socialize in a natural, fun environment, an experience not typically offered to both groups of children and families. The inclusive event required the teacher education students to plan and implement activities that were developmentally appropriate for children with a wide range of cognitive and physical abilities and social interaction skills. Students had to reflect on the environment and its possibilities as well as barriers, such as the openness and unfamiliarity of the physical space and any potential physical obstacles for children with physical disabilities. They needed to consider the role and interaction of the other family members and their influence on the children s involvement in activities. In prior years, students enrolled in the Young Children with Special Needs course planned activities adapted for children with special needs. However, there was not a field experience associated with the course and lesson plans were not implemented. The planning and implementation of the inclusive event and activities added a dimension of authenticity and reality not previously included in the university coursework. Students in all of the early childhood classes (Child Development, Young Children with Special Needs, Strategies in Early Childhood, and Early Childhood Student Teaching) in collaboration with the ECEC classroom teachers prepared the children for the family event in a number of ways. Throughout the year children explored similarities and differences in traits and capabilities among themselves and others. Given that this is a multiage classroom and included children with special language and social and behavioral needs,

6 Education and Medical Professionals 67 discussion about each child s abilities and needs occurred regularly in the daily context of classroom activities. Children also investigated similarities and differences using art media and children s literature. Two young adults with cognitive disabilities (one of whom used a wheelchair) who attended a vocational training center, were placed for 2 half days for 4 months in the classroom to assist children in their activities. The experience of having adults with disabilities in the classroom led to many interesting observations and classroom discussions. Children were particularly interested in exploring how being in a wheelchair affected mobility and they experimented with mobility using a wheelchair in their classroom. Finally, those student teachers that planned the activities specifically for the inclusive family event discussed with the children what activities they enjoyed and how these activities might be adapted for children with disabilities. In addition to the inclusive family event, the teacher education students in the Young Child with Special Needs course had the opportunity to shadow special education and health professionals in the CEF program. Education students attended the CEF multidisciplinary clinic where they had the opportunity to observe a child with disabilities and their family during assessments conducted by a physician, speech, physical, and occupational therapists, and social worker, and to attend the follow-up meeting with all professionals discussing the assessments. The 2nd Year Several innovative and collaborative events for the education of the children and families, as well as for the professional development of teacher education students and ECEC and CEF staff occurred during the 2nd year. An art therapist was invited to the university to present to the education students, the staff, and faculty about using art as a medium of expression for children with disabilities. This professional shared the values of art therapy, discussed various art media, and presented some effective techniques for working with children with disabilities. Immediately following the presentation, the art therapist worked with a group of 4-to-8-year-old children with disabilities at the CEF on art activities. While the disabilities ranged in nature, many of these children had cognitive impairments, attention deficits, and physical disabilities. The early childhood university students had the opportunity to observe the art therapist at work with the children and to practice some of their newly learned techniques with the children. One goal of the art therapy event was to have the children with disabilities express themselves in art and to produce a piece of art that could be displayed in the Early Childhood Program Exhibit at the University. During April, the Month of the Young Child, the early childhood program displays the work of the children, university students, teachers, and faculty. Included in the Early Childhood Program Exhibit are children s project work produced using a wide variety of art media as well as the teachers and university students documentation and interpretation of the children s project work. The exhibit is displayed in a public place on the university campus for the whole community to view. Having the work of the children with disabilities included in the exhibit served the purposes of: 1) celebrating the work of all children with and without disabilities, as well as the work of all of the staff and faculty involved in the collaboration; 2) demonstrating the values of inclusion; 3) enhancing and making public the partnership between the university and the hospital; and 4) serving as an educational tool to inform ECEC and CEF families about both the programs. The exhibit opened with an evening event where all family members from the ECEC, participating CEF children and family members, as well as staff, faculty, and administration

7 68 M. Trepanier-Street from the university and hospital were invited. The planning for this event required the staff from both the ECEC and the CEF to attend university classes to organize and plan the event with the teacher education students. At the event, guests had the opportunity to view the Early Childhood Program Exhibit, share a potluck dinner, and engage in activities led by the university students such as listening to stories, singing songs, playing with puppets (some of whom displayed disabilities), having their picture taken and decorating a frame for their picture and painting. This was truly an inclusive event with preschool children with and without disabilities, their families, and ECEC and CEF staff and faculty enjoying activities and celebrating the good work of children, university students, and the transdisciplinary team. During this 2nd year a number of other collaborative efforts occurred. The university students from the early childhood classes continued to shadow the professionals at the CEF, attending the multidisciplinary clinic and various therapy sessions. Grants written by the team were funded to support a collaborative research project, a teen disability support group, and collaborative program events. Members of the transdisciplinary team shared expertise with each other on a regular basis and presented in university classes on a variety of topics related to medical and educational issues for children with special needs. A significant event during the 2nd year was the purchase by Oakwood Hospital of a 6-year-old child care facility sufficiently large enough for both the ECEC and the CEF programs to double their current size and meet their expansion expectations. This building was well designed, required minimal renovation for the ECEC, and had a large, wellequipped outside play area. For the CEF program extensive renovation was necessary to change from a child care facility to a medical clinic, but the building offered many possibilities for an excellent clinical space. The purchased facility offered the ECEC and the CEF opportunities for growth and exceeded expectations both for space and quality of environment. The 3rd Year The 3rd year began with the opening of the new facility. Consistent with the philosophy and mission, children with and without disabilities, families, university students, staff, and visitors enter the building through one entrance and many areas are shared spaces including the outdoor play space. A collaborative grant to reconstruct some of the outdoor play structures has been submitted. The purpose of this grant is twofold: 1) to develop a play structure suitable for children with and without disabilities to play together and 2) to create a training opportunity for education and health care professionals to learn how to encourage play in an inclusive setting. During the 3rd year several children from the CEF enrolled at the ECEC adding to the diversity of ability in the ECEC classrooms and several ECEC children were referred for special services at the CEF. Collaborative events for children and families included a picnic, a Halloween party, a special book day, and a book fair. In all of these ventures children with and without disabilities, their families, and university education students participated. While the events for the children in the previous years were successful, the transdisciplinary team recognized the need to provide children with play opportunities that were more focused and extended over time. Such an experience could permit children and university students to become more comfortable with each other and have more meaningful interactions. Two playgroups, each consisting of 4 ECEC children and 4 CEF children with disabilities, met weekly for 8 weeks. An ECEC teacher, CEF speech and language therapist, and teacher education students coplanned, implemented, and documented each

8 Education and Medical Professionals 69 playgroup s activities. Documentation of these activities and the children s products/ artifacts were displayed in the 3rd year s Early Childhood Program Exhibit, opening again with an inclusive family event. In the summer certified elementary teachers enrolled in a graduate program in early childhood teacher education were involved in the summer camp offered by the CEF. These teachers had the opportunity to observe and assist speech, occupational, and physical therapists providing therapy to young children in a fun camp environment. An opportunity for certified teachers to have a weeklong experience to work with children with special needs and with a transdisciplinary team added a new dimension to the UMD early childhood graduate program. To meet the professional development goals for the transdisciplinary team and university students and the goal of dissemination of learning from the collaboration, several events occurred. A monthly colloquium series was established where experts within the team, the university, or the community shared information about a variety of topics surrounding special and early childhood education, and teacher preparation. Staff at both the ECEC and the CEF presented at an early childhood conference held at the university. Early childhood teachers throughout the metropolitan area had the opportunity to learn from medical professionals about young children. The CEF staff continued to present in early childhood university classes and expanded their presentations to other university courses. Public awareness of the ECEC and CEF and the collaborative relationship occurred through a number of facility tours, an open house with over 500 people attending, media reports, and state and national conference presentations. Three-Year Reflections for the Teacher Education Program The benefits of the collaboration with the medical community have been extensive for the UM-D teacher education program. The teacher preparation program is now able to offer authentic learning experiences with children with and without special needs and their families and to undergraduate and graduate early childhood students. University students are able to observe, plan, and implement activities in an inclusive setting. They have the opportunity to observe and interact with a transdisciplinary team, a valuable component for their success as future teachers. Medical professionals, who are passionate about the type and quality of education for young children with special needs, have shared their expertise and provided a new perspective on the preparation of teachers. Professional exchanges around a variety of education and medical topics have enriched the university classroom and the professional knowledge of both the university students and the ECEC staff and faculty. During these 3 years several challenges and unexpected learning opportunities with implications for the teacher education program arose. Children, families, and university students all need to have intensive, long-term experiences in order to increase comfort, ease, and interaction with each other. Carefully planned learning opportunities that take place over an extended period of time, with assigned roles for the university students, increases the interaction for both children and university students. While one-time large events may have a purpose and benefit, multiple interaction opportunities over time in a natural learning environment provide deeper learning and possible friendships. The major challenges for the transdisciplinary team were time and scheduling problems, differing levels of professional experience, and funding for collaborative activities. The development of a team from two different institutions with different primary missions takes a great amount of time and extensive interaction to be successful. It takes time for

9 70 M. Trepanier-Street team members with different educational training, traditions, and culture to learn each other s language and understand the other s traditions and culture. Respectful relationships take time to nurture and develop. Change in how therapies and education is offered can be easier for some members than others. While the members are committed to the collaboration, time for planning and sharing expertise is often limited. This is particularly true for members whose major commitment is offering medical services to patients or the administration of programs. Since transdisciplinary teaming is not the traditional service delivery model of either institution, new funding sources to support collaborative activities, scholarships, and professional development is needed. End of the First Chapter The first 3 years have been at times challenging, but full of excitement and promise. An exceptionally exciting aspect was the experience of early childhood and medical professionals with different training and backgrounds, working together and sharing a passion about the best educational practices for children with and without disabilities and the best practices for their teachers. We look forward to increasing the opportunity for children with and without disabilities to be educated in the same classroom and for families of children with and without disabilities sharing time and support for each other. Teachers will be prepared to work with all young children, children of varying abilities, skills, and social, cultural and economic backgrounds, in an inclusive environment. We eagerly anticipate collaborative, innovative programming and research among education and medical professionals to ensure the best possible education for children, families, and teachers as well as to further best practices in both education and medicine. References Hyson, M. (Ed.). (2003). Preparing early childhood professionals: NAEYC s standards for programs. Washington, DC: NAEYC. Kilgo, J. L. (Ed.). (2006). Transdisciplinary teaming in early intervention/early childhood special education: Navigating together with families and children. Olney, MD: Association for Childhood Education International. Miller, P., & Stayton, V. (2000). Recommended practices in personnel preparation. In S. Sandall, M. McLean, & B. Smith (Eds.), DEC recommended practices for early intervention/early childhood special education (pp ). Longmont, CO: Sopris West. Oakwood Health System, Inc. Program for Exceptional Families. (2008). Exceptional families deserve exceptional care. Retrieved May 7, 2008, from the Oakwood Health System, Inc. Program for Exceptional Families Web site: Saltz, R. (1997). The Reggio influence at the University of Michigan-Dearborn Child Development Center: Challenges and change. In J. Hendrick (Ed.), First steps toward teaching the Reggio way (pp ). Englewood Cliffs, NJ: Prentice Hall. Sandall, S., Hemmetter, M. L., Smith, B. & McLean, M. (2005). DEC recommended practices in early intervention/early childhood special education. Missoula, MT: Division of Early Childhood Education. Trepanier-Street, M. (1999). Children directed learning: The project approach. Offspring, 41(2), Trepanier-Street, M. (2000). Multiple forms of representation in long-term projects: The garden project. Childhood Education, 77(1), UM-D ECEC, University of Michigan-Dearborn Early Childhood Education Center. (2009). About us. Retrieved January 30, 2009, from the University of Michigan Dearborn Early Childhood Education Center Web site: