Starting in March, Ontario will begin offering core clinical services for children in the Ontario Autism Program. These services include applied behaviour analysis, speech language pathology, occupational therapy and mental health supports based on the child's individual needs.
Launching the determination of needs process
The ministry has asked Child and Parent Resource Institute to oversee the launch of core clinical services.
Care coordinators will be trained to conduct and guide families through a new determination of needs process that will include:
- Meeting with a family to identify a child's goals, strengths and support needs
- Allocating funding to families to purchase core clinical services
- Supporting families with next steps to access core clinical services of their choice
Approximately 600 children and youth from across the province, who represent a diverse sample of Ontario Autism Program registrants, will be invited to participate in the launch of core clinical services beginning in March.
Clinical and research experts at the Child and Parent Resource Institute will work closely with the Ontario Autism Program Implementation Working Group, which continues to provide advice on the process. The process will be evaluated on an ongoing basis to make sure it is responsive to the individual needs of children and youth on the autism spectrum.
How the process works
As recommended by the Autism Advisory Panel, the determination of needs process was developed based on the advice and clinical expertise of the Implementation Working Group as well as current research. This process is separate and distinct from the clinical assessment that would be completed by a clinician as a first step of treatment planning for core clinical services. Families will work directly with their chosen clinician(s) to develop treatment options and plans for their child.
Guided by a standardized tool, a care coordinator will ask the family a series of questions to understand the child's or youth's goals and strengths, as well as their support needs across nine domains, including:
- Communication – how individuals communicate and understand others to successfully participate in activities of daily life
- Social interaction – how individuals participate in social situations, shared activities and interactions with others (groups, peers, new settings)
- Play and leisure - how individuals engage in play independently and with others
- Activities of daily living - how individuals complete daily tasks, such as getting dressed and eating
- Motor skills – how individuals participate in activities that involve using fine motor skills and gross motor skills, such as writing and walking respectively
- Cognitive skills – how individuals follow instructions, concentrate and solve problems
- Sensory system – how individuals manage reactions to stimuli
- Interfering behaviours – how individuals manage interfering behaviours that that may impact their ability to participate safely in activities of daily life
- Mental health – how individuals manage needs that impact their resilience, daily functioning and capacity to access or engage in services
In addition to the nine domains, the care coordinator will consider factors such as developmental and life stages, as well as co-existing health and environmental factors.
Based on the results of the standardized, clinically-informed process, care coordinators will identify the intensity of support needs as being extensive, moderate or limited across different age ranges. This information will result in a corresponding Ontario Autism Program funding allocation that families can use to purchase core clinical services. These allocations were developed by clinical experts from the Implementation Working Group based on published research and provincial data to reflect the estimated amount of service that a child with a defined level of support need might access.
Children and youth may be eligible to receive the following based on their identified support needs:
- Children aged 0-3 could receive from $10,900 to $65,000 yearly
- Children aged 4-9 could receive from $8,900 to $65,000 yearly
- Children aged 10-14 could receive from $7,600 to $41,400 yearly
- Youth aged 15-18 could receive from $6,600 to $31,900 yearly
Additional funds for childhood budget and interim one-time funding recipients
Eligible families who received a childhood budget or interim one-time funding may be eligible to receive an additional payment of $5,000 or $20,000, based on their child's age. Further details about eligibility and how to apply for the extension of funding will be shared in the coming weeks.
Families continue to have up to 18 months to spend their childhood budget or interim one-time funding and submit their expense forms. Families with existing behaviour plans will continue to receive services up to the current level of intensity, or less as clinically appropriate, until their child or youth transitions into core clinical services in the needs-based program.
Additional elements of the needs-based Ontario Autism Program
Urgent response services
The government is initiating a community-based proposal process to identify organizations in the sector to deliver urgent response services. In line with the recommendations of the Autism Advisory Panel, these services will be available for a limited time to any child or youth registered in the Ontario Autism Program who meets defined criteria. These services will provide a rapid response to a specific, identified need to prevent further escalation.
The services may include:
- A short-term consultation with an interdisciplinary team that can include intervention specialists, family members and educators
- Time-limited respite support
- Identifying additional services and supports within and outside of the Ontario Autism Program
- Direct support for families and/or professionals who work with the child to implement personalized interventions or therapy techniques
Increasing investments in Ontario's autism diagnostic hubs
This year, the government will invest $3.8 million, in addition to $5.5 million in annual funding, for its five diagnostic hubs. This additional investment will improve families' access to a diagnostic assessment for their child by reducing waitlists and wait times, resulting in families being able to register for the Ontario Autism Program and access services as quickly as possible.
Regulating behavioural clinicians providing applied behaviour analysis (ABA)
Previously, the government announced its intention to regulate providers who deliver ABA therapy in Ontario to increase oversight and set standard expectations for quality therapy across the province. The government intends to regulate ABA as a new profession under the College of Psychologists of Ontario, beginning with providers in supervisory and assessment-focused roles. Next steps will include drafting proposed legislation that, if passed, would bring this change into effect, and working with the College to develop regulations.