Between an educational task and an idea for treatment: multiprofessional collaboration for supporting children “at risk” – a coordinator role in pedagogical practice

ABSTRACT

This article contributes knowledge regarding professionals’ experiences, conceptions, and expectations of a coordinator role in preschools/schools while multiprofessionally collaborating for supporting children “at risk”. Data were collected via semi-structured interviews with professionals involved in a project in a Swedish municipality intended to prevent children from getting into difficulties. Procedures for thematic analysis were followed, and Billig’s ideological dilemmas were used as a methodological tool. A coordinator role, assigned to head teachers, emerges as tense where dilemmas need to be addressed. The dilemmas are related to opposed, overarching ideas – education for “all” versus treatment for specific children – which require coordination. This article suggests that dialogues between actors need to be held when opposite positions can be articulated. To initiate and maintain such dialogues, a coordinator role is important.

KEYWORDS:

• Coordinator role
• multiprofessional collaboration
• prevention
• children “at risk”
• ideological dilemmas

Introduction

Collaboration between professional actors across organisational borders, for example, schools, health care, and social services to promote children’s development and health and prevent them from getting into difficulties is not a new phenomenon. Research and previous and ongoing initiatives both internationally and nationally in Sweden demonstrate confidence in multiprofessional collaboration (Anderberg et al., 2022; Coles et al., 2016; Cross & Cheyne, 2018; Enell & Denvall, 2018; Forbes, 2011; Johanssson et al., 2017; Swedish National Agency for Education & The National Board for Health and Welfare, 2021). Over time, such collaboration has been advocated and emphasised by national government assignments and legislation changes (Ministry of Education, 2017; SOU, 2021, p. 23). Nevertheless, studies (e.g., Blomqvist, 2012; Widmark, 2015) show a gap between ideals and practice because guardians for children in difficulties, need to act as coordinators of professional actors. This article focuses on a professional coordinator role in pedagogical practice.

This coordinator role is of particular interest because it is considered to promote cooperation while appearing complicated (Hewitt et al., 2014; Englund, 2017; Thelin et al., 2021; Widmark, 2015). According to Thelin et al. (2021), the holders of such a role need to solve and deal with perceived difficulties in collaboration. Thus, difficulties regarding the collaboration of professional actors (or lack thereof) are highlighted in previous research (Coles et al., 2016; Drugli et al., 2008; Enell & Denvall, 2018; Sjöman, 2018; Thornberg, 2012). For example, individual teachers carry out initiatives for children with difficulties without collaborating with other professions. This is in line with the Swedish Schools Inspectorate’s (2015, 2017) criticism that head teachers (also called principals and school leaders) do not create conditions for staff to collaborate with other professions. Also, systematic strategies and head teachers’ opportunities to organise and promote supportive activities are reported as inadequate. Despite the idea of collaboration as an almost universal solution to problems, fragmentation tends to happen regarding professionals’ initiatives for children in difficulties (Coles et al., 2016; Englund, 2017). However, research on multiprofessional collaboration for the prevention and promotion of children “at risk” still seems rather sparse (Allcock, 2019; Hjörne & Säljö, 2021). Additionally, professionals’ understanding of the implementation of such initiatives is still under-researched (Cross & Cheyne, 2018).

This article is based on an interdisciplinary study in which we investigated a pilot project in a Swedish municipality (2018–2020). Its intention was primarily to prevent children from getting into difficulties through improved collaboration between education, social services, and healthcare (x municipality, 2017¹ [location anonymised]). The project was intended to benefit children not yet in difficulties but who could end up so. In this article, these children are called children “at risk”. The project was based on a local political decision initiated by the social services in the municipality and mainly implemented in some of its preschools/compulsory schools. The coordinator role assigned to the head teachers in these schools was supposed to be a link between families and others involved (x municipality, 2017). How head teachers and other professionals at different levels in various fields of this municipality, perceive and experience the responsibilities and tasks that the coordinator role is considered to comprise, is the question this article answers. The purpose is thus to contribute knowledge regarding professionals’ experiences, conceptions, and expectations of a coordinator role while multiprofessionally collaborating for supporting children “at risk”. Exploring and thus contributing knowledge about this role can contribute to deeper understanding and provide a basis for dialogues (von Ahlefeld Nisser & Olsson, 2018) concerning multiprofessional collaboration.

Multiprofessional collaboration and coordination

Multiprofessional collaboration can take several forms and be defined in different ways. Our point of departure is a wide understanding of this concept, such as that different professions work together across organisational borders and accomplish something in common (cf. Englund, 2017; Germundsson, 2011). In a broad sense, collaboration in this current article is about society’s initiatives for children and their guardians. With the ambition of placing the coordinator role in a context, research on multiprofessional collaboration is first presented. Thereafter, studies on the coordinator role are outlined.

Previous research illustrates that multiprofessional collaboration is beneficial in comparison with actors acting individually when difficulties occur – difficulties mainly related to children’s individual shortcomings. For example, these collaborations have shown positive effects in reducing children’s absences from school (e.g., Gall et al., 2000), challenging behaviours, and for children’s academic achievements (e.g., Brown & Bolen, 2008) and more accessible support for children and guardians (e.g., Börjeson, 2017). Collaboration can support professionals in identifying target children and promoting professionals in sharing their knowledge of various supportive activities (e.g., Backlund, 2007). However, teachers are expected to be responsible for preventive initiatives (Bergnéhr, 2015; Sandberg et al., 2010).

Regarding collaboration processes, the importance of professional autonomy and reflection on how preventive initiatives can be understood in relation to other initiatives is emphasised by Backlund (2007) and Bergnéhr (2015). This includes drawing boundaries between multiprofessional collaborations and other activities to clarify professional roles. Hewitt et al. (2014) point out the importance of overlapping roles. They increased the continuity of work and promoted the scrutinising of decisions, joint responsibility, and mutual respect for and learning through different competencies. Other studies (Germundsson, 2011; Slonski-Fowler & Truscott, 2004; Spratt et al., 2006; Thornberg, 2012) highlight conflicts and mistrust between professions based on unclear assignments and conflicting expectations. For example, Thornberg (2012) describes some teachers’ involvement as lacking, and rather than collaborating with other professions, teachers sought relief from responsibility for supportive activities. As a result, this responsibility was taken over by a resource team whose professionals were not involved in everyday classroom practice.

Coles et al. (2016) formulate the significance of the coordinator as “a key role” (p. 355) in multiprofessional collaboration for preventive initiatives. However, this role has also generated criticism. Given preventive intentions, information is supposed to be shared between different professions at an early stage, which has raised concerns about the intrusion into and monitoring of a family (Thelin et al., 2021). It is also noted that this role reduced children’s and guardians’ involvement, due to the intention that families should not have to attend as many meetings as before (Coles et al., 2016). However, a coordinator role can change over time. As Englund (2017) illustrates, this role became less important over time, which is understood as the fact that collaboration had become permanent. Simultaneously, Englund illuminates a negative development regarding the clarity of roles.

The coordinator role thus appears to be multifaceted and given that multiprofessional collaboration is seen as a process, it is impossible to predict how this role is understood and developed in pedagogical practices.

Theoretical assumptions

As a theoretical framework and analytical tool, we use Billig’s (1991) theoretical and methodological concepts of ideological dilemmas. Ideological dilemmas are overarching dilemmas in society, such as offering children an equal education, while considering their individual differences (Nilholm, 2005). Rather than consisting of coherent building blocks, ideological dilemmas comprise contrary rhetorical positions, such as equal education versus individual differences. Nevertheless, a general expression such as “a school for all” may appear coherent, but dilemmas are revealed when polarities are positioned against each other. According to Billig et al. (1988), ideological dilemmas might appear in various contexts, for example, scientific and political, but also in people’s everyday talk. The different sides of a dilemma are somehow present but not necessarily visible to the individuals themselves. On the contrary, arguments can be understood as expressions of common sense (Billig, 1991). What is considered as such is not given but can vary over time depending on what is defined as “right”. Multiprofessional collaboration to solve perceived problems in schools can be understood as such an idea. However, an individual’s arguments to justify an idea may contain opposite positions based on ideological dilemmas.

Although a dilemma indicates something that can be perceived as difficult and limited in everyday life, Billig et al. (1988) argue that ideological dilemmas are productive, with the potential to, for example, improve pedagogical practices. Consequently, different positions on a particular issue are valuable, which can be illustrated by the question of whether children should be categorised as in need of support. Such a categorisation draws attention to children’s needs, which can be met. However, categorising can construct children as deficient, negatively affect their self-confidence, and obscure the surrounding context. Thus, both positions are potentially positive, while one-sided arguments at the expense of others are “risky” (Börjesson & Palmblad, 2013, p. 97).

In this current article, ideological dilemmas are fruitful for analysing both opposing logics in the participants’ reasonings regarding a coordinator role and general dilemmas operating in the educational context.

Methods

The aforementioned pilot project that we investigated was carried out in a medium-sized Swedish municipality. Initially, two preschools and one compulsory school were involved, and after one year, another preschool was included. Qualitative and quantitative data were collected for two years (2018–2020) via interviews, observations, and surveys. This article is based on semi-structured interviews, which made it possible to examine in-depth the participants’ experiences, perceptions, and expectations of the coordinator role.

The interviews were conducted at the end of the pilot project’s first year (29 interviews) and second year (18 interviews) with informants at the project’s decision level (e.g., head school administrator and head of social services) and at the implementation level (e.g., head teachers, teachers, school social counsellors [in Swedish “kuratorer”], social workers and nurses). All the head teachers had a coordinator role. To facilitate an understanding of this Swedish municipality some of the titles and professional roles of the informants are described briefly below:

1. Head school administrator [in Swedish: “förskolechef/grundskolechef”] – the civil servant with overall educational responsibility for the management and direction of all preschools/compulsory schools in the municipality.

2. Head of social services [in Swedish: “socialchef”] – the civil servant with overall responsibility within the municipality for the delivery of social services and the management of social workers.

3. Head teacher [in Swedish: “rektor”] – the head of an individual preschool or compulsory school and the management of its teachers.

4. Teacher– a qualified professional with general teaching competence. This term also includes teachers with qualifications in special needs education; special educators [in Swedish: “specialpedagoger/speciallärare”].

The first-round interviews involved all informants who were part of multiprofessional teams, which were created within the municipality to support the implementation of the project. The second-round interviews included a selection of previous informants and newcomers with similar assignments and additional teachers outside these teams. These additional informants were understood to have knowledge of a tool developed for identifying the target children for the project. Nine of the informants participated in both the first and second interviews. Overall, the selection of informants can be described as both a strategic and snowball selection (Bryman, 2015), consisting of the informants with presumably good knowledge of the project and the teachers to whom the informants conveyed contact information.

The interviews were based on an interview guide, where we sought the participants’ expectations, perceptions, and experiences of the coordinator role. This article’s authors and another researcher conducted the interviews, which lasted between 30–90 min and were recorded and transcribed verbatim. We translated the excerpts presented in this current article.

This study was approved by the Regional Ethical Committee, Sweden (Dnr: 2019-02115) and in accordance with the Swedish Research Council’s ethical principles (2017), informed and written consent was obtained. Ethical issues were considered throughout this study. Thus, participation was voluntary, and the informants could withdraw from this study at any time. In this article’s Results section, we have anonymised the municipality and informants by removing local formulations related to the project. To avoid identification of the heads their organisations have not been specified.

Data analysis

The selection of interview data for this article was made based on its relevance to the coordinator role. Initially, the data were analysed inductively, inspired by Braun and Clarke’s (2006) thematic analysis. Our analysis started with reading the transcriptions to familiarise ourselves with the data, that is, reading and rereading the data and noting initial ideas about the coordinator role. Initial codes (e.g., responsibility, mandate, contact) were extracted using interesting features of the data. The codes were sorted into potential themes intended to capture important findings regarding the purpose of this article and to represent a level of patterned responses or meanings within the data. We then reviewed the themes, and they were checked in relation to the codes and the informants’ statements. The following overarching themes were formulated: “to coordinate the “new” with existing practice” and “to coordinate initiatives for families”. Within each theme tensions between opposing rhetorical positions emerged. These positions were understood as ideological dilemmas and constructed as subthemes: top-down governance versus professional autonomy and the public sphere versus the private. In summary: Two overarching themes and two subthemes were constructed:

1. To coordinate the “new” with existing practice

   • - Top-down governance – professional autonomy.

2. To coordinate initiatives for families

   • - The public – the private.

To ensure the quality of the analysis, as a team of authors we discussed and compared our interpretations of the original material and the categorisations we devised during the analytic process. Various categorisations were tested, rejected, and changed. Additionally, versions of the findings were presented to participants in the multiprofessional teams to ensure the interpretations of the informants’ perspectives were reasonable (cf. Bryman, 2015).

Results

The head teachers describe their coordinator role as central and as a fact through the recurring metaphor “the spider in the web”. But their described experiences and other informants’ reasoning about what the holder of the role is expected to do, achieve and be responsible for, construct a complex and tense role, which is presented in the themes described above. Initially, an overview of each overarching theme is given, and thereafter, ideological dilemmas that appear within each theme as subthemes are presented.

To coordinate the “new” with existing practice

Through the coordinator role, head teachers are assigned responsibility for the existing practice, while they are expected to integrate something “new”, a pilot project. In this respect, a head teacher’s role and the coordinator role appear intertwined. Simultaneously, the “new” can be understood as part of existing practice, for example, in terms of prevention and collaboration with child/student health care.

Head teachers must consider the time of the teachers and what should be prioritised. Like other informants at the implementation level, the head teachers express that the “new” can be coordinated with existing activities, such as discussions of a child’s situation and his or her perceived needs in preschool. As one informant puts it, “So it’s nothing new, nothing isolated from other things”. At the intersection between the “new” and existing practice, head teachers must thus prevent isolated activities from being created. At the same time, the existing practice appears as in need of change, or as informants formulate it: “The school shouldn’t have to solve everything”; “we run after” children, “children roll around in isolated initiatives”, and “one actor doesn’t know what the other does”. The intentions of the project seem to be shaped by the idea of shortcomings, where the existing practice is constructed as inefficient and narrow; the collaboration between professionals is insufficient, efforts are made too late and time is wasted.

To support the implementation of the project and the coordination of the “new” with existing practice, multiprofessional teams are created. Through their recurring meetings, the collaboration between head teachers and other professions is formalised. It is no longer up to individual head teachers to create informal networks that can cease when changing employment. Head teachers have dialogue partners outside of their organisations. By getting to know each other it seems easier to get in touch with other professionals and act as coordinators. As one of the head teachers puts it: “Then I can just pick up the phone and talk about what’s happened”. Other informants also describe those contacts as positive:

When I call the preschool head teacher, it feels like we have something in common that we should work together. So, it already feels like we are all on board (Nurse, first-round interview)

However, the created networks and dialogues do not seem to meet the project’s intentions regarding the children who are intended to be the subjects of preventive initiatives. According to the informants, it is unclear which children to involve. Head teachers must consider the existing requirement to support children who have already been identified as being in need of special support. These needs are described as extensive, especially concerning older children. The project was intended to benefit children who are not in difficulties but may end up so. In this respect, problems arise for head teachers regarding how the “new” should be coordinated with existing practice, that is, how preventive initiatives should be carried out in daily activities with their requirement, besides promoting all children, to provide special support to some.

A year after the project started one of the multiprofessional teams was replaced by child health care teams in preschools and an expanded, existing student health care team in compulsory schools. These teams are strengthened by professionals from social services and health care, and collaboration between the various professions is perceived as positive. The head teachers become self-described formal leaders for these teams. Based on the development of existing structures for collaboration in which head teachers already have an obvious role, their coordinator role appears to be more prominent. Also, professionals at the decision-making level seem to strive to strengthen the mandate of the role:

Maybe [we] need to tell the head teachers that they have been mandated to assign tasks to others. I’m constantly asked:” How much time can we spend on this?” The answer is: “The time the head teachers think you need to spend”. (Head, second-round interview)

Over time, changes in the division of labour and meeting structures are also illustrated. From the fact that these at first seem unclear and create ambiguity regarding the responsibilities and tasks of the coordinator role, intentions, and the role seem to be clarified.

Although the mandate of the coordinator role appears to be strengthened, it seems problematic for head teachers to convince teachers of the project’s benefits, a project that teachers have not initiated. This raises questions about how the project should be run at local preschools/schools.

Top-down governance – professional autonomy

Questions concerning governance relate to how the project is justified in informants’ arguments about the shortcomings of existing practices. In this respect, both distrust and trust in professionals, including head teachers, are articulated. The informants express an assumed lack of commitment and ignorance among teachers which is said to require top-down governance:

I don’t think they always do what they say theýre going to do at social services. That’s possible. But I definitely don’t think that they’re doing what they should be doing in schools. I think they have a much greater responsibility. / … / You also have the responsibility for the children who are not in school: “Why don’t you come to school”? You have to ask that question. It’s not done. If the school staff doesn’t get involved, it won’t work. Head teachers must be more visible. (Head, first-round interview)

Here, distrust is directed from above towards the head teachers and actors at a lower level. Professionals are positioned against other professionals, the social services’ against schools’. A hierarchical order is constructed in which the school’s professionals are positioned as less competent. Arguments are formulated that head teachers need to convey the right information and values to teachers in an authoritarian way.

Other arguments concerning governance also emerge, which are based on an opposite positioning in comparison with pointing out shortcomings, that is, trust. The need for collaboration between more equal parties is emphasised, where the head teachers are expected to promote networks and what can be understood as a more democratic form of governance. The competence of one’s profession is not considered sufficient, but others’ competencies must be added. Meetings across organisational borders, where the “new” can be worked out jointly, are advocated:

You have to trust each other’s different competencies and not handle something you don’t know. It’s fantastic that we can meet across organisational boundaries and develop relationships and ways forward. (Head, first-round interview)

The opposing logics that emerge in arguments about how the “new” should be coordinated with an existing practice, and for the project to be put into action, refer to an ideological dilemma. Tensions are revealed between top-down governance based on a local political decision initiated by the social services, that is, the social field and the autonomy of professionals belonging to the pedagogical field.

How head teachers should influence teachers to adopt the project’s ideas, regardless of the opposed logics of governance, is no easy task. A lack of preparation and establishment among teachers is pointed out, where their information and education are too sparse. When head teachers take an active role in the everyday activities of implementing the project, teachers are involved to a greater extent, but not all:

Since several children and families have received closer contact, I’ve been very close to some of the teachers. And probably, it can make others feel excluded. (Head teacher, first-round interview)

This ideological dilemma, top-down governance versus professional autonomy, is also closely linked to questions about the project’s idea. According to the informants, it means something beyond the educational task:

The school has a very clear … educational task. So, the [project] clinches with their values. We have to work on it. We can't just say that you´re obliged to do that. (Head, first-round interview)

There may be too much focus on wellbeing / … / It’s the treatment culture that is at the forefront. Yes, the individuals’ wellbeing affects everyday life at school, that’s it. But it may not be obvious for a teacher to take in just these bits of wellbeing. (Head teacher, second-round interview)

The excerpts indicate that the head teachers in the role of coordinator need to address tensions between protecting and extending an educational task against what is perceived as a treatment task, that is, coordinating different ideas based on different fields: the pedagogical versus the social. When the project is presented as too one-sided in terms of well-being, it seems to create resistance among teachers, and solely top-down governance is not expected to work.

This ideological dilemma also appears in the informants’ descriptions of the coordinator role in the organisation that develops by the project. By changing multiprofessional teams, reorganising the school district, and change of head teachers, the different logics, top-down governance versus professional autonomy, emerge as increasingly complementary. The mandate for the coordinator role seems strengthened, and the increased scope for teachers’ influences and responsibility for coordinating and running the project is described:

[Special educators] have been working together quite a bit and have developed some documents and tried to help the new head teachers get into work. It wasn’t easy for them to take over someone else’s work, so it was a long procedure. But now I think it’s clear. (Teacher, second-round interview)

To a greater extent than before, the project seems to be controlled by professionals positioned and positioning themselves as more autonomous. However, this does not preclude top-down governance from being requested, such as in the form of a general plan for how the project will be run in the preschools/schools.

To coordinate initiatives for families

Initially, expectations emerge from both head teachers and other informants that the coordinator role includes active participation in identifying children “at risk”, contacting guardians, and coordinating initiatives for these children. For such involvement, the head teachers are, at first, positive:

As a coordinator, I have a responsibility to relieve the parents by making contacts with different people. Earlier, they had to do a lot themselves. (Head teacher, first-round interview)

As part of coordination, the head teachers are also expected to communicate the need for preventive initiatives to one of the multiprofessional teams to receive advice. As mentioned, however, it seems unclear which children are intended to be part of the target group. Below, an informant illustrates how different perceptions between head teachers and the team create frustration:

Well, it’s difficult for the head teachers to identify the children. So, the proceedings are not clear. There has been a frustration [speaks for head teachers]: “We bring the children, but they don’t want them, because they are … [not the right ones]”. (Head, first-round interview)

This excerpt can be understood as an insufficient distinction between children with different needs. The problem is formulated in terms of proceedings but is more complicated. Categorising specific children as needing preventive activities is based on the idea, according to informants, that it is possible to “see clear signs” that children may end up in difficulties which have not yet been experienced. Also, head teachers are responsible for ensuring that a pedagogical practice promotes different needs: partly for children “at risk” and those who are not “at risk” with proactive initiatives, partly for children already in need of special support, with reactive initiatives. Thus, head teachers need to navigate between different assigned responsibilities.

Over time, the head teachers’ active involvement in initiatives for children “at risk” appears to be too time-consuming. A more peripheral coordinator role is described where tasks can be delegated:

If you have a case where the school nurse or the social services is working, it rolls on without me being involved in it; they report to me on the student healthcare team. They work a little more on their initiative. For me, it has been an improvement. / … / They don’t have to ask me as soon as they initiate or continue an initiative. It will be impossible for me to be involved in every single meeting with parents. (Head teacher, first-round interview)

Gradually, identifying the children shifts from the coordinator role to the teachers. The coordinator role is now seen to include introducing and motivating a tool for the teachers, consisting of preformulated questions that are supposed to identify specific children. The indicators of the tool are intended to control what professionals should focus on through various indicators of a child’s well-being, to map the child’s “life situation” based on a “holistic view” (x municipality & region, 2020²). The coordinator role is assigned responsibility for documenting preventive initiatives for particular children. A specific plan for an individual child is introduced, which is supposed to create a common picture of the needs and initiatives for the involved professionals and families (x municipality, 2020). Thus, the role includes responsibility for a plan to be initiated at an earlier stage than other documentation about children in need of special support.

Overall, preventive initiatives for families raise normative questions concerning what is perceived as the best interests of a child and who is best suited to represent those interests – the children themselves, their guardians (and), or representatives of society, such as the holders of a coordinator role (e.g., head teachers).

The public – the private

Formally, the coordinator role is assigned a social and public responsibility to ensure a child’s best interests. This includes the head teachers’ involvement in the private sphere, the family. Although the informants position themselves as obviously positive towards a preventive ambition, a dilemma needs to be addressed:

If we act earlier, we can reduce the risks of things going really badly. At the same time, there’s a moral dilemma. What should we be involved in, sort of the families … . How different can you be? And what makes children suffer? I can understand that it’s difficult for staff to point out something that isn’t really clear. It can be seen as a violation of the family. (Head, first-round interview)

Thus, head teachers need to navigate this ideological dilemma and its tensions between the care of children and individuals’ right to privacy. However, children’s guardians need to give consent to preventive initiatives, which can be an attempt to bridge the public and private spheres. Head teachers’ contacts with guardians are described in various ways, such as that guardians have asked for help, that they have been “grateful” for the initiatives and that head teachers have been met with a “big no”. In the following argumentation, however, the dilemma is not explicit. Instead, relationships are constructed as the reasons for guardians’ attitudes:

Relationships are of great importance. So, you can consider who should really have a coordinator role. We had a meeting with the special educators. They said: “We do this; it’s special educators who hold all the strings”. (Teacher, second-round interview)

As guardians are expected to be more positive in meetings with someone whom they already trust, the coordinator-role holder is questioned. However, head teachers continue in this role, but it seems to be shifting from active involvement regarding these contacts to becoming more peripheral. This shift can be understood as a way to bridge the opposite polarities within the dilemma. A more well-known societal professional actor, such as a teacher who is involved in the private sphere, may become less of an outsider from a guardian’s perspective. Nevertheless, this does not answer the question in the previous excerpt about what can be regarded as risk or natural differences. Accordingly, questions are at stake about what the subject of coordination should be and why.

Questions can possibly be handled and answered through the aforementioned tool introduced to facilitate the identification of children “at risk”. By arguing that staff should meet all children, the head teachers shift the responsibility of identifying the children to the teachers:

Well, I presented that we’re looking at this tool, which might be something we can use to identify if there’s something that a child lacks to feel well. As head teacher, I don’t meet all children and parents, but the staff participating in the activities with eyes and tentacles; they must be the ones who raise the alarm. So, our challenge is now, that … you got that question when I presented this: “Well, it’s something that comes from above”. (Head teacher, first-round interview)

Although head teachers seem to meet criticism from teachers by introducing the tool, the argument wins approval, among others. However, the tool raises questions regarding the pedagogical task. Using the tool “is about so much more”, as a social worker puts it, and criticism is indicated if “the pedagogical” is not exceeded:

It’s important that you [refers to the teachers] don’t solely ask about the pedagogical. Because you only know a small part of the situation, and then maybe the new info doesn’t say much. But if they perceive the child’s entire life situation, perhaps they understand that the new info together with this and that means that it has taken the next step in severity: “Now we must act”. (Head, first-round interview)

When the task of identifying children seems to be shifted from the coordinator role to the teachers and they are expected to act outside of their pedagogical function, resistance is expressed:

The focus is on wellbeing. If we’re the ones to collect information based on the tool, you’ll encounter resistance at school: “No, it’s not our task”. Even if it lays the foundation for my teaching, you don’t think … . “No, this can be handled by a school social counsellor or school nurse or someone else / … / I wouldńt have designed it like that. (Head teacher, second-round interview)

The excerpts above illustrate the professionals’ resistance to a too-narrow perspective, based on different points of departure, that is, the social and the educational, on how children should be identified. When “wellbeing” is perceived as too dominant, at the expense of a pedagogical task, ambivalence emerges among head teachers regarding the tool: for whom or by which professionals should its use be justified?

Then, we’ll also use it more from the student health perspective, so the school social counsellor will use it in their conversations. They already use about the same questions. So, it’s just a matter of syncing together the questions with those in the tool. / … / It adds a common professional language. / … / Do they work according to the tool? No, not all. Definitely not. Should they even do that? That’s another question. Or is it for the social counsellor? I think it’s difficult when you need to spread out a task to everyone. (Head teacher, second-round interview)

Above, the question emerges as to whether a school’s social counsellor is a more suitable representative of society’s involvement in the private sphere, the family, than a teacher. Tensions between care and integrity are thus shifted from the pedagogical to the social field for the involvement of society. However, this does not solve the ideological dilemma; it simply reappears in other forms, such as via questions about the documentation of preventive initiatives.

As the holder of a coordinator role, head teachers are responsible for ensuring that documentation is drawn up at an early stage when risks are perceived. Consequently, it must be handled by a societal representative and stored and possibly shared with other professional actors outside the private sphere. The documentation, which can concern a child’s private situation and the one in preschool/school, raises questions:

So, there’s quite a lot to think about from the child’s perspective. What’s good for the child? Do you make the problems bigger than they are? How does the child perceive what will be written? I think about the child’s self-image and development. (Head teacher, second-round interview)

The responsibility for and the task of documenting appear to be ethically problematic. The documentation is described as complicated by informants in different fields at the implementation level. Over time, issues concerning documentation do not seem to be sorted out in a common manner but are handled by head teachers in various ways and different forms.

Discussion

This article contributes knowledge regarding professionals’ experiences, conceptions, and expectations of a coordinator role in preschools/schools while multiprofessionally collaborating for supporting children “at risk”. In summary, the coordinator role emerges as important over time, which also confirms prior research (e.g., Coles et al., 2016; Hewitt et al., 2014). However, its position appears to be changing to become more prominent regarding coordination with existing practices and more peripheral regarding coordination of initiatives for families. These motions are not necessarily contradictory but can rather be understood as a way to navigate ideological dilemmas (cf. Billig, 1991).

The ideological dilemmas, presented under dichotomies, top-down governance versus professional autonomy and the public sphere versus the private, relate to general questions of governance of education and professional responsibility. The preschools/schools in Sweden are politically controlled, while their practices must be able to control themselves via the professionals. Professionals’ responsibilities include caring for children and guardians’ involvement, where their integrity may be at stake when private circumstances are affected (Coles et al., 2016). Thus, all these positions have relevance and need to be articulated. In previous studies, a coordinator role emerges as multifaceted and complicated (e.g., Coles et al., 2016; Englund, 2017) with demands to solve difficulties in collaboration (Thelin et al., 2021). Through this article’s theoretical framework, ideological dilemmas, an additional layer of complexity is added. The identified dilemmas cannot be solved, but they need to be addressed by professionals in a coordinator role. Also, the analysis shows a broader task for these professionals than coordinating initiatives for families and integrating these with existing practices. The role also encompasses the coordination of opposing ideas.

The role holders, that is, in this case, head teachers, can be understood as involved in a professional context where different traditions with an emphasis on different logics meet – education, a pedagogical task, and the treatment of children, a social task. The project was initiated by social services, with its specialisation in children’s and guardians’ problems and how they should be treated. The project was carried out in preschools/compulsory schools not specialised in such issues, although children may require various types of support. Schools are specialised in providing education for all children, regardless of their needs of support. Thus, it is at the intersection of these logics the head teachers need to balance.

The analysis shows that when one logic emerges as dominant, coordination difficulties seem to arise. When “the social” appears to prevail, resistance from professionals in the educational field emerges. On the contrary, when “the pedagogical” is too dominant, it is argued to be too narrow a view. We suggest that such overarching logics need to be articulated and discussed at and between different organisational levels, both within and between organisations, and not just become a matter for a coordinator role.

The logic above can be linked to questions regarding how preventive initiatives, the subject of coordination, relate to other activities. In this article, the coordinator role is intertwined with a head teacher’s role. Thus, additional complexity can be attributed to a coordinator role via head teachers’ different responsibilities to ensure that practice meets children’s varying needs. Besides the responsibility for prevention for specific children, it also includes reactive initiatives for children in need of special support and the promotion of all children’s development. In turn, overall responsibility can relate to different ideas:

For children presumed to be “at risk” or already in difficulties, it is a matter of eliminating or reducing risks. Promoting all children is based on something that already works. Distinguishing prevention initiatives from others, as Bergnéhr (2015) suggests, can here be understood as complicated. Whether professionals with intertwined roles, such as head teachers, have an interest in distinguishing different initiatives is another question. However, the analysis indicates that a coordinator role is individual-oriented. Like other studies (e.g., Brown & Bolen, 2008), children’s perceived shortcomings are in focus, in this case emerging ones. Thus, the role is in danger of becoming one-sidedly focused on children as problem carriers, which may overlook how educational contexts, such as school environments or teaching, affect or create perceived problems. To prevent such one-sidedness from becoming dominant and marginalising other approaches, we advocate that dialogues be held within and between different professions. As Thelin et al. (2021) suggest, questions about for what, for whom, and why initiatives are carried out is essential.

This article contributes knowledge of the coordinator role through professionals’ experiences and perceptions. Given the theoretical framework, this article also contributes to a deeper understanding and provides a basis for critical dialogues of this role and multiprofessional collaboration (cf. von Ahlefeld Nisser & Olsson, 2018). A methodological strength is that the data were collected from different professionals from various fields and organisational levels on different occasions. The interdisciplinary collaboration between us researchers through our involvement in data collection, analysis, and negotiation of the results is another strength.

Regarding the limitations of this article, the informants cannot be representative of the actual professions in general, which we do not claim, as qualitative data have been collected. However, given the general theoretical assumptions, this article may be transferred to other contexts (cf. Olsson et al., 2020). Data were collected during the implementation of the project, and the results formed part of an ongoing process, not a completed project. The selection of informants can also be discussed. The teachers were involved with presumably good knowledge of the project or through other people’s contact information. Overall, these informants expressed themselves in positive terms. In this respect, the voices of additional teachers could have been valuable for more varied experiences and perceptions. Nevertheless, the empirical data can be understood as rich, consisting of informants’ different perceptions and described experiences. However, the voices of children and guardians are missing despite our ambition for their involvement. It proved difficult to obtain contact information for the families involved in the project during the timeframe of this study. Hence, the perspectives of children and guardians are important to investigate in further research.

In conclusion, we would like to point out that this article’s exemplified ideological dilemmas are not new, but this is the point. Over time, they appear in new forms, in this case through the “talk” of a coordinator role for multiprofessional cooperation. Here, we do not provide an answer to who should best assume such a role, but regardless of its holders, dilemmas will return. The question is, then, how they will be addressed. Like Billig (1991), we argue for the importance of clarifying opposing positions of dilemmas. Thereby, differences are not necessarily constructed as individuals’ shortcomings and distrust, as our article and others illustrate (e.g., Thornberg, 2012). Instead, opposite arguments can be the basis for fruitful dialogues, and in this regard, we see the coordinator role as important for initiating and maintaining such dialogues. Hence, as Billig suggests, dilemmas can be resources in preschool/school practice where collaboration and coordination have a place.

Acknowledgments

The authors wish to thank the leader of this research project Dr. Kari Jess, School of Health and Welfare, Dalarna University, who contributed to this article by collecting data.

Disclosure statement

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

Additional information

Funding

This work was supported by Dalarna University and a Swedish municipality [grant number 9.1-2018/1409].

Notes

1 Unpublished material.

2 Unpublished material.