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Medical Services

Practitioners with specialized intellectual and developmental disability expertise

At Surrey Place, our caring team of doctors and nurses is here to support your health and well-being. We offer personalized health assessments, consultations, recommendations, and referrals in a variety of clinics including:

Our physicians and nurses provide high-quality care to families and specialized consultation to healthcare providers seeking specialized intellectual and developmental disability expertise. We also contribute to education and knowledge-sharing efforts related to diagnoses and pharmacological strategies and lead all infection control activities at Surrey Place.

Where can I learn more about the physicians who are employed at Surrey Place?

Here is some information about the experience, research and expertise that our physicians bring to Surrey Place:

Dr. Alvin Loh, MD

Chief of Paediatrics, Surry Place / Assistant Professor, University of Toronto

Dr Loh is a developmental paediatrician and Medical Chief of Staff at Surrey Place.

Clinical: He has worked in the area of assessment of FASD, Behavioural Medical issues, Transition Aged Youth with IDD, and ASD in children with genetic syndromes.

Education: He has co-created curriculum on intellectual & developmental disabilities in undergraduate medical education at U of T such as a clinical skills standardized patient interaction, and visits to community agencies for people with IDD.

Research: He was the leader of the Autism Speaks Autism Treatment Network Toronto site from 2008-2017 and published research on sleep interventions for parents of children with ASD, and the low prevalence of Creatine Deficiency Syndrome in children with ASD. He has also published research on the care of persons with IDD and behaviours that challenge.

CPA: He has worked for many years in advocacy as a member of the steering committee for the Physicians of Ontario Neurodevelopmental Advocacy (PONDA), and was Vice Chair, Chair and Past Chair from 2017-2023. In 2022, he led a group to apply for a new Ontario Medical Association Medical Interest Group in Neurodevelopmental Disorders and is the first Chair.

Significant Work

Symptoms of ASD are reported in patients with Creatine Deficiency Syndrome. We assessed 443 children with ASD with urine screening and genetic analysis, and found no positive cases of Creatine Deficiency Syndrome and no obvious association between creatine metabolites and autism.

Sleep difficulties are a common problem for children with ASD and affect child and parent functioning. The findings of this study using parent-based sleep education, delivered in relatively few sessions by nurses, was associated with improved sleep onset delay in children with Autism Spectrum Disorder.

Behaviours that challenge in adults with Intellectual and developmental disabilities (IDD) are a significant problem for primary care practitioners (PCPs) that often results in emergency room visits and overprescription of antipsychotic medications for aggression. This paper outlines an approach to the assessment of behaviours that challenge looking at physical health issues, environmental factors, supports, and the function of behaviours, lived experiences and psychiatric disorders, and helps PCPs support these complex patients

Created a framework for the development of an innovative multidisciplinary program to support children and adolescents with ASD/IDD in a tertiary children’s hospital setting

Created a coding algorithm and established reliability for videotape analysis of children with Autism Spectrum Disorder (ASD) and typical controls, at 12 and 18 months of age. Children with ASD “arm waved” more frequently than controls, but there was considerable overlap in stereotyped behaviours for both groups. For publications please see PubMed.

Dr. Ullanda Niel, MD

Chief of Developmental Medicine Surrey Place / Adjunct Professor, University of Toronto/ Assistant Professor Queen’s University, Kingston

Dr Niel is a Family Physican, Chief of Developmental Medicine and Clinical Lead, Family Medicine, Developmental Disability Primary Care Program (DDPCP) at Surrey Place.

Clinical: She is a primary care physician with extra training in the care of adults with developmental disabilities (PGY3) from Queen’s University. She is a trained Acceptance and Commitment Training (ACT) clinician providing the Caring for the Caregiver workshop for caregivers of people with intellectual disabilities with a special interest in the care of black caregivers. She enjoys working with diverse patient populations including newcomers to Canada and culturally adapted care for Black Communities.

Education: She has co-created curriculum on intellectual & developmental disabilities in medical education at U of T such as the Transition to Residency Seminar: Ability in Disability as well as Family Medicine seminars about intellectual disability and health. She has also been a HUB member for the Project ECHO Adult Intellectual Developmental Disability (AIDD) interdisciplinary CME program with CAMH.

Research: Dr. Niel has an interest in implementation science (knowledge translation) and provides Family Medicine support for the DDPCP which strives to promote the primary care of adults with developmental disabilities through the creation of guidelines, educational resources and partnerships.

CPA: She also has interests in mentorship for students from minoritized groups and health literacy.

Significant Work

Mendoza, O., Thakur, A., Niel, U., Thomson, K., Lunsky, Y., & Bobbette, N. (2023). Project ECHO-AIDD: Recommendations for care of adults with intellectual and developmental disabilities. Advances in Mental Health and Intellectual Disabilities. 17(4): 292-309.

Sullivan, W.F., Diepstra, H., Heng, J.Q., Ally, S., Bradley, E.A., Casson, I., Hennen, B.K., Kelly, M., Korossy, M., McNeil, K.P., Abells, D., Amaria, K., Boyd, K.E., Gemmill, M., Grier, E., Kennie-Kaulbach, N., Ketchell, M., Ladouceur, J., Lepp, A., Lunsky, Y., McMillan, S., Niel, U ., Sacks, S., Shea, S.N., Stringer, K.C., Sue, K., & Witherbee, S. (2018). Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines. Canadian family physician Medecin de famille canadien, 64 4 , 254-279.Canadian family physician. 64(4): 254-279

Dr. Shelby Olesovsky, MSc, MD, CCFP

Dr. Olesovsky is a family physician at Surrey Place.

Clinical: She supports adults with intellectual and developmental disabilities, with special focus on transition aged youth, as well as working with the adult FASD diagnostic team at Surrey Place.

Education: She enjoys teaching medical learners in clinic. She also delivers lectures on primary care and the care of people with intellectual and developmental disabilities to Genetic Counselling students as well as second year medical students through her role as the Co-Week Lead for Complex Pediatrics and Developmental Disabilities week at Temerty Faculty of Medicine at the University of Toronto.

Research: She completed her Master’s in Neuroscience at the Centre for Neuroscience Studies at Queen’s University. Currently, her research interests lay in the use of tools to support physicians care for people with intellectual and developmental disabilities and creating opportunities to teach family medicine residents how to care for this population in their future careers.

Dr. Joelene Huber, MD, PhD, FRCPC

Medical Lead, ABILITY Program, SickKids Hospital & Surrey Place, Assistant Professor, University of Toronto

Dr. Joelene Huber is a developmental paediatrician and the Medical Lead of the ABILITY Program at the Hospital for Sick Children, which is a collaborative program with Surrey Place.

Clinical: Clinically, she specializes in the assessment and care of children and youth with autism spectrum disorder (ASD) and intellectual and/or developmental disabilities, with a particular emphasis on providing adaptive, individualized care for neurodiverse patients requiring tertiary care at SickKids hospital.

Education: She teaches medical, post-graduate, and health care professional students at the University of Toronto.

Research: Her research focuses on autism spectrum disorder and improving hospital care for neurodiverse patients.

CPA: As Medical Lead, she developed the ABILITY Program (Adaptive, Behavioural, Intellectual/Developmental Disability, Integrated Tertiary care for Youth & Children) at the Hospital for Sick Children. This innovative, multidisciplinary program provides individualized and adaptive care for neurodiverse patients requiring tertiary care at SickKids hospital.

Dr. Marian Coret, MD, MSc, FRCPC

Adolescent Medicine Pediatrician, ABILITY Program & Adolescent Medicine Division, Department of Pediatrics, SickKids Hospital & Surrey Place

Assistant Professor, Department of Pediatrics, University of Toronto

Dr. Marian Coret is an adolescent medicine pediatrician at the Hospital for Sick Children and contributes to the Adolescent Medicine and ABILITY Program, which is a collaborative program with Surrey Place.

Clinical: Marian provides adolescent medicine care to youth with ASD and IDD with restricted eating, obesity, reproductive health concerns, and complex medical and mental health challenges.

Education: She provides education and mentorship to medical students, residents, and subspecialty residents at the University of Toronto.

Research: Her research interests are in neurodevelopmental disorders (ASD, ADHD, IDD) and restricted eating, reproductive health, mental health challenges, and complex medical presentations among neurodiverse youth.

CPA: She helped to develop adolescent medicine based inpatient consultation for youth with ASD and IDD within the ABILITY Program (Adaptive, Behavioural, Intellectual/Developmental Disability, Integrated Tertiary care for Youth & Children) at the Hospital for Sick Children.

Dr. Ivona Berger, MD, CCFP, Enhanced Skills in IDD

Clinical: Throughout her medical training and in her clinical career, she has developed skills to provide comprehensive, patient-centred care to adults with IDD through a family medicine lens.

Education: She is passionate about teaching medical students and residents about the importance of providing care for people with IDD and the health gaps that exist for this population, especially as they transition into adulthood. She has been a part of designing and evaluating the curriculum for undergraduate medical education at UofT, facilitating and teaching sessions for UofT and Queen’s medical students, and is taking part in IDD primary care module and resource development.

Research: With a Master’s in Rehabilitation Science prior to medical school, she has had experience in a variety of disability research. Notably, she has published an evaluation of the undergraduate medical curriculum at UofT and presented these findings at conferences.

Creative Professional Activity: She is involved with a variety of professional and advocacy groups as a member of the CFPC Member Interest Group in Developmental Disabilities, and the OMA Member Interest Group in Neurodevelopmental Disorders. For many years, she has also been an advocate and coach for Special Olympics.

Relevant research:

https://doi.org/10.3109/13668250.2022.2112511

Dr. Natasha Fernandes, MD

Clinical: Dr. Fernandes is a general psychiatrist specialized in the care for adults with developmental disabilities. She works in the Adult Neurodevelopmental Services outpatient clinic and at Surrey Place providing psychiatric consultation to adults with IDD.

Education/ Research: Her main research and teaching interests center on the psychiatric care provided to adults with a developmental disability. Previous projects have included the care this population receives in the acute care setting and most recently the care they receive during the COVID-19 pandemic.

Miriam Maarse, MB, BCh, BAO, FRCPC

Assistant Professor, Department of Paediatrics, University of Toronto,

Educational Lead, ABILITY Program, Sick Kids, in partnership with Surrey Place

Clinical: Miriam Maarse is passionate about providing care to patients with neurodevelopmental conditions. She works as an in-patient physician on the ABILITY team at Sick Kids, providing in-hospital developmental support and consultation for neurodiverse youth and their families, as part of a multidisciplinary team.

Education: Miriam has longstanding roles in postgraduate and undergraduate education. Her academic interests include improving care for autistic children/youth and she has worked to create and implement new diagnostic pathways for this population.

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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