Heather Woltman, Renée Nossal, Nathalie Gougeon, & Dr. Lise Bisnaire 7 th Annual CANS Conference Baltimore, Maryland May Evaluation of the Connections for Students Service of Eastern Ontario

Presentation Overview  Service Overview  Evaluation Purpose  Methods  Discussion of Results  Knowledge Exchange

Service Overview

Service goal: to provide coordinated and seamless transitions for children with Autism Spectrum Disorder (ASD) who are discharging from Intensive Behavioural Intervention (IBI) services and transitioning to an Applied Behavioural Analysis (ABA) instructional classroom setting through the publically funded school system. 0 MONTHS 6 MONTHS 12 MONTHS  Clinical decision for discharge from IBI  Transition team established  Child leaves IBI and begins/continues ABA in school  End of transition plan  Ongoing support (principal, teacher & parent(s)/caregiver(s) (Ontario, MCYS/MEDU, 2010) Connections for Students

Classroom Teacher Resource Teacher Principal School Designate Consultant Parents/ Caregivers Therapist Transition Teams Personalized Service

What are personalized services? Child and his/her family Individualized service planning Tailored to needs and strengths Families as integral partners Heart of all decision- making Child-centred at all system levels

Benefits of personalized services? Child and his/her family Enhanced child outcomes Improved quality of care Partnerships and Collaboration Common language Service integration (Supported by MCYS and MEDU)

Total Clinical Outcomes Management (TCOM) Child and family needs and strengths are at the heart of service provision, and are considered in all transition activities Child and family characteristics are monitored in order to better manage transition outcomes Ongoing quality assurance is embedded in service planning Competing stakeholder perspectives and objectives are aligned in order to best serve the child and his/her family Standard child and family focused assessments drive decisions at multiple service levels (e.g., family, service, program, agency)

CANS-Autism Spectrum Profile (CANS-ASP) Child and adolescent needs Life domain functioning Cognitive functioning Sensory/motor functioning Communication Co-morbidities Maladaptive behaviours Parent/caregiver needs and strengths Child/adolescent strengths Environmental strengths

Evaluation Purpose

Does the Connections for Students transition process deliver personalized services to a child and his/her family? Evaluation Goal

Objectives 1. What are stakeholder perspectives on how personalized the services are in Connections for Students? 2. What factors support or impede the ability of the transition team to deliver personalized services to children in Connections for Students? 3. How does the use of a process-and outcomes-based assessment tool (CANS-ASP) assist the transition team in planning and carrying out a personalized transition process? 4. What factors support or impede the ability of the transition team to use the CANS-ASP to deliver personalized services to the children of Connections for Students?

Methods

Approach Participants Parent(s)/ caregiver(s) (n=50) Service providers (n=23) 5 psychologists 9 therapists 9 consultants Information sources File review Service process adherence to needs and strengths (SPANS) Semi-structured interviews Surveys Analysis Qualitative ( Nvivo, thematic content analysis) Quantitative (SPSS, descriptive statistics)

Tools CANS-ASPSPANS File Reviews Ministry Questionnaire Stakeholder Surveys Interview Guides

Analysis of Approach File Reviews Large sample Quantity of data School board perspectives Bird’s eye view Time consuming Inter-rater reliability Lack of opportunity to correct errors/ misperceptions Semi-Structured Interviews Buy-in Rapport Probe First person Detailed Time consuming Scheduling Participation rate Electronic/ Written Surveys Compare perspectives Response rate Equal opportunity Speed of response Interpretation of responses Lack of opportunity to correct errors/ misperceptions Less detailed

Discussion of Findings

Different Perspectives File reviews Parents/ Caregivers Service Provide rs 1.Program implementation 2.Transition teams (formation, members, process, meeting content) 3.Documentation 4.CANS-ASD language in transitions 5.Discussion of child needs, strengths 6.Implementation of measurable transition goals 1.Program implementation 2.Transition teams (formation, members, process, meeting content) 3.Documentation 4.CANS-ASD language in transitions 5.Discussion of child needs, strengths 6.Implementation of measurable transition goals

Comments “Parent involvement is frequent and solicited throughout the Connections process.” “Transition goals […] will be a standing item on the agenda at all Connections meetings.” “Parents are also invited to have the community professionals involved with their child attend the Connections team meetings […].” School Boards, Ministry-mandated Connections for Students Implementation Reporting Questionnaire

Limitations New survey & interview guide Indirect recruitment strategy Relatively new tool (SPANS)Participant rate?

Next steps Complete file reviews Continue participation recruitment Complete surveys and interviews Analyze data Knowledge exchange

Knowledge Exchange

Evaluation Stakeholders Connections for Students program staff Program funders Other regional programs School boardsPraed Foundation Autism Intervention Program Parents/Caregivers Provincial advisory team Children in program

Knowledge Translation Plan Engage stakeholders throughout evaluation and encourage requests for dissemination of results. Dissemination methods:  Technical report  1 page summary document  Poster presentation at the 7 th Annual CANS Conference  Presentation at the Autism Intervention Program of Eastern Ontario

Summary  Service Overview  Evaluation Purpose  Methods  Discussion of Results  Knowledge Exchange

Any Questions?