Strategic Direction 2: Champion a connected system
In this section:
Ontario Autism Program-Durham partnership
While the name has changed in recent years, our partners at Resources for Exceptional Children and Youth-Durham, Lake Ridge Community Support Services and the Regional Municipality of Durham have long collaborated with us to co-deliver services to clients and families across Durham Region.
When the Ontario Autism Program (OAP) was established in 2017, this partnership began to be referred to as the “Ontario Autism Program – Durham (OAP-D).” We are the three lead agencies for applied Behaviour Analysis (ABA)-based services in the Central East Region of the Ministry of Children, Community and Social Services.
Through this partnership, we provide three OAP-funded Caregiver Mediated Early Years Programs (e.g., Social ABCs, PLAY Project, Project ImPACT), as well as the Entry to School Program.
The success of this partnership is felt across all levels of governance and operations. We are one team. Interconnectedness has become a core value of our work. This references a collaborative, interdisciplinary approach to problem-solving and service delivery, where the strengths of every staff member and each partner organization is recognized and amplified to contribute to collective success. A deep trust has been established after years of working together toward a common goal of serving clients and families and championing inclusivity across our community. And we are energized by the continuous opportunities for innovation and quality improvement to further enhance OAP services in the Durham Region.
School-based Occupational Therapy Tiered Service Model
During focus groups with caregivers, we heard that long waitlists for school-based Occupational Therapy (OT) was a major concern for parents and families. Some clients were waiting four years before receiving services. We needed a change to improve access to these needed supports so students could better access the curriculum and receive earlier intervention.
In Fall 2023, we rolled out a Tiered OT Model in 87 early adopter schools. This model provides students and schools with the right help, at the right time, in the right way. It builds greater capacity within our school partners to support diverse learning needs, while also reducing intervention wait times for students who may require more tailored approaches.
- The first level of service is Tier 1, which provides strategies that are beneficial to all. This level is provided through universal consent and does not require a referral to occupational therapy. Tier 1 may include resources, problem solving with educators, in-class activities or activity centers, and workshops for educators and caregivers.
- Tier 2 services require the educators to have a discussion with the OT supporting their school prior to referral. This level of service is beneficial for some and is supported by short-term services and needs-based observations.
- In Tier 3, services are specific to one client and include an individualized assessment and plan of care for intervention and/or equipment.
All of theearly adopter schools received Tier 1 support in 2023-24, with over 939 hours of time directed toward Tier 1 services in these schools. Benefits include decreased referrals requiring completion for educators, with this time re-invested back into classroom activities. We have also enhanced access to resources for caregivers and school staff. Communication between Grandview staff and school staff has improved.
Most notably, the capacity of educators to support their students, or apply knowledge to future students, has improved. This also has helped Grandview staff be more quickly respond to requests for support from schools.
Feedback from school staff has been positive:
- “I am liking it so far. I feel like it gets faster results for kids needing the lower support levels instead of being on long waitlists.”
- “This was the best year for occupational therapy and that a lot was accomplished this year, more so than other years. Communication has been amazing. The program has been seamless for our school.”
We are preparing for a full launch to all Durham Region elementary schools in September 2024. This will add another 94 schools receiving this OT tiered model of service delivery, including two French school boards.
Extensive Needs Service
Our partnership withHolland Bloorview Kids Rehabilitation Hospital, Michael Garron Hospital (MGH) and Surrey Place was announced at an exciting event in October 2023, sharing how our agencies will combine efforts to deliver the Extensive Needs Service (ENS) to children and their families across the Greater Toronto Area.
At Grandview Kids, we continue to see children and youth experiencing challenges with behavioral regulation, elopement, severe aggression, communication delays, and even difficulty completing the most basic daily tasks, such as dressing and bathing. We have struggled to match our current service offerings and capacity to these families’ extensive needs. Families tell us that they have no options. That they feel helpless. That they have done everything to help their child, but it’s not enough.
Funded by the Ministry of Health and the Ministry of Children, Community and Social Services, this program was developed for children who have multiple neurodevelopmental, behavioural, medical and physical needs, as well as social vulnerabilities – kids who have otherwise fallen through the cracks of a complex health and developmental services system. Overall, the program is designed to reduce barriers to accessing timely, evidence-based treatment for some of the most vulnerable children in the province.
Extensive Needs Services (ENS) are delivered at Grandview Kids in partnership with Holland Bloorview Kids Rehabilitation Hospital, providing intensive, coordinated, time-limited wraparound service to children and youth who have complex interfering behaviors. ENS brings services closer to home for clients and families in the Durham Region. The services are provided by a team of professionals, including physicians, nurses, social workers, behavioral analysts, occupational therapists, speech-language pathologists, dietitian, recreation therapists, service navigators, peer navigators and research coordinators.
“The impact of ENS is significant and immediate. It prevented us from losing our kids and home. Our daughter’s therapy is vital to her life.”
ENS Parent
Internal referrals began in 2023-24, with external referrals opening up in Spring 2024.
The innovative, much-needed Extensive Needs Service underscores the power of collaboration, seamlessly coordinating care across clients’ medical, therapy and school teams to enable the best possible outcomes for children and their families.
Ocean eReferral
As part of our digital transformation journey, we continued to work with our referring agencies to move from the paper-based referrals to electronic referrals using the Ocean platform. Last year, we launched a pilot in June 2023 with our school boards and gradually transitioned all eight school boards (English and French) to submit School Based Rehabilitation (SBR) referrals electronically by Fall 2023. All schools are now submitting SBR referrals electronically – 100% of the time.
We also launched electronic self-referrals that clients and families can submit as part of the SmartStart Hub initiative. Similar eReferrals have been created for our Ontario Autism Program – Durham Partnership, where families are directed to our electronic platform to submit their referrals for Entry to School and Caregiver Mediated Early Years Programs.
We are continuing our digital transformation journey and working with our Preschool Outreach Program (the last group of referring agencies) to move to our electronic platform when submitting referrals.
Best Start Network
Executive Lead Dr. Taryn Eickmeier was elected the Co-Chair of Durham’s Best Start Network this year. This Network is a collaborative table of agencies focusing on service delivery for children from birth to 12 years. Alongside Co-Chair Julie Gaskin, Director of the Children’s Services Division at The Regional Municipality of Durham, the vision and mission of the Best Start Network were revised. Hundreds of ideas of how to Network hopes to impact the lives of families were consolidated and reviewed. With a renewed vision of “Happy Childhoods, Better Futures,” Dr. Eickmeier will continue to work alongside community partners to mobilize best practices in child development and rehabilitation sciences to children, youth and those who care for them.
Black Creek Pioneer Village/Surrey Place partnership
On November 25, 2023, we held a Relaxed Visit Day in partnership with Black Creek Pioneer Village and Surrey Place – the Children’s Treatment Centre in Toronto. We created a program plan informed by consultation; providing Ability Acceptance training for Village staff; made recommendations for improved wayfinding, including sensory trigger warnings in Village buildings; consulted on how to create relaxed spaces for visitors; offered sensory kits to visitors; and drafted resources, such as a social story and communication cards, to help visitors navigate the museum. This partnership enables the Village to offer more relaxed visits to people with sensory and development needs. It also elevated the Village’s overall accessibility in a sustainable way, informed by those with lived and professional experience. More Relaxed Visit Days are planned at Black Creek Pioneer Village throughout 2024!
