Why we need a concept to describe collaborative support instead of labelling children as demanding: perspectives from Finland

Abstract

In this article, we draw on our research and expertise in a problematic concept of ‘demanding special support children’ in Finnish early childhood and basic education, and the scarce international research, to propose a concept regarding multidisciplinary and collaborative support for children. Our conceptualisation shifts the focus away from children’s deficits to effective collaborative practices surrounding the child. This can facilitate comprehensive support practices without labelling children as ‘demanding’ based on their disabilities.

Keywords:

• Inclusive education
• special education
• multidisciplinary collaboration
• interprofessional support
• disabled children

Introduction

The number of children needing special educational services has increased in many nations (e.g. NCES 2022; Taberner 2023). Although the core value of inclusion needs to guarantee that every child’s right to receive support in education based on their individual needs is met (UNESCO 2021), their access to timely and effective accommodations is being endangered by the increasing demand and a lack of adequate services provided by various professionals (e.g. Heiskanen et al. 2021). In Finland, concerns about inclusive schooling for all led to introducing the concept of ‘demanding special support’ (a direct translation from Finnish) in 2012 to describe multidisciplinary collaborative support for children in situations in which the pedagogical arrangements of the Finnish education support system were not sufficient enough (Kontu et al. 2017). This concept is recognised and practised by Finnish teachers but not officially included in legislation. Concepts and their definitions are often shaped by those who apply them in practice (e.g. teachers), and the intended meanings can change from nuances to substantial differences (Thuneberg et al. 2014). Thus, over the years, the concept has even led to exclusive education arrangements and talk about ‘demanding special support children’. Such terminology has become increasingly common due to varying situational challenges in meeting the needs of all. In this article, we draw on our research and expertise in a problematic concept of ‘demanding special support children’ in Finnish early childhood and basic education, and the scarce international research, to propose a concept regarding multidisciplinary and collaborative support for children.

Three tiers of support and demanding special support in Finland

In Finland, three tiers of support – similar to the Response-to-Intervention model (Fuchs and Fuchs 2005) – were implemented in basic education in 2011 and in early childhood education in 2022. The first tier of ‘general support’ is for most children. The second tier consists of targeted interventions for children who struggle. The third tier of ‘special support’ comprises more individualised and continuous support. The level of support a child receives is based on their teachers’ educational observations on children’s individual needs; formal diagnoses are not required (Thuneberg et al. 2014). However, despite this system, there have still been concerns that not all children in Finland are receiving effective support (Honkasilta, Pihlaja, and Pesonen in press).

Thus, in 2012, the concept of ‘demanding special support’ was introduced to describe multidisciplinary collaborative support for children in situations in which the three-tiered support was not always meeting their individual needs (Kontu et al. 2017). Such practices require interprofessional collaboration among special needs education, social work, and healthcare (Bricker et al. 2022). Since the concept was introduced, the focus has been on developing collaborative approaches to support children (Kärnä et al. 2022). They emphasise that support should be based on the child’s individual situation regardless of the ‘severity’ of the support tier or possible medical diagnosis. However, the concept of ‘demanding special support’ is sometimes considered a subset of ‘special support’ or a fourth tier of support, which has led to exclusive education arrangements. Children with disabilities have been placed in special classes based on their diagnoses or learning needs. This has even led to talk about ‘demanding special support children’. Similarly, terms used internationally – such as significant support needs, extensive support needs and enhanced special support (e.g. Ruppar, Roberts, and Olson 2018) – focus on the child’s needs within (special) education contexts instead of the comprehensive support they need both within the education system and from various other sectors. Internationally, models of effective collaborative support are unclear (e.g. Heiskanen et al. 2021). In Finland, work toward developing a concept of collaborative working methods instead of labelling children ‘demanding’ has begun (e.g. Alila et al. 2022). Clarifications on how to describe and efficiently organise collaborative support is scarce and unquestionably needed.

The purpose of this article is to propose a concept for multidisciplinary and collaborative support for children that shifts the focus away from their deficits to describing the methods used to support them. This will permit the development of comprehensive support practices without labelling children as ‘demanding’ based on their disabilities. Our article is timely, contributing the insight that education for all is not possible without functional collaborative support that consists of various actors from different sectors.

Conceptualising interprofessional support for special education

In developing our concept, we have focused on lessons learnt from two recent research and developmental projects in Finland. Both projects investigated educators’ perspectives on demanding special support, interprofessional collaboration and inclusive education. They also organised in-service teacher training sessions related to collaborative working approaches and supporting children with ‘demanding special needs’. First, in 2018–2021, in the project entitled ‘Research-based strengthening of competence regarding demanding special support in teacher and continuing education’ (Kärnä et al. 2022), we developed teacher education courses and formulated interprofessional collaboration practices in conjunction with other universities in Finland. We also examined support practices in schools and redefined the concept of interprofessional support based on empirical data. In the project called ‘Significant support in early childhood education’ (VAKA-TUVET Project 2022), we focused on demanding special support and interprofessional collaboration in the early childhood context. This project specifically identified conceptual tools relevant to early childhood education by considering the perspectives and practices of in-service early childhood teachers.

Our work for these projects was based on knowledge about current collaboration practices in demanding special support in Finland, which vary from structured daily routines (e.g. pedagogy) and flexible groupings to collaboration among those with different areas of expertise (e.g. hospitals, special centres for learning and consulting). For example, teachers often need consultation when they are adapting the curriculum for children with intellectual disabilities. In addition, children who experience traumatic events typically require immediate, intensive, and carefully planned interprofessional support, which may include working with medical professionals or communication experts. Recent educational reforms in Finland have emphasised interprofessional collaboration as a means of support for children (Alila et al. 2022). However, it is typically evaluated based on medical diagnoses, not the child’s situation as a whole (e.g. Honkasilta, Pihlaja, and Pesonen in press).

We learned from the project work that when interprofessional support is not ongoing, there is a particularly high risk that children are excluded from mainstream education (Äikäs and Pesonen 2022). Ongoing interprofessional support requires an intense and systematic approach, including expertise and responsiveness. Support should not be guided by medical diagnoses. It is also fundamental to ensure that support is available in all three tiers (i.e. general, intensified and special) in early childhood and primary education. We also learned that various sectors (e.g. education, social work, health care, rehabilitation) must adopt a common language, vision and practices (Äikäs et al. 2023).

Significant interprofessional support

Based on the lessons learnt from the aforementioned projects and our discussions, we propose the concept of significant interprofessional support, which emphasises the multidisciplinary nature and versatile possibilities of support and highlights the structures and systemic factors rather than the individual child. Significant interprofessional support can be provided at all tiers of the education support system, not only the special support tier. It is first and foremost praxis. The scope and intensity of the support should always be determined by the individual child’s situation and cooperation with their guardians. Further, all adults involved should have the values and attitudes toward inclusive principles that enable significant interprofessional support to be implemented smoothly.

Conclusion

In significant interprofessional support, responding to children’s individual needs requires intense, systematic and interprofessional approaches to work, including expertise and responsiveness. This is not so much due to the needs of individual children but to systematic factors (e.g. organisation and collaboration of different sectors) and professional-related factors (e.g. competence, values, beliefs). Successful significant interprofessional support requires a common language, vision, and practices among various sectors, including education, social work, health care and rehabilitation.

In the future, more systematic research into the common terminology of interprofessional working methods is needed. Finally, although our discussion is based on the Finnish context, this phenomenon is present internationally. Thus, we would like to invite readers of the journal to discuss the support characterised by interprofessional approaches to work by considering the following question: What barriers to and enablers of the development of collaborative practices can be identified? As education for all plays a central role in building socially sustainable societies, this discussion is unquestionably needed.

Disclosure statement

No potential conflict of interest was reported by the author(s).