More services for GTA children and youth with extensive neurodevelopmental needs

With limited financial resources, Anthea Charles has struggled to find the right care and services to help her son
Idika function outside their home. Since turning 15 years old, his meltdowns have included aggressive and
destructive behaviour that his family had never seen before and has made school attendance increasingly difficult.
His inability to communicate with his family and loved ones made it almost impossible to know how to help him —
until Idika was able to receive care through Holland Bloorview Kids Rehabilitation Hospital’s new Extensive Needs

Now, more children and youth, like Idika, with complex and extensive care, neurodevelopmental and behavioural
needs can receive timely, personalized, wrap-around supports – right in their own neighbourhoods in the Greater
Toronto Area, thanks to the partnership announced today by Holland Bloorview, Grandview Kids, Michael Garron
Hospital (MGH) and Surrey Place.

This regional partnership comes on the heels of the April 2023 launch of the Extensive Needs Service (ENS)
program through which Holland Bloorview, the Children’s Hospital of Eastern Ontario (CHEO) and McMaster
Children’s Hospital are providing critical specialized neurodevelopmental health services to over 1,000 families

Funded by the Ministry of Health and the Ministry of Children, Community and Social Services, this program was
developed for children who have multiple neurodevelopmental, behavioural, medical and physical needs, as well
as social vulnerabilities – kids who have otherwise fallen through the cracks of a complex health and
developmental services system.

Overall, the program is designed to reduce barriers to accessing timely, evidence-based treatment for some of the
most vulnerable children in the province.

Families participating in the Extensive Needs Service can connect to a team of professionals, including physicians,
social workers, occupational therapists and behavioural consultants who work together to provide tailored support
based on the individual needs of the child or youth and their families. Services are individualized, trauma-informed
and can include prescribing or adjusting medications; goal-directed behaviour therapy; mental health assessments
and treatment; social work, such as counselling for parents and caregivers; and other specialized interventions to
support children and youth to build skills, such as communication and self-regulation.

As the SmartStart Hub for Toronto, Surrey Place will serve as an entry point to help families navigate to and access
care through the Extensive Needs Service with dedicated service coordinators who will work closely with families
to coordinate their care at Holland Bloorview’s Extensive Needs Service program.

Toronto families interested in the Extensive Needs Service program and who are not currently receiving care at
Holland Bloorview can connect with Surrey Place online or by calling 1-833-575-KIDS (5437) to inquire about their
eligibility to access these supports.

For Anthea, Holland Bloorview’s Extensive Needs Service Program has given her reason to hope again. Since Idika
was enrolled in the program early this spring, she has noticed that he is more expressive, more patient and more
flexible. “I feel like I’m getting my son back. I can’t thank the program staff enough for how they’ve helped my son
so much now.”


“Our government is improving the experiences and long-term outcomes for children and youth with complex
special needs. We are investing $97 million in the Extensive Needs Service pilot program to support more than
1,000 children with complex special needs every year,” said Michael Parsa, Minister of Children, Community and
Social Services. “When children and families can access services tailored to their needs, the short and long-term
outcomes for children improve, as do their parents well-being.” – Michael Parsa, Minister of Children, Community
and Social Services

“Our government is taking action by working with our health partners to connect children and youth and their
families to specialized care, closer to home. This new and innovative partnership will ensure children and youth
with complex needs in Toronto and Durham Region can access the care and services they need and deserve in
their community.” – Sylvia Jones, Deputy Premier and Minister of Health

“This new partnership between Holland Bloorview, Grandview Kids, Michael Garron Hospital and Surrey Place will
provide access to Extensive Needs Service program to more families of children with complex care needs in the
Greater Toronto Area. Instead of spending time navigating a complex system, families will be able to get their care
their child needs and deserves in a way that is connected and convenient.” – Hon. Peter Bethlenfalvy, Minister of

“By joining forces with our new partners, children, youth and their families living in Toronto and Durham Region
can receive the specialized care they need closer to their homes and delivered by their local healthcare teams.
Thanks to the support from the Government of Ontario, we are helping to support a health system that is more
agile, socially accountable and accessible to families.” – Julia Hanigsberg, president and CEO of Holland BloorView

“We are honoured to partner with Holland Bloorview Kids Rehabilitation Hospital to implement an Extensive
Needs Service Program in Durham Region. Children with extensive needs, living in our community, deserve to have
access to coordinated, responsive care close to home. This reduces the burden on these families to travel long
distances to see their providers, which only further exacerbates the caregiver burnout so many experience due to
the current lack of support for this vulnerable population.” – Tom McHugh, CEO, Grandview Kids

“As a mother, I have done everything I can for my children and it’s still not enough. Available resources are greatly limited, waitlists are long, being selected for funding is akin to playing the lottery and costs to procure private services are high. The Extensive Needs Services is helping prevent us from losing our kids and our home. Rory’s therapy is vital to her life and the wellbeing of our entire family.” – Jamie, mom to Rory who is receiving care from Grandview Kids

“MGH is excited to partner with Holland Bloorview to launch this critical service in early 2024 to meet the needs of
children, youth and families in East Toronto. Most importantly, this service is close to home, low-barrier, with
timely, personalized care based on each child’s need.” – Dr. Krista Lemke, medical director of Child and
Adolescent Mental Health Services at Michael Garron Hospital (MGH)

“We are thrilled to be part of the Extensive Needs Service and are honoured to join all our partners to provide
more seamless and personalized health services for families who need it the most. Surrey Place has a unique role
in this partnership, acting as the entry point to help families access and navigate care through Extensive Needs
Service. In our role as the lead agency for coordinated service planning, our focus is to reduce barriers for families
with children and youth who have multiple or complex special needs, and connect them with the right services and
supports, based on their strengths and needs. Our dedicated service coordinators will work alongside families to
determine goals for services, coordinate and make referrals to the right community supports, and ensure families
are at the center of the decision-making process.” – Terri Hewitt, CEO, Surrey Place

Logos of Holland Bloorview Kids Rehabilitation Hospital, Grandview Kids, Michael Garrson Hospital, and Surrey
Place are placed linearly, side by side.

By 2 months

Has your baby had their hearing screened? YES NO

By 6 months

Does the child?

Startle in response to loud noises? YES NO
Turn to where a sound is coming from? YES NO
Make different cries for different needs (hungry, tired)? YES NO
Watch your face as you talk? YES NO
Smile/laugh in response to your smiles and laughs? YES NO
Imitate coughs or other sounds such as ah, eh, buh YES NO

By 9 months

Does the child?

Respond to their name? YES NO
Respond to the telephone ringing or a knock at the door? YES NO
Understand being told no? YES NO
Get what they want through using gestures (reaching to be picked up)? YES NO
Play social games with you (Peek-a-Boo)? YES NO
Enjoy being around people? YES NO
Babble and repeat sounds such as babababa or duhduhduh? YES NO

By 12 months

Does the child?

Follow simple one-step directions (sit down)? YES NO
Look across the room to a toy when adult points at it? YES NO
Consistently use three to five words? YES NO
Use gestures to communicate (waves hi/bye, shakes head for no)? YES NO
Get your attention using sounds, gestures and pointing while looking at your eyes? YES NO
Bring you toys to show you? YES NO
Perform for social attention and praise? YES NO
Combine lots of sounds together as though talking (abada baduh abee)? YES NO
Show an interest in simple picture books? YES NO

By 18 months

Does the child?

Understand the meaning of in and out, off and on? YES NO
Point to more than 2 body parts when asked? YES NO
Use at least 20 words consistently? YES NO
Respond with words or gestures to simple questions (Where's teddy? What's that?)? YES NO
Demonstrate some pretend play with toys (gives teddy bear a drink, pretends a bowl is a hat)? YES NO
Make at least four different consonant sounds (p ,b, m, n, d, g, w, h)? YES NO
Enjoy being read to and sharing simple books with you? YES NO
Point to pictures using one finger? YES NO

By 2 years

Does the child?

Follow two-step directions (Go find your teddy bear and show it to Grandma.)? YES NO
Use 100 to 150 words? YES NO
Use at least two pronouns (you, me, mine)? YES NO
Consistently combine two to four words in short phrases (Daddy hat. Truck go down.)? YES NO
Enjoy being around other children? YES NO
Begin to offer toys to other children and imitate other children's actions and words? YES NO
Use words that are understood by others 50 to 60 per cent of the time? YES NO
Form words or sounds easily and without effort? YES NO
Hold books the right way up and turn the pages? YES NO
Read to stuffed animals or toys? YES NO
Scribble with crayons? YES NO

By 30 months

Does the child?

Understand the concepts of size (big/little) and quantity (a little/a lot, more)? YES NO
Use some adult grammar (two cookies, bird flying, I jumped)? YES NO
Use over 350 words? YES NO
Use action words such as run, spill, fall? YES NO
Participate in some turn-taking activities with peers, using both words and toys? YES NO
Demonstrate concern when another child is hurt or sad? YES NO
Combine several actions in play (puts blocks in the train and drives the train, drops the blocks off.)? YES NO
Put sounds at the beginning of most words? YES NO
Use words with two or more syllables or beats (ba-na-na, com-pu-ter, a-pple)? YES NO
Recognize familiar logos and signs involving print (Stop sign)? YES NO
Remember and understand familiar stories? YES NO

By 3 years

Does the child?

Understand who, what, where and why questions? YES NO
Create long sentences using five to eight words? YES NO
Talk about past events (trip to grandparents house, day at child care)? YES NO
Tell simple stories? YES NO
Show affection for favourite playmates? YES NO
Engage in multi-step pretend play (pretending to cook a meal, repair a car)? YES NO
Talk in a way that most people outside of the family understand what she/he is saying most of the time? YES NO
Have an understanding of the function of print (menus, lists, signs)? YES NO
Show interest in, and awareness of, rhyming words? YES NO
Read to stuffed animals or toys? YES NO
Scribble with crayons? YES NO

By 4 years

Does the child?

Follow directions involving three or more steps (First get some paper, then draw a picture and give it to Mommy)? YES NO
Use adult type grammar? YES NO
Tell stories with a beginning, middle and end? YES NO
Talk to try and solve problems with adults and with other children? YES NO
Show increasingly complex imaginary play? YES NO
Talk in a way that is understood by strangers almost all the time? YES NO
Generate simple rhymes (cat-bat)? YES NO
Match some letters with their sounds (letter b says buh, letter t says tuh)? YES NO