Utilizing a transdisciplinary model to serve students with visual impairments in Croatia with Martina Sedlar and Hrvoje Gudlin
Welcome back to the podcast, my friend. Today's episode is amazing. I feel like we're on a roll. Let's think about this or what would it take to teach from a trans disciplinary model? Given whatever circumstances we have going on in our worlds? How can we take the steps towards a transdisciplinary model? Whether we're going from disciplinary to multidisciplinary or multidisciplinary to interdisciplinary or interdisciplinary to transdisciplinary. How can we actually move the needle forward?
Today I get to bring you along for a conversation with Martina and Hrvoje who live in Croatia. They work for a center called Mali Dom where they both have different roles, but work seamlessly together for the students in a transdisciplinary model. And it's really really working for them. We get to take a peek behind the scenes of who they are as people and the exact actions that they take to make their students’ lives better.
In this podcast episode:
Who is Martina Sedlar and Hrvoje Gudlin?
What is Mali Dom?
How did Martina and Hrvoje end up working in Mali Dom?
The Transdisciplinary Model in Mali Dom
What everyday looks like in Mali Dom
Steps to become more transdisciplinary
A step forward with Martina and Hrvoje
Transcript of the Episode:
Who is Martina Sedlar and Hrvoje Gudlin?
Martina is a special education teacher with a master's degree in rehabilitation of visual impairement. Since finishing her master's degree in 2011. she has been working with children with multiple disabilities and visual impairment, mostly in the daycare center for rehabilitation of children and young adults, Mali Dom, and that's in the city of Zagreb. She works in a group of children with multiple disabilities as a special education teacher and as an orientation and mobility instructor for the past few years.
She finished a training course assessment and rehabilitation of vision to work as a vision therapist in 2016 and for the past two years, she has been working in assessment of functional vision as a member of a transdisciplinary team, along with physiotherapist and early intervention therapists. She works in the educational center of Mali Dom Zagreb, where she is a part of the education team in the course, assessment and rehabilitation of vision. She's a mother of a two year old girl, enjoys doing yoga in her free time, and spending time with her dear ones.
Hrvoje is a 30 year old pediatric physiotherapist with a master's degree focused in physiotherapy from Faculty of Health Studies in Rijeka, Croatia. He is interested and highly motivated in rehabilitation of children with cerebral palsy and additional developmental difficulties. He has a history of working in the medical and social organization industry. Since 2016, he has been working as a physiotherapist and halliwick instructor with children and young adults who have multiple developmental disabilities in the daycare center, Mali Dom Zagreb.
Hrvoje has a role in EACD, European Academy of Childhood Disability National Coordinator for Croatia. In his free time he loves running, cycling and other outdoor activities. Now there is a word in there that you may not know, halliwick, I didn't know that either. it is a form of aqua therapy. It's gonna be brought up a few times within the podcast episode every other word that you may not know, we get into it in the podcast organically. All right, all right. All right. Ain’t ought to hold you up any longer. Let's get to the show.
Kassy:
Hi, guys. Welcome to the podcast. I'm so so glad that we could make this happen. Martina and… I'm totally going to mess up your name age, but I'm going to try… No, it's gonna I'm gonna mess up so bad. I should have done this before we started recording. I had it. I had it before and now I feel very nervous.
Hrvoje:
Okay, just relax and say it
Kassy:
Hrvo. Do you say the J or not?
Hrvoje:
Yes, exactly. You know, Hrvo is my nickname.
Kassy:
Hrvo. I could do that one.
Hrvoje:
Okay. My full my name is Hrvoje but Hrvo is my nickname in Croatian.
Kassy:
It's the J that's messing me up. Hrvoje.
Hrvoje:
Yes! it's in your language. It's J in Croation It is ‘Yeh’.
Kassy:
Hrvoje.
Hrvoje:
Yes nice!
Kassy:
I mean, now you added more stuff. But I'm so glad that you guys could be on this podcast with me. I really enjoyed listening to your presentation during the symposium. Before we even get into it. Can you guys let our community know a little bit about you and who you are, and even how you got into the field? Both of you.
Martina:
Do you wanna start first?
Hrvoje:
Do you want to start? I’ll be the gentleman.
Martina:
So I'm actually a special education teacher. We now… for the past, I don't know how much, maybe 10 years, maybe more we have like, after bachelor degree, we have a master's degree. So I went and had a master's degree in field of visual impairment, like teacher of visual impaired in United States. And after graduating, I've been working now about 11 years, with children with MDVI, from 3 to 21.
And during that period, I don't know exactly when I do not remember. But I started to work in orientation and mobility. I had some classes on faculty. But after that we actually in Croatia do not have like a course of four O and M instructors, we had it previously but now we do not. That something we are missing here or in all of the field.
But my colleagues that actually are working with people with just visually impaired people and grownups, I asked them for some advice. But the field is very, very different. When you work with children with such profound intellectual disability, you have to use different strategies.
And actually, why Hrvoje and I wanted to show our work is because we actually have to do everything transdisciplinary, you have to keep everything in mind when you work with these children. And actually eight years ago, I finished a course in assessment of functional vision. So that is also one field that I'm very, very interested in. And I work in a transdisciplinary team, assessing visual functioning, but looking at all of the areas of functioning with children. Some of them are not MDVI, some children come and they only have other kinds of disabilities, or maybe none, and just visually impaired. Yeah, so there's the field I’m working in. Do you want some personal information? I don't know.
Kassy:
I'd love to hear it all. Martina, share.
Martina:
Okay, besides from that I don't know, I'm very interested in yoga as you are as well, as I've read. And I've been doing a little bit of yoga a few years ago here with children with MDVI. Yes, I had a course for yoga for special child. The woman came from, I think she lives in California. I'm not sure which country was, yeah, that's what I did for a few years. And I practice myself and I have a little girl at home, two year old, a toddler. And I don't know… That's pretty much it.
Kassy:
That's a lot. I mean, having a little one at home and doing yoga and with everything that you do in our profession. One thing that I really loved was getting to see how similar our lives and our pads are, even though we're all the way around the world from one another. And I love that there are still similarities. Hrvoje… no, I messed that out. Will you tell us a little bit about yourself?
Hrvoje:
Yes, thank you. I will do reverse. I will say a few words about myself and then about my professional career. So I've been living in Zagreb since I was born. In free time, I like to do everything outdoor, especially inline skating, cycling, Nordic walking, everything just I must be outside.
And the reason why I like my job Physiotherapy is sometimes I can connect my spirit, my sport recreational spirit with what I will do with my clients so children and maybe young people with less or more difficulties. In Mali Dom Zagreb I have been working for last seven years. My special areas of interest are children with CP and additional difficulties, aid and mobilities, sport and recreation and mobility and orientation in children with disabilities.
So I finished a master's degree in physiotherapy, at the University of Wide Health Sciences in Rica in Croatia. Rica is one of four large cities in Croatia, Sunday Adriatic Sea, so nice place to be and study. And yes, I'm very happy to be here in Mali Dom because as Martina said, My physiotherapy education really don't give me enough knowledge about MDVI children. I know a lot about motor development and the movement and everything connected today. But I really don't have… I think I will be learning from my whole life, about the adult developmental areas and how they are connected. Because every child is really different. That's the beauty of our job here, because we really learn a lot from each other. Me alone here in Mali Dom, I will not be working with a job, but me in partnership with my colleagues, we can be a great disciplinarity.
Kassy:
I love that. You know, one thing that you mentioned that I see a lot with teachers is they really get to flourish, when they get to bring the things that they love, from the outside world into work. And I even talked about that a little bit in what will be the last podcast episode of we talked about, of course, we right now you and I are recording this before it gets released, but about falling back in love with the profession.
And one way to fall back in love with the profession is to look at your personal life and bring that in to the relationship with your learners. Because you're in a relationship with them. They want to know about you personally, just as much as you want to know about them personally. And just as much as you bring their interests into your class. If they're into some new game, or some new sport or some new song, you're probably gonna play that game or sport or song in your class because they like it. But it's also vice versa. They want to know about you, because you're building trust with them.
So it makes complete sense, Hrvoje, that you thought out like this specific type of student and that profession, all in and of itself, you really get to blend the two. And I bet that that makes you such an amazing teacher.
Hrvoje:
Thank you. I hope… I cannot say about myself the best what others need to say, but I really hope thank you.
What is Mali Dom?
Kassy:
Yeah, yeah. Okay, so you both mentioned Mali Dom and working in a transdisciplinary team. Can you tell us a little bit about Mali Dom, what it is for people who don't know, and what happens there? Maybe what types of students you serve, and then we'll get into the transdisciplinary model. And I really want to break down the different types of models for maybe those who don't know or need a reminder. And then we'll talk about the transdisciplinary model and how you guys have built it and sustained it through all the challenges that we faced especially over the past three years.
Martina:
Okay. So, actually, what we also already said in the presentation, that is the only way we can work these children is because here now, we have children from zero to three in early intervention program. And after that, children who cannot be involved in special kindergartens, in some other centers, or in special schools, they come in Mali Dom.
We are not under education system, we are under social welfare. So they… for children, I don't know how to say to, who cannot be involved in regular school system, they come here to Mali Dom. I already said they have profound intellectual motor disabilities. Often, I would say over 80% of our children are in a wheelchair with some kind of wheelchair. So they stay here, most of them until they're 21 years old. And after that, they go to some other center.
Firstly, from the assessment, which where I work in, most of the children that come in with that part are children from zero to three, so the babies come. And if we see some of them are involved in our early intervention program, but we can involve children that are in the region around Zagreb, it happens very often that we have children from the coast from the islands, or from some other countries around Croatia, because no one else provides this kind of assessment to here in this area of Europe.
So there is the assessment is the part… It’s one part of one program where I learned here in the room, you have a parent, child and three professionals, me as vision therapist, special education teacher who looks at ways of learning communication, interaction, and physiotherapist who mainly looks at motor development, but also looking at what is the specifically for that child, what is their needs now, and in the next few months.
I've learned that as we already showed the phases of the role of release when you come and you lose your role and use the strategies and techniques of other professions. It's a consuming, very consuming process, you have to… Firstly, you have to really know the area you're working with. And when you start to feel very frightened. If you know, you are new in any area, you are frightened if you know all the things you need to know, the techniques you use, and then use.
After working for a few months, I started to actually look at the area of motor development, that is the thing I'm weakest, I would say, and how the position of a child how the motor answer can be communication to me that I may be too fast, I need to speed up, I need to change the position so I can have better visual response. So that knowledge, I would say, for me, I started after doing the assessment I started using in the everyday work with children on the daycare program, from three to 21.
Actually, I work with children now from 6 to 12, who are profoundly visually impaired, some of them, I would say, have residual vision and use it functionally. But some of them are like behaving like they're completely blind. Yeah, so is the only way we could work. If we actually share knowledge we share knowledge with, of course, with parents who are 24/7, with these children, and with other professionals and paraprofessionals. We actually have caregivers in every group. So they spend the most time with the children. So we also educate them in a specific area that we're interested in. So they can also use some of the techniques we use, and adapt the materials environment, etc. So I've been talking a lot… Feel free to cut me and if you want to hear something specific if you're interested in something that didn't mention.
Kassy:
Yeah, so I want to clarify to everybody listening. It sounds like Mali Dom, where you both work is a residential school that children can go to after they've tried going to their regular school. But that schooling doesn't work for them.
Martina:
Actually, no, we have… after the assessment, we say to the… of course parents can decide that we think that's in the child's best interest if the child stays here. in Zagreb, for example, we have different centers, and they have a criteria that lets the child be involved in that program. So the children that we work with, cannot be accepted in the other centers. So for example, one center works with children with visual impairment and some additional disabilities, but not the kinds of children we work with. So we cannot be involved there.
Kassy:
Got it. Okay, let me just wrap my head around what Mali Dom is so that we can then move forward with the conversation. Mali Dom, it's a school right for children with any sort of disability or just visual impairments plus?
Martina:
A child has to have visual impairment.
Hrvoje:
But Mali Dom isn't a school. Mali Dom is a rehabilitation center found in the city of Zagreb. So we are a public institution. And if some parents want to enroll their child in our program, I mean child needs to have visual impairment and many of almost all of our children have a profound intellectual intellectual disabilities and disabilities in other areas of development.
So we actually work with children with really multiple developmental disabilities and with very… may not sound nice, but with very limited abilities. So but we try to do everything what they can do in all areas of development and then to transform those little tiny little things they can do in really functional activities in their everyday work.
Martina:
Let me just say other centers also have children with profound disabilities. But if they have any kind of visual impairment, then they're sent here in Mali Dom.
Kassy:
Yeah. That makes sense. So I'm trying to ask you guys questions in a way for people who possibly didn't come to the symposium and have that background information as well. Do the students live there? Or do they live at home with their families?
Martina:
They live at home and they come here to for six or eight hours. Some parents work for four hours, so their children cannot come here for eight hours. The state provides for parents to work for hours or maybe not work so their children can come here.
Kassy:
That's amazing. We don't have that.
Hrvoje:
Yes. But you always give… Parents in Croatia always really get measly of money, if they have child with disabilities.
Martina:
I don’t know how many Euros it’s will be…
Hrvoje:
It will be around not even 400 Euros.
Kassy:
Let’s look that up, what 400 Euros is…
Martina:
I think it’s about US Dollars something like that?
Hrvoje:
I think it’s about US Dollars yes.
Kassy:
Per month?
Hrvoje:
Per month, yes. So if you're a parent and you have a child with profound multiple disabilities, okay, you can be a caregiver. You don't have to work, your middle child, but you will be faced with misery. It's realistic. And just one thing I wanted to say. So Mali Dom is a representation center. And you asked about do they sleep here or not, we have four different programs. One is daycare program. So children from 3 to 21 years old, they are here 3, 4, 5, 6, or maybe 8 hours a day. But they do not sleep here.
During that period. They are in a group of children, we have seven groups, and every group has their own daily schedule. So they're here about 8:39am. And the children are here till 1, 2, maybe 3pm. In there, their day is really full of different activities.
The other program is early intervention. So children from 0 to 3 years old, they have their own educational rehabilitator and physiotherapist who they work with. And every child has some specific needs. So they can be involved in pool therapy, pool sessions, therapeutic swimming, or maybe music therapy, or maybe speech language pathologists work with them. Maybe chemotherapy, so depends on what the child our primary means.
Martina:
And the child and services are provided at home by a special education teacher and they come to physiotherapist to our center.
Hrvoje:
Yes. And the two other programs are Martina also mentioned transdisciplinary assessment. And the four hour program is educational center. I think you mentioned that or so we work a lot with other institutions and centers in Europe.
Martina:
We provide webinars or courses.
How did Martina and Hrvoje end up working in Mali Dom?
Kassy:
It sounds like Cinderella's castle. I want to come visit. I want a tour. It sounds amazing. How did each of you decide that you wanted to work at this one specific place versus other places in Croatia?
Martina:
Oh, I already knew at the first year of my college I had to work with visual impairment with people with visual impairment. That was my dream and today I enjoy best in working with blind children, completely blind. But then we don't have much choices. Here in Zagreb we we actually have but I was… how do you say to when you're a student and you go on practice in some other centers?
Kassy:
Your internship?
Martina:
Yeah, something like that. Not after I've finished but during.
Kassy:
Here we do our internship before we graduate.
Martina:
Okay, so I don't know how much information I can share. But I wasn't satisfied when I saw the way they work. Mali Dom actually grew from the NGO. They were called Little House before. And 2009, the city took us under their wing, and we became a public institution. So they, in the core, they have the spirit of NGOs, where people are closer. People work. And they have like, the energy because they were small, they had to build their foundations. Because they started actually in the early 2000s. Yeah, ‘99 and 2000s.
Because the field is very new here in Croatia. Children with MDVI weren't anywhere before Mala Kucha and now Mali Dom. Make sure they were the first ones. We were the first ones and early intervention started actually in Croatia started from Mali, Mala Kucha. There wasn't any early intervention before that before Mala Kucha.
So I don't know even when I was a student, when I came here, I learned many of teachers here they come and have classes in the university in my faculty of education rehabilitation. So when I heard how they are thinking about children, how they look at the child how they work. Yeah, that was something I just wanted to do. There was nothing else. Yeah, that's for me.
Hrvoje:
And my story is really interesting, but I will try to make it really short. Since my third year of college, I was only in sport. I wanted to be a sports physiotherapist, nothing else, nothing. There wasn't anything such interesting for me. And I had one really special good professor teacher at my university. He was really… and he's my friend now. He was really amazing. And his way of teaching and transferring knowledge to students was one of the best I have ever seen.
And there's a period when the child physiotherapy, especially visitor with… children with neurological conditions, started to interest me a lot. After that, I started to learn a lot about physiotherapy in children. And I was volunteering in one swimming club for children with disabilities here in Zagreb. I was getting knowledge about therapy, in pool, in water. And in Mali Dom, I came, I think, 10 years ago, as a student, we have a practical sessions here.
So my college sent us here to learn something about work with children. And I was in a group with four girls, and they were ashamed. They didn't want to go into the pool with colleagues because I don't know why. And that's when I get the chance to be every day in a pool with children in Mali Dom, because I knew something about pool therapy became interesting to me. And then after my college finished, okay, I didn't go to Mali Dom for the next one and a half year.
And then after that, Mali Dom need this physiotherapist because one physiotherapist went away in Australia. And I heard about that. And I said, Okay, it's really nice. So I can do pool therapy here, besides anything else, I can do pool therapy and a lot of different other things. And then I sent my CV and everything else and I got the job.
So my first contact with children was in a pool. And finally, the main criteria to get the job in my job was to be a hallawick therapist. So to do a therapeutic swimming, I needed to be a physiotherapist. But the main criteria was the hallawick instructor of therapeutic swimming. And this the circle closed when I came here now for the last seven years, and now, sport physiotherapy doesn't interest me at all, more literally.
Kassy:
Isn't it funny how your life can like go certain ways. And you just don't know until you get to just different points. I kind of like to think of it like you're crossing a river and you ever step on those big stones and one stone is like off to the side. And you don't really think about it and then you get back on to the stones you think you're supposed to be on. But then you look at it and you're like, oh, all of that made sense. But it only makes sense when you look back, you know?
Martina:
Yes, I agree.
Kassy:
Yeah. Okay, so, you guys mentioned this one word NGO. It's not really a word that we use here in America. Can you explain that? And then I have another question for you.
Martina:
So a non-governmental organization. They started with, I think it was first Vision of Hope they had some donations from other countries. I don't know if you know, but in the 90s, Croatia was in war. So after that many people were hurt by the mines. Yeah, so many people got blind after that. And we had many, many donations in the late 90s. So I'm not actually sure if we got that money from Europe, or I don't know where and then they started, it was like a project at first. So they will fund it like that.
Kassy:
Okay, that makes sense. I just wanted to clear it up for people.
Martina:
Association, I don't know how to say it. Is it association? No, I think like when you have association of I don't know, parents with children with disabilities, is that the right word?
Kassy:
Yeah, it doesn't typically come with like a building, and teachers and things of that nature, I kind of think of it as like a nonprofit entity. Especially when you're talking about the start up in the energy. I think, when you talked about that it clicked for me, because when you think about government agencies, it's like all the walls and the place are brown. And like, everybody, you know, it's just like, we're just here.
But about a startup or a nonprofit, and everybody has that energy. It's like the building in your picture, where it's bright, and you are drawn to it, and you want to support it. And it's exciting. And everybody is moving in an upward momentum. And even as I'm talking right now, my hands are going together and in an upward momentum, and I didn't do that on purpose. And that's just the energy that it feels when you talk about NGO. And so when you mention it, that's kind of what I get.
The Transdisciplinary Model in Mali Dom
Okay, I'd love to get into the transdisciplinary model. Was there a time at Mali Dom where it wasn't transdisciplinary? And then they had to figure this out to say, Okay, this isn't working. Were either of you guys there during that time before they brought in the transdisciplinary? model?
Martina:
I think not. I think it already was when I came, I came a little bit before Hrvoje.
Hrvoje:
Yes. If I can say I think transdisciplinary model is what we are developing, and what we will be developing for a long period of time because we are a team of 49 people. We have few colleagues in administration. So it's about 40 to 41-2 therapist. So educational teachers, physio, Speech, Language, occupational. And I think we need to understand what is really transdisciplinary approach and the model of working.
I can say for myself, sometimes, I am not doing transdisciplinary because it's not easy, it's difficult. We need to pass all those steps leading to role support, role enrichment, role, release, roll everything. And I think for myself for definitely, but many of our colleagues are still learning. And we are still trying to develop transdisciplinary approach.
Some of our can say older and more experienced colleagues, they are really doing transdisciplinary because they accumulate a lot of experience. But I think many of us are still learning and we'll be learning for a long period of time, how to work, how to think transdisciplinary is really not easy, especially because that many of our colleges, universities. For example, physiotherapy, we are drilled with motor development. So at my university, we don't learn about vision, development, communication, development, behavior, social emotional, we are dealing with muscles, tendons, joints, body posture, okay, I know that but until I came in Mali Dom, I didn't know anything about other developmental areas. So I started to learn here, and I'm learning each day. So I think we are developing transdisciplinary one,
Martina:
I want to point out two things. Firstly, I think if you ask older colleagues, they would say they don't think they work transdisciplinary all the time. Nobody's ever satisfied. I think it's something you think you have to come to some point and when you come there, you see oh, there's so much I do not know that I do not use yet. I shouldn't be using every day. So I think it's a journey that we will be taking for the rest of our career.
That's one thing and the other thing is that sometimes we actually feel alone and that is… I think that's the problem and the parents feel alone that in many, I cannot say all but many other centers, our colleagues do not work in the same way. And shouldn't be because they're the population of children with additional disabilities. I don't know how it's in the US, but in Croatia, and especially in Zagreb, here in the capital, we rarely now see children with one kind of disability. And you can I can say, I can work with a child with ADHD, and then I have to work on their concentration. And I don't have to look at their posture or walking or etc. Now, I think the population of children with additional disabilities is growing, as the medicine develops and children are born with the 25-26 weeks of gestation. We have children that come here are below zero, and come here to this assessment.
Kassy:
Yeah, right. And same with us. I think here in the United States, it's probably the same as with you guys, I worked at a residential school, which is basically what you guys are describing, I know, we're using different words, it's state funded, but all of the children came to the school. And for where I worked, the children lived there. But they got into a point over the years where the children lived there just for a few years, like three years, and then they go back to their homes.
You're right, and then the transdisciplinary model is really hard. And it's kind of nice to hear you guys who are in a place where you have two different, very different jobs, but you work in the same place, say that it's hard. When you have it the easiest given your environment. You know what I mean?
So let me give you an example. So I worked at this residential school. And it was really easy for me to run into the physical therapist or the occupational therapist in the hallway and have a two minute meeting about this one student. And then we both would walk away and go about our day. Because we were in close proximity, I saw them often. Now, I work in a situation where I am contract. So I am employed by different school districts. But I'm not an employee of that school district. I'm not on their staff. So I don't do staff meetings. There's no team meetings, there's nothing. And oftentimes, I don't even know who the VI specialist is. I don't know who the physical therapist is, I don't know who the occupational therapist is, I might have an evaluation from three years ago. But I have to track that down, I have to see if I can figure out who this person is. Because they're not on staff. They don't even have the same email address like ending.
So creating a transdisciplinary model when I'm working for five or six different districts. And nobody knows who I am. I'm not on any staff rosters. Those people are not on any staff rosters, just finding them figuring out who they are, is really hard. Do you see the difference of how your environment because you're in close proximity, you're friends with these people, you might go to happy hour, you might see them in the cafeteria, you might have a staff meeting a staff meeting.
Martina:
But I think, Hrvoje correct me if I'm wrong, but I think you're here talking about an interdisciplinary model. Before when you had meetings, we actually work together with the child in the same room together, for example, Hrvoje can take the child and put it in one position, then I would offer something or I don't even have to be there. He knows what kind of visual target he can offer to the child. Yeah. So that I would say that's one step closer to the transdisciplinary.
What everyday looks like in Mali Dom
Kassy:
Exactly, exactly. And I was able to do that at the other school not often. In your presentation, you have this amazing slide where it explains the difference. Can I talk about that real quick, so we can all be on the same page. So with the disciplinary model, you had different fruits in their own different goals, and I love this visual representation. Then the multidisciplinary was like, I don't know how you guys got this. It was like cut up fruit. I'm looking at it off to the side in like a baking dish, but they're all in their own little rows. And then inter disciplinary is where all the fruits are still caught up, but they're mixed together in the same bowl. And then transdisciplinary is fruit juice. I love this. Yeah. What does it look like for you on a day to day this transdisciplinary model?
Martina:
I would say the best moment for me is when the parents doesn't know what profession is going to wear what professionals myself that from year to transdisciplinary.
Hrvoje:
I think that parents say the most, because as Martina said, When I work with children from zero to three, so it's really often that I hear from parents, for example, oh my god, she's so calm down here with you. When we are in that some other center, she is always crying and trying to escape. And then I said, Okay, I am physiotherapist. But if your child is nervous, maybe she is afraid, I cannot force her to do something hard motorically. Firstly, I need to get in contact with your child and make her feel okay here and that she is not afraid of anybody or anything. And then when we get in touch when we are relaxed, then we can work on some motoric skill. And then the parents often say, Oh, I thought your physiotherapist always looked and consulted about standing working muscles, bones, joint and something. And that's what makes me happy, really, because I see, for me, the parents and the child are the center of my work and clinical reasoning. And when I hear something like that from them, that's all I need to hear and we need to hear.
Martina:
And I would say that is the correct pinch point for me, is when I start to think about the motorex, in which I don't feel very familiar with when I see a some kind of motoric response. And then I ask the physio, is that the thing I'm thinking about? Do you think they see this? Which is not anything from my area? Or when I give a child support? And someone says, oh, yeah, that's the thing I wanted to do. When I just go out from my discipline. Yeah, that's when I feel good.
Don't get me wrong. Sometimes I'm not even sure if a child is seeing in that part of the visual field. Of course, I'm not I'm always questioning myself. But when I step out of my comfort zone, that's when I think I'm learning the most.
Steps to become more transdisciplinary
Kassy:
So how do you guys facilitate the transdisciplinary model? What are some steps that we can take, even if they're small, to become more transdisciplinary, to maybe step from multi to inter or inter to transdisciplinary?
Martina:
I think firstly, it has to come from above, the principal or the head of the… has to be up for it because it requires much time and the energy is very time consuming. We'd have meetings like three times a week after we are finished working with children. Sometimes you do not get to go to the computer and write everything you need, because you have a staff meeting. So yeah, that I would say. Of course, the thing I want to mention, I think it's working together, you have to always be willing to share your knowledge and not to keep it for yourself because it's in the best interest of the child. I'm not afraid that Hrvoje will steal my work or my job I'm willing to share, and he will take what he needs for himself. Yeah, I think when you hire new people to know that the organization is open for that everybody is willing to share their knowledge. You have to have that kind of team that kind of people.
Hrvoje:
Yes, I will add to what Martina said. We are really in some way forced interdisciplinary because why? When I came here, I really didn't know how I need to approach to some child. Does he sees me? Does the child can hear me? Does a child want me to touch his shoulder or face or something? Then I started to ask my colleagues who worked here already. Okay, can you tell me please how can I do this? How can I do that? What the child is feeling? What the child is seeing, hearing or something? And then I started to learn, okay, I cannot work with these children alone.
I must ask someone because I didn't know such many things as I know now and every new person, every new employer who come here is some kind of natural thing to start asking people, because our children are really children difficult to work with. They're really challenging. And I think, okay, we need to have principle and transdisciplinary approach and time for that. But I think it comes natural for us, because children are really challenging. And every expert, at one point understand that he or she has to ask someone else, and that we have to work together to make the best possible treatment activities and plan for child.
Martina:
And we are also lucky, because, of course, we have different kinds of laws here in Croatia, where a physio has to see how many seven kids a day in health care services, system. And here we have that luxury, that we do not have to have a specific amount of children per day, I have to work, for example, six and a half hours per day, directly with children. But the organization is structured that way that we have the time. And we always find the time to have that, what you said five minute meeting, and it's easier for us to work. When everybody comes to the group or comes to work with the child. You don't have to speak anymore about that. You already know what you're doing. And what's your goal. And it's easier. It looks like it's time consuming, but actually it's not.
Kassy:
Yeah, it's like that return on investment.
Martina:
Yeah, yeah.
Kassy:
So I know we're getting close to time. And I do kind of want to wrap up. Everything that you guys have said is really helpful. And to summarize, working together is one of the things that I heard like scheduling co-teaching times also be open to sharing your knowledge. I think there's a lot of fear of not like I have to keep this knowledge for myself, but will they judge me because I'm not good enough? Is my information good enough?
Here, at least in the United States, there's a lot of, a lot of not sharing of information simply because they don't really believe in themselves as a professional as the expert of I do have something to share. And yes, you do need to do it my way. And I will do it your way. And vice versa. But cultivating those relationships, and it's not just one sided, and then the short but consistent communication, where you can't just ignore your coworker for two weeks, and then come at them and say like, I have this five paragraph email that I want to share with you. Because that's not gonna work, a quick meeting a text, but also doing that before you see the student or even after, but before you see them next time, so that way you come together to the student as a united front, instead of figuring it out as much in front of the student..
Martina:
I just remembered something we also have now… I think we had it last year. We also have a team buildings, and we try to work on relations inside the team. It's also something that is important. And you have to have like you said happy hour or something not all of us get along and and all of us go for coffee. But you have to have something like we have supervision for two teams for professionals working with children. And that is that one, i dont’t know if it's supervision in English, but it's called in Croatia, when a person comes and we talk about different problems, but in human relations, not in working or working with parents also. So I think that is… they had that supervision from their beginning, I think hearing. It's also an important thing.
A step forward with Martina and Hrvoje
Kassy:
Love it. I know we've given a lot of tangible tips and action items, which I really like to do within our conversation. As we wrap up. I'd love to know from each of you, if you could give one piece of advice for our community to take a step forward into being a more transdisciplinary type of professional, what would you say they could do?
Hrvoje:
Interesting question for us, I would say that, just be aware of what you know, and what you can know better in future and be open to advices from other colleagues for more experienced colleagues. And when we are not sure it's completely okay. There's so many things that I don't know and maybe I will never know. But if I get from day to day, if I get aware of one or two things that I could be better in. Okay, now, I know that tomorrow I want to be better in that. And I think we need to know what we know. Where can we get more experienced and better and from day to day, we will learn a lot, we will get more…
Kassy:
Competent?
Hrvoje:
Yes, more competent. And we could give the best of us for children and parents and also our colleagues.
Martina:
I would say, in any other profession, you have to know that you will be learning until you go to retirement and maybe after that, and maybe to gather around people you want to learn from, you will see that if, as I said, there is some part that you don't not know, try to find the person you that's willing to share their knowledge with you from that area and see what you can give to them. So if like you, you are not a part of that center, but maybe you can find some people from there that can give you the information you need and you can share your information in your best interest.
Kassy:
Love it. Well, thank you both so much for your time and for coming on the podcast. It was so amazing to get to learn from you in this little less structured way. I really appreciate it.
Hrvoje:
Thank you, Kassy.