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By: Sabrina Lin/ Meducator and Sarah Ge

Frustrated by the inefficiency of the therapy model used to support children with special needs in schools, McMaster School of Rehabilitation Science professor Cheryl Missiuna decided it was time for change. At the onset of her journey, she didn’t realize how her team’s innovative service delivery model would revolutionize the field of special needs therapy in elementary schools across Canada.

Prof. Missiuna has served as Senior Scientist and Director at the CanChild Research Centre for seven years and is leading the Partnering for Change project. The project introduces a novel service delivery model that allows occupational therapists to provide services to school-aged children with Developmental Coordination Disorder.

Touching nearly one in five children across Canada, DCD is a motor disability that affects a child’s ability to complete everyday self-care and academic tasks such as zipping up a jacket, folding a piece of paper or using a pencil for schoolwork.

In Ontario, children identified with DCD are referred to school health support services for occupational therapy, after which they spend up to 24 months on waitlists to receive in-school treatment. Without the proper support, children with DCD remain at a standstill in these crucial years of development. Meanwhile, secondary academic, mental health, and physical health issues unfold, making their needs more complex and difficult to cope long-term.

Promoting collaboration between families, educators, and therapists, Partnering for Change is distinct from previous therapy models as it takes a more holistic approach to special needs therapy. “We have had traditional models in the past of servicing children one child at a time. At Partnering for Change, we recognize that this one-child-at-a-time model is not effective in large part because the kids spend so long on waitlists. Even if we had an intervention that was effective, children are waiting two years to see a therapist,” Missiuna said.

In response to this issue, she has worked with families, educators, therapists and other stakeholders to create a socio-educational therapy model that sees the whole school as the client. This is a departure from the current medical model characterised by referrals, check-ins, and long wait times.

“[Partnering for Change] helps to support features within the school to change or improve the environment around the child,” she said. Unlike previous methods, the development of the model centers around the needs of the children it services. It provides support with a focus on the child, and employs strategies in the classroom to resolve problems the child is having.

Occupational therapists play an important role in the process. After observing the child in the education setting, they assist in the development of individual learning profiles that are catered to the needs of the child. OTs will then provide knowledge and resources to educators and parents by either suggesting specialized instructional strategies or recommending specific tools that enhance learning.

In Ontario, children identified with DCD are referred to school health support services for occupational therapy, after which they spend up to 24 months on waitlists to receive in-school treatment.

P4C has seen widespread success in the school community. Missiuna explained that this is largely due to participatory action research, an approach that incorporates the opinions of families into the project design. “From the very beginning, we made sure that we were developing a model that was going to target issues that were identified by families, educators, and the health care system,” she said.

As the John and Margaret Lillie Chair in Childhood Disability Research, Missiuna hopes to continue to develop P4C in the next four years, systematically expanding its outreach both provincially and nationally. The program has already been implemented in 40 schools across three school boards, including the Hamilton Wentworth Catholic District School Board.

In addition to contributing to the field of childhood disability research, the new integrated delivery model has the potential touch the lives of nearly 400,000 Canadian children who are affected by the disorder.

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