Northumberland/Hastings/Prince Edward County Special Needs Strategy. Stakeholder Engagement Executive Summary April 15, 2015

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1 Northumberland/Hastings/Prince Edward County Special Needs Strategy Stakeholder April 15, George Street North, Peterborough, ON K9H 3S2 laridaecommunications.com 1

2 Contents Hastings/Prince Edward County/ Northumberland Special Needs Strategy Stakeholder Contents... 2 Introduction... 3 Overview of Engagement Strategy... 4 Who did the SNS reach out to, and how?... 5 Purpose and Engagement Mediums... 5 How will the engagement inform the process?... 5 The Purpose of the Survey and the In-Person Engagement Sessions... 5 Survey... 5 In-person focus groups... 6 Executive Summary Key Findings... 7 Section 1: General... 7 Section 2: Transitions... 8 Section 3: School Services... 8 Section 4: Transportation Section 5: Communication Section 6: Finances Section 7: Respite Survey Summary Parent Responses Staff/Agency Survey Summary Next Steps Appendix: Acronyms Works Cited

3 Introduction Hastings/Prince Edward County/ Northumberland Special Needs Strategy Stakeholder Ontario s Special Needs Strategy marks the beginning of a new way of delivering services to children and youth with special needs and their families. Coordinated service planning and the integrated delivery of rehabilitation services will improve service experiences and outcomes for children and youth with special needs and their families. (Ontario's Special Needs Strategy, 2015) The goal of Ontario s Special Needs Strategy is to help children and youth with special needs get the timely and effective services they need by: Identifying children s needs earlier and getting them the right help sooner; Coordinating service planning for children with multiple or complex special needs; and, Making rehabilitation services more seamless from birth through the school years. (Ontario s Special Needs Strategy, 2015) Ontario s Special Needs Strategy lays the foundation for a system where young people with special needs get the timely and effective services they need to achieve their full potential. (Ontario's Special Needs Strategy, 2015) Within the Special Needs Strategy, there are two proposal development tables: 1. Coordinated Service Planning 2. Integrated Delivery of Rehabilitation Services In order to achieve these goals, the Ministries have divided the province into 34 regions. Our local region includes Northumberland, Hastings, and Prince Edward Counties. The Ministries have also identified organizations that are responsible for overseeing the process. These organizations include: Children s Treatment Centres (CTCs), Preschool Speech and Language Program lead agencies, Agencies funded to provide inter-agency service coordination, Autism Intervention Program (AIP) lead agencies, Applied Behaviour Analysis (ABA)-based services and supports lead agencies, Local Health Integration Networks (LHINS), Community Care Access Centres (CCACs), and District School Boards/School Authorities. The committee is in the process of developing two proposals (Coordinated Service Planning and Integrated Delivery of Rehabilitation Services) to be considered by the Ministries. The proposals are being developed based on the feedback received during the recent engagement sessions that took place in January, February, and March 2015, as summarized in this report. Once the draft proposals are complete, they will be submitted to the Ministries for review and feedback. The deadline for the Coordinated Service Planning proposal submission is June 15 th, the Integrated Delivery of Rehabilitation Services deadline is October 31 st. 3

4 Hastings/Prince Edward County/ Northumberland Special Needs Strategy Stakeholder The key findings in this report were prepared by and are based on results arising from a number of methodological components, including: 21 focus groups have been held cross the region. Parents, youth, frontline staff, and agencies with an interest in the Special Needs Strategy have all given input. 362 responses to our online surveys were received. Surveys were sent to parents and frontline staff (both in English and French). Written submissions were accepted. Finally, we will be holding additional engagement meetings to obtain feedback on our progress and direction. Overview of Engagement Strategy In order to achieve the goals and objectives defined by the Special Needs Strategy, the Steering Committee saw meaningful stakeholder engagement as a critical early step in the process. Before the two Special Needs Strategy proposal development tables could begin their work, the Committee reached out to capture and engage the voices of parents, youth, military families, Francophone families, First Nations service providers, frontline professionals, and agency staff who have a vested interest in special needs services. Their feedback will serve to strengthen and shape the coordinated service planning and integrated delivery of rehabilitation services tables. This engagement report comes at a critical juncture in the process. It has been prepared for Steering Committee and Working Groups in advance of the upcoming meetings a milestone in the overall process. This stakeholder engagement will play an important role in informing decisions for the Steering Committee and Working Groups. A number of different engagement strategies were used to solicit input and feedback. These included focus groups, online surveys, written submissions, and a request for Focus Group participation Expressions of Interest. What follows is an overview of the themes, ideas, compliments and concerns identified by each stakeholder group and/or method of engagement. 4

5 Hastings/Prince Edward County/ Northumberland Special Needs Strategy Stakeholder Who did the SNS reach out to, and how? The SNS invited the following audiences to participate in the SNS engagement: Youth and young adults Parents Community partners Frontline professionals Agency staff Military families Francophone families First Nations service providers Planning tables/networks Communication regarding SNS engagement was disseminated utilizing a number of methods in order to reach a wide, but targeted, audience: Social media Other electronic methods Mail Phone Websites Word of Mouth Purpose and Engagement Mediums How will the engagement inform the process? Before moving forward with developing the coordinated services and integrated delivery of rehabilitation services proposals, the SNS Steering Committee decided early on to seek input from a wide array of stakeholders. In doing so, the SNS tables are ensuring that the proposals will have a solid base, one informed by lived experience, evidence, and the broadest-held perceptions. The Purpose of the Survey and the In-Person Engagement Sessions The survey and the in-person sessions had two general purposes: To engage stakeholders by gathering input, ideas, suggestions and including them in the planning process directly in a meaningful way To educate stakeholders about the Special Needs Strategy Survey Two surveys were administered: parents and frontline staff/professionals. The surveys were available online in both French and English. The surveys were open to parents, stakeholder groups, and individuals with a vested interested in the Special Needs Strategy. The survey was communicated through a variety of mediums, including: mass s, listed on school and agency websites, social media, word of mouth, and distribution through related networks. 5

6 Total Survey Responses Total Responses Completed Responses Completion Rate Parent/Guardian Survey Total % Staff/Agency Survey Total % Total Survey Responses % In-person focus groups Focus groups were held across the region Focus group participation was open to parents, stakeholder groups and other individuals with a vested interest in the Special Needs Strategy. A French focus group was conducted in Trenton on the military base. Below is a summary of the focus groups that took place. Date Community Audience January 29 Belleville Agency January 29 Tyendinaga First Nations January 29 Belleville Staff (Rehab) January 29 Belleville Youth January 29 Belleville Parents January 30 Cobourg Agency January 30 Cobourg Staff (CSP) January 30 Cobourg Staff (Rehab) January 30 Cobourg Youth January 30 Cobourg Parents February 2 Picton Parents February 2 Picton Staff (CSP & Rehab) February 2 Bancroft Parents February 2 Bancroft Staff (CSP & Rehab) February 3 Trenton Staff (CSP) February 3 Trenton Youth February 3 Trenton Parents February 3 Trenton Parents FRENCH February 26 Campbellford Youth February 26 Campbellford Parents February 26 Campbellford Staff (CSP & Rehab) March 30 Trenton Parents and Staff (CSP) Several focus groups were held as a result of the Hastings/Prince Edward/Northumberland geography. The region has a combination of rural/urban communities across a vast geography. In addition, the area includes a First Nations as well as the largest military air force base in Canada. Although the area is not designated as French, there are many francophone families within the Trenton area as a result of the military base. 6

7 Executive Summary Key Findings Special Needs Strategy The purpose of the engagement was to identify trends within the broader system as related to supports and services available to children and youth with special needs. Although the aim was to obtain feedback surrounding coordinated service planning and the integrated delivery of rehabilitation services, additional trends were identified that are related, however outside of, the Special Needs Strategy objectives. These trends have been included for informational purposes. This document contains a summary of the top themes from the local Special Needs Strategy engagement activities that took place between January and March These themes represent the views and opinions of the people who participated in the engagement mediums (online survey, focus group, targeted meetings, and written submissions). Every effort has been made to document these comments in a neutral and impartial manner. The views expressed by respondents in this report should not necessarily be considered representative of the views of all individuals with experience, and an interest in, children and youth special needs supports and services; rather, they are a reflection of the opinions of those individuals who have participated in the engagement. Section 1: General a. Many parents have difficulty navigating the system (programs, services, and supports). It was identified that some parents do not have the necessary skills, support, or education required to navigate the complex system or to advocate on behalf of their child/youth. Peer mentors were identified as being needed to help guide parents with newly diagnosed children through the process and to provide support. b. Parents do not want to repeatedly tell their child s diagnosis and services received to-date to agencies/service providers. However, parents do want to explain their child s individual and unique needs to agencies and direct service providers. A total of 99% of parents agree that, with their consent, those providing services to their child should share information with one another even if they are not within the same agency/organization. The system needs to be based on compassion, care, love, kindness, and respect you need to receive these things in order to function. What do you need to get you to tomorrow, the next day? Love them up. ~ First Nations Frontline professional c. There is a general feeling, from Parents and frontline staff, that there are too many consent forms requesting the same basic information. Consent forms should be streamlined across services and agencies and should be simplified based on the service being received. d. One main contact to assist parents, families, and guardians with navigating the systems and supports for their child/youth is needed. A total of 99% of parents want to know how to access services for their child, with 99% of parents wanting clear contact information for these services. Parents would like this information communicated either in-person or on a website. Please note: parents do not feel that the main contact should be the only access point for services. It was generally felt that having one main access point will create a bottleneck and will result in longer waitlists for services. However, having one agency to call that can provide guidance related to services available and that can assist with system navigation would be helpful. 7

8 e. Parents indicated that they would like to be viewed as an entire family. In addition to their special needs child(ren), the entire family s needs should be taken into consideration. It was frequently noted that the marriage breakdown, stress for siblings, etc., is higher among couples with a special needs child. f. When developing individualized goals for children/youth, parents and frontline professionals both agree that the goals should be developed with parent input. Parents define what success looks like for their child. This is supported by the parent survey, with 93% of parents indicating that they would like to meet with the team in person as their child s goals are being developed. g. There are unique challenge for First Nations families due to funding (provincial vs federal), socioeconomics, and culture. h. There are also unique challenges for military families. They are transient and programs/services operate differently in each region. There are also unique language Instead of a child as a separate entity, they must be viewed as part of a family unit. ~ Frontline professional challenges (French and English services). Every time a military family relocates, they must learn how to navigate the local system. Section 2: Transitions a. Transitions from preschool to school, school to school, and school to adulthood was an area identified as needing improvement by many participants. b. The preschool/kindergarten to grade 1 transition was frequently raised as a concern. A total of 82% of parents do not want to reapply for services at any time during transition or change, with 81% indicating that they do not want to wait for services when transitioning to school. During this transition, speech/language services transfer to the Community Care Access Centres (CCACs). As a result, the child s therapist often changes. In addition, there is often a gap in services being received due to waitlists. Lastly, new consent forms are required. c. Transition to adulthood was also identified as being a concern. It was generally felt that the adult system is fragmented and that there is a bottleneck with Developmental Services Ontario (DSO). The DSO access requirements were also a concern because cognitive assessments are required. Cognitive assessments are often very difficult to obtain in the public system via the District School Boards due to lack of resources. Many families cannot afford to purchase the assessments privately. Lastly, participants reported that some diagnoses are not accepted by the DSO even though the child/youth has been receiving support services in school. d. There is a lack of respite, summer camp options, resources and supports during school breaks and vacation periods. Section 3: School Services a. Within the local population, there is a diverse range of needs among special needs children/youth. Support is often needed by both school services as well as community agencies. Some children/youth require short-term support, while others require long-term, ongoing support. b. Parents and school staff work collaboratively to develop Individual Education Plans (IEPs) for children with special needs. c. Currently, speech and language services are separated within the school system. Both parents 8

9 and frontline professionals indicated that these services should not be separated and that there should be one Speech Language Pathologist (SLP) providing services to each child/youth requiring the support. Also, it was noted that having CCAC-funded SLP s assigned to specific schools would be helpful. This would allow SLP s to develop strong relationships with the children and youth that they provide services to, as well as school staff (teachers, principals, etc.). Supporting this, 91% of parents who responded to the survey feel that the same team of therapists should support their child at home, at school, in the community, and when working with other agencies. d. It was felt that there is a gap with Educational Assistants. If a child does not have significant behavioural needs, high medical needs, and/or poses a risk, they often will not receive EA support even though it may be needed in order for the child to be successful at school. e. Educational Assistants (EAs) have a high turnover rate which impacts children/youth and their families. The turnover may be as a result of transfers, bumping, relocations, or personal reasons (e.g. maternity leave). Although no solutions were suggested, the negative impact of frequent EA turnover on the child/youth was a concern. In addition, parents/guardians must educate each new EA on their child's specific needs. Get things centralized. Figure it out for us, don t make us figure it out all for ourselves we are trying to care for a special needs child. That s hard enough. ~ Parent a. Both community and school-funded supportive devices were a concern. A total of 88% of parents feel that specialized equipment should be provided without interruption, with 93% of parents indicating that the same specialized equipment should be available to support their child at home, at school, and in the community. In addition, there are different processes required to obtain supportive devices within the school and within the community. In addition, each District School Board utilizes different types of supportive devices and programs which can be difficult for children/youth (e.g. A child may use x in elementary school, the high school may use y.). Consistency across school boards and schools is needed as it relates to school supportive devices. f. Teachers may benefit from additional training which will allow a better understanding of special needs. Training related to diagnoses, sensitivity, and attachment may be helpful. It was noted that training is provided by some agencies but teachers must travel to the session and they are not compensated. Training could be provided within the schools to encourage participation and attendance. g. Community support services should provide programs/services within schools. A total of 87% of parents who responded to the survey would like all services to be received in one place. There are some pilot programs providing speech and language in kindergarten which have received positive reviews. It was felt that children/youth are often too tired to receive therapy services after school. In addition, transportation and work schedules can be challenging for families. h. A total of 82% of parents felt that whether provided at school, in the community, or at home, their child/youth receives the services needed to attend school, with 80% agreeing that the services received allow their child to be successful at school. During focus groups, parents and front line staff indicated that there is a "general sense" of an increase in home schooling and part-time schooling over recent years because some parents do not feel that their child/youth is safe, and/or properly accommodated, and/or comfortable and/or able to learn. These parents 9

10 do not feel that they are getting the right level of support, care, and/or therapy in school. Or, they are frequently called to pick-up their child before the school day is over. A few of the reasons cited for this include: large classroom sizes, inadequate number of educational assistants, limited access to specialized equipment, limited access to therapists, inadequate access to toileting, assistance with transitions such as recess or lunch times, medications, and lack of physical space. i. It was commonly felt that services decrease for children as they get older, however the children's needs do not decrease they shift and change. j. It was felt that some schools provide much stronger supports for children/youth than others, there is a sense of inequity. k. Federally funded First Nations schools do not provide the same level of supports/services when compared to provincially funded schools due to limited resources. It was reported that some First Nations special needs children/youth are attending provincial schools where there are more services. This creates challenges related to their cultural education. Section 4: Transportation a. Although transportation falls outside of the Special Needs Strategy, lack of public transit and transportation options was flagged as an issue. Some families do not have vehicles or cannot afford to travel to appointments. Section 5: Communication a. There were significant concerns raised surrounding communication among: i. Parents and Agency ii. iii. Parents and School Parents and CCAC I feel that when the families actually get service; they get iv. First Nation and Agency v. Agency and District School Board Staff amazing service. ~ Parent vi. CCAC and Agency Staff vii. Non-local tertiary hospitals and local General Practitioners (GPs) viii. Non-local tertiary hospitals and Agencies b. In order to help address the breakdown in communication amongst the child s care team, many parents have created binders that contain all of their child s information and reports. A solution to this barrier would be shared electronic records. Electronic records should be accessible by parents and everyone within the child's care team. Section 6: Finances a. When parents/families can afford private services, they are being purchased due to waitlists or to augment the public services being received. Services that are being purchased include: SLP, OT, PT, psych-ed assessments, and respite. b. Concerns were raised surrounding Canada Revenue Agency (CRA) audits for mileage and services. When parents/families are audited, they must justify their expenses related to their child/youth s services. It can be emotionally difficult for parents to justify these expenses because they have to re-live each appointment and service. It is also stressful. c. It was generally felt that one document or website that lists all financial support options and eligibility is needed (including: government supports and non-profit supports such as Easter 10

11 Seals). d. Many families have one parent who cannot work due to the time commitments required to ensure their child is receiving the needed support. As a result, many families with a special needs child only have one income. e. There is a lack of licensed day cares in some areas within the region. Subsidies are available for families that qualify, but because there are not enough spaces, many people turn to unlicensed daycares which results in extra costs. Holistic training of all therapists. The key to special needs children is not that they are unable, they have other ways to learn. You have to determine the best way for the child to learn. It takes a village to raise a child. ~ Parent Section 7: Respite a. Additional respite services/support are needed in order to better support families. It was noted that respite services within the Northumberland area are very good. b. Trained and competent individuals are needed to actually provide respite services. Many parents cannot find respite providers who are able to provide their child s care due to medically complexities or other issues. c. Many parents are hiring unqualified respite workers. Many EAs work "on the side" as respite workers. Survey Summary Please note: Since the French survey generated less than 10% (6.3%) of the total survey responses, the French answers have been combined with the English survey results. Overall, the French and English feedback was very similar for all of the questions with the exception of geography. It is apparent that some communities, such as Trenton, have a higher number of Francophone families and frontline staff. Parent Responses Whether provided at school, in the community, or at home, my child/youth receives the services needed to... Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable Attend school 44% 38% 6% 6% 7% Be successful at school 46% 34% 5% 3% 3% Develop social relationships and be meaningful engaged with others 39% 42% 9% 4% 6% 11

12 This section asks you about what you expect when receiving services for your child. I want to be given opportunities to be involved in decisions regarding services provided for my child/youth. I believe it is important to attend or watch my child s therapy sessions. I want timely services for all my child s needs. I want to receive ongoing training to follow through with my child s therapy at home. I want to receive information needed for my own decision making to ensure my child s needs are being met. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 78% 20% 0% 1% 1% 41% 40% 14% 1% 5% 77% 23% 0% 0% 1% 67% 28% 2% 1% 2% 74% 25% 0% 1% 1% This section asks you about what is important to you about accessing services for your child/youth. I want to know how to access services for my child. I want the needs of my child identified efficiently. I want clear contact information for these services. I want to understand why my child was recommended for services. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 79% 20% 0% 0% 1% 85% 13% 1% 0% 1% 82% 17% 0% 0% 1% 78% 18% 2% 0% 3% 12

13 This section asks you about therapy services at school: Thinking about your child/youth in school, an early learning program, licensed child care or preschool program, please answer the following... I want to be involved in all decisions regarding support services provided for my child. My opinion and questions should be addressed and valued. I should be made aware of the progress of my child at all times. The same team of therapists should support my child at home, at school, in the community, and when working with other agencies. My child should receive the therapy services needed to be successful in school settings My child should receive the therapy services needed to be successful outside of school, at home as well as in social and recreational settings. I want to understand the role of all team members in my child s therapy and treatment (including therapists, school staff, and staff from community agencies). My child s educational and therapy team should work well together. Education plans for my child should include input from my child's therapists. My child's therapy team should be included within all environments in the school/early learning program/preschool program where my child participates and learns. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 75% 22% 0% 0% 3% 77% 20% 0% 0% 3% 76% 21% 0% 0% 3% 55% 36% 5% 0% 4% 74% 22% 0% 0% 4% 69% 27% 1% 0% 3% 73% 23% 1% 0% 3% 76% 20% 0% 0% 4% 71% 24% 1% 0% 4% 66% 28% 1% 1% 4% 13

14 How rehabilitation services work together. Special Needs Strategy The integrated plan of services should be based on my priorities for my child. I do not want to reapply for services for my child at any time during transition or change. I want to understand the role of each of the therapists in my child s treatments. If my child received services as a preschooler, I do not want to wait for those same services once my child attends school. I value that all therapies are provided in one place for my child. Any specialized equipment should be provided without interruption. The same specialized equipment should be available to support my child at home, at school and in the community. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 62% 27% 7% 0% 3% 62% 20% 6% 4% 7% 68% 26% 1% 0% 4% 66% 15% 3% 0% 16% 51% 36% 6% 0% 7% 59% 29% 2% 1% 7% 62% 31% 1% 0% 6% What is the best way to inform you of available services? Please number the following from 1 to 6 in order, with 1 being most important and 6 being least important. Summary (in order of preference): 1 In-person meeting with resource person 2 On a website 3 Printed materials (pamphlets, handouts, newsletter) 4 ed newsletter 5 Parent support network/social media information phone line 14

15 This section asks you about how you would like to see your services coordinated. Those providing services to my child should work well together. With my consent, those providing services to my child should share information with one another even if they are not in the same agency/organization. I want to understand the role that each team member plays in addressing the goals for my child. Everyone working with my child should clearly understand their role. My consent needs to be given at all times of my child s information being shared. I believe it is important to tell my child s story to different professionals in order to receive the best care. Advanced notice should be provided when a change or transition occurs in my child s service. I prefer to meet with the team in person as my child s goals are being developed. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 80% 20% 0% 0% 0% 74% 25% 0% 0% 1% 76% 24% 0% 0% 0% 82% 18% 0% 0% 1% 68% 21% 11% 1% 1% 62% 33% 5% 0% 0% 74% 24% 2% 0% 0% 64% 29% 7% 1% 0% In order to support access for families and children/youth please number the following from 1 to 4 in order, with 1 being most important and 4 being least important. Location: Summary (in order of preference): 1 Located at the school 2 In the community where I live 3 At a child care centre 4 On a public transit route 15

16 In order to support access for families and children/youth please number the following from 1 to 4 in order, with 1 being most important and 4 being least important. Hours: Summary (in order of preference): 1 Weekdays between months of the year, including summer 3 Before 9 or after 4 4 Weekends Staff/Agency Survey Summary Think about those services that you provide. Please respond to the following: Whether services are provided at school, in the community, or in a home setting, the services I provide allow children and/or youth to... Attend school, early learning program, licensed childcare and/or preschool Be successful at school, early learning program, licensed childcare, and/or preschool Develop social relationships and be meaningfully engaged with others Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 51% 38% 1% 1% 10% 55% 36% 3% 1% 6% 57% 39% 1% 0% 3% This section asks you about what you feel is important about access to services. Parents need to know how to access services for their child. Children s needs are determined efficiently. Children s needs are identified early so treatment is effective. Services are provided quickly to children who are determined in need. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 91% 9% 0% 0% 0% 55% 31% 10% 4% 0% 57% 23% 15% 5% 1% 55% 19% 21% 6% 0% 16

17 This section asks you about the key elements that need to be considered when designing a system that supports you to provide coordinated services. Those providing services to a child and/or youth should work collaboratively with one another even when from different agencies. Those providing services to a child and/or youth should share information with one another even if they are not in the same agency/organization. Everyone working within a child s and/or youth's team should understand their role. Consent should be provided by parents at all times of transition and information sharing. It is important for me to hear a child s and/or youth's story from the parent/guardian when providing services. Team members should communicate appropriately with one another. It is important to include parents in developing goals for the child and/or youth. Advanced notice should be provided to families when a change or transition in service will happen. Waitlists should be coordinated to minimize waiting time. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 83% 16% 1% 0% 0% 74% 24% 1% 0% 1% 82% 18% 0% 0% 0% 70% 26% 3% 1% 0% 57% 40% 1% 1% 1% 84% 16% 0% 0% 0% 78% 21% 0% 1% 0% 76% 23% 1% 1% 0% 83% 14% 1% 0% 1% 17

18 This section asks you what is important to you about therapy services at school. Parents are involved in all aspects of services. Children and/or youth receive therapy services to be successful in any environment within the school (e.g. classroom, gymnasium). The role of each team member is clearly understood in how each supports the child s participation in home, school and community. Parents are receiving the information they need to make an informed decision regarding support services provided for their child or youth. Children and/or youth do not wait for services in school if they have received services previously. Parents are encouraged to be involved consistently throughout their child s or youth's treatment. Therapy goals are integrated into the child s or youth's education plan. Team members include the parents, educators, therapists and all involved service providers. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 33% 51% 16% 0% 0% 53% 47% 0% 0% 0% 62% 31% 7% 0% 0% 55% 44% 2% 0% 0% 44% 35% 16% 2% 0% 58% 40% 2% 0% 0% 67% 27% 5% 0% 0% 64% 31% 5% 0% 0% 18

19 Please provide your input regarding the importance of the following elements in providing a seamless system of rehabilitation services. Children/youth receive the services they need. Therapy services should be provided by the same therapists whether at home, school and in the community. The role of each therapist is clearly understood in a team setting. Specialized equipment is provided without interruption. Consistent specialized equipment is available to the child/youth at home, school and community. Professional development on the education system and curriculum is available to enhance the quality of service provision. There is a clear pathway developed for any child/youth receiving services. Services provided make a difference for children/youth and improve their participation at home, school, and within community. Professional development is offered collaboratively for educators and therapists. Strongly Agree Agree Disagree Strongly Disagree Unsure / Not Applicable 69% 20% 11% 0% 0% 31% 33% 29% 7% 0% 55% 42% 4% 0% 0% 51% 35% 11% 0% 0% 51% 35% 11% 0% 4% 44% 45% 7% 2% 2% 42% 51% 7% 0% 0% 73% 25% 0% 0% 2% 44% 33% 18% 5% 0% 19

20 What does 'family centered' care mean to you? I believe family centered care means... Other (please specify) 2% Professional staff and family members working together in the best interest of the child/youth. 64% Valuing the personal information families provide about their children. 12% Families making educated choices about treatment and providing support for the choices they make 44% Valuing families' knowledge of their children and respecting their authority as decision-makers. Respecting each family's values, beliefs, and religious and cultural background. 37% 41% What does seamless care mean to you? Please prioritize from 1 to 8, with 1 being the most relevant and 8 being the least relevant. Summary (in order of preference): 0% 20% 40% 60% 80% 1 Not having to wait on multiple waiting lists throughout a child s/youth's preschool and school career. 2 Timely delivery of services. 3 Coordination and planning. 4 Coordinated access for intake processes. 5 Not having to complete multiple assessments to access services. 6 A smooth and safe transition from home to school and school to adult services. 7 A smooth and safe transition from school to school (e.g. elementary school to high school). 8 Therapists with the same philosophy and approach to service provision. 20

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