Introduction

Early Intervention Special Needs Modernization

The vision for the Early Intervention and Special Needs sector is:

Children, youth, and young adults with special needs^{footnote 1[1]} are supported holistically through flexible, individualized, and coordinated supports so they can participate meaningfully in school, community, and work; can achieve their life course goals; and are set up for success in adulthood.

This vision will be realized through the following objectives:

• Children, youth and their families receive services as early as possible to support improved outcomes
• Children, youth and their families receive services in an efficient and streamlined way
• Children and youth will be connected to appropriate, available services through their lifecourse
• Children, youth and their families receive quality services

A focus on early identification and early intervention is central to achieving this vision. In this context, early identification and intervention means both age and timeliness in addressing developmental difficulties and needs. Identification should happen at the earliest possible age and intervention should happen at the earliest possible opportunity.

Developmental difficulties can impact children’s ability to participate in everyday activities.

Children with disabilities are more likely to be at risk for learning difficulties and subsequent academic challenges than their peers.^{footnote 2[2],footnote 3[3],footnote 4[4]} These delays can have a negative impact on long-term outcomes related to education and employment.^{footnote 5[5]}

Children with communication disorders often experience functional limitations that go beyond their speech and language difficulties.^{footnote 6[6],footnote 7[7]} These include barriers to social participation and engagement during the preschool years and upon school entry.^{footnote 6[6],footnote 8[8]} Such barriers can negatively impact a child’s ability to make friends and be accepted by peers^{footnote 9[9]} and can significantly impact a child’s developmental trajectory.^{footnote 10[10]}

Early identification of communication, mobility, and social needs is essential so that children can enter school with the best possible skills to support their academic and social development. Timely supports lead to more successful transitions into school, help students to participate in school and access the curriculum, and reduce the need for more intensive interventions and supports later in childhood, adolescence, and adulthood.

Preschool Speech and Language services

The PSL Program provides seamless access to early identification and a range of early intervention services for children with speech and language difficulties and their families from birth until school start.

The PSL Program is delivered through a Lead Agency model in each catchment within a locally integrated early intervention system.

Services are:

• Delivered within a coordinated continuum of supports and intervention services to identify difficulties, needs, and strengths, and achieve meaningful, child- and family-centred goals, with efficient access to services
• Available year-round and may be accessed in various settings including at home, in clinic, early years and community settings, and/or through remote delivery methods
• Child- and family-centred, support the diverse needs of families in a culturally safer way, and promote equity, anti-oppression, anti-ableism, and anti-racism, including dismantling anti-Black and anti-Indigenous racism

Further service details can be found in the Service Objectives Descriptions housed in the Transfer Payment Ontario (TPON) system.

Children’s Rehabilitation Services

Community-Based Rehabilitation Services (CBRS) and School-Based Rehabilitation Services (SBRS) programs are delivered by regulated health professionals and supportive personnel through Children’s Treatment Centres (CTCs).

Services are:

• Delivered within a continuum of supports and interventions to address needs and meet family-centred goals, with efficient access to services.
• Child- and family-centred, support the diverse needs of families in a culturally safer way, and promote equity, anti-oppression, anti-ableism, and anti-racism, including dismantling anti-Black and anti-Indigenous racism.

Community-Based Rehabilitation Services (CBRS)

CBRS include speech-language pathology, occupational therapy, physiotherapy, and other complementary services. Services are delivered year-round in community-based settings, including multi-service agencies, community settings, at home, and/or through virtual approaches.

CBRS are provided to children and youth up to 19 years of age, or up to age 21 if they are in a publicly funded school and living in Ontario with physical and/or developmental disabilities, chronic illness and/or communication disorders, or other developmental support needs, and their families.

CBRS are designed to support children’s development and day-to-day-functioning so that they can participate meaningfully at home, school, and in the community, achieve their life course goals, and are set up for success in adulthood.

Further service details can be found in the Service Objectives Descriptions housed in the Transfer Payment Ontario (TPON) system.

School-Based Rehabilitation Services (SBRS)

SBRS consist of speech-language pathology, occupational therapy and physiotherapy for children and youth enrolled in publicly funded schools to support their functioning and development so they can participate more fully at school, at home, and in their communities. SBRS services begin when a child starts school (at kindergarten or Grade 1).

Students attending publicly funded elementary or secondary school in Ontario can access SBRS any time from school start through to their exit from secondary school.

Further service details can be found in the Service Objectives Descriptions housed in the Transfer Payment Ontario (TPON) system.

Purpose of guidelines

The guidelines set out the ministry’s expectations for PSL Lead Agencies and CTCs as service provider organizations responsible for the provision of the Preschool Speech and Language (PSL) Program and the Children’s Rehabilitation Services Program (CBRS and SBRS).

For the provision of the PSL Program, these guidelines replace: 1996 Planning Guidelines for the Development of a Speech and Language Services System for Preschool Children; and 2000 PSL Initiative Planning Guidelines for Transition to School.

These guidelines:

• Outline the ministry’s expectation that PSL Lead Agencies, CTCs and service partners within each catchment area should function as a children’s rehabilitation services system from birth to young adulthood wherever possible
• Seek to support and improve service access, family experiences, and functional outcomes in service delivery as well as to promote a continuous shift towards culturally safer, inclusive, and family-centred services, while applying an intersectional equity lens across the service continuum
• Are intended to improve consistency of services for families across the province, while at the same time being flexible enough to enable continued innovation among service providers to address local and regional circumstances, implement new and emerging knowledge, and adapt in an evolving landscape
• Are intended to support both the ministry’s and service providers’ continuous quality improvement efforts, including using data and information to monitor and measure program outcomes

The guidelines support service provider organizations and individuals to fulfill their essential roles within a coordinated system of early identification and intervention services that:

• Puts children, youth, and families at the centre of planning and delivery
• Supports optimal development of children and youth
• Addresses needs from birth through to school start and the transition to adulthood
• Supports seamless connections and transitions throughout the service experience