In the 1990’s, new tools for early diagnosis and treatment increased the interest in early intervention in ASD, and especially with the role of parents in coordinating and delivering treatment. During my tenure at the Centre Hospitalier Douglas, I came to focus much of my clinical and research work on children with autism.
In 1994, I led the creation of an intensive, bilingual, multidisciplinary treatment program (the Therapeutic Nursery) with the support of other clinicians at the hospital. We coached small groups of parents on how to work directly with their toddler or preschooler on early social, communication, and play skills. Over the course of the 6 hour/week, 14 week program, parents also participated in parent education and support groups, while their child completed other assessments and interventions.
Over a 5 year period, I provided psychological services and acted as the team leader for the program. I also conducted full diagnostic assessments (using the ADOS and ADI-R), as well as cognitive and adaptive behavior assessments on all participating children. This program helped to extend the hospital’s ASD diagnostic clinic to address the needs of younger children.
At the Douglas Hospital, I also began to recognize the potential impact of broad policy decisions on day-to-day clinical work, and sought other leadership opportunities. I was subsequently elected by 35o allied health professionals as their at-large representative to the hospital's executive committee and on the hospital's board of directors, for all clinical, research, and administrative concerns. I also served as Director of the Department of Psychology for Child and Adolescent Services. A majority of my clinical and administrative work, and some academic work (Doehring 1997 & 2001) during this period was conducted in French, my second language.
The importance of multi- and transdisciplinary teamwork was emphasized throughout my training, but early in my career I realized teamwork is not something that "just happens". It requires an understanding and an appreciation for the unique contribution of each discipline, and a team structure that balances leadership and shared decision making.
In the case of ASD, this is complicated by the fact that different disciplines espouse different theories about ASD, rely on different techniques for assessment and treatment, and may play different roles in hospital-, school-, and university-based programs. As the elected representative of multiple disciplines to the Hospital's executive, I met regularly with department heads to capture their concerns. In every organization in which I have worked since, I have sought to clarify the role(s) of each discipline, educate professionals about the roles and contributions of their colleagues, and actively championed teaming.