The OAP Advisory Panel Report – A Reason for Hope
Like many, I spent the summer (and part of the fall) waiting for the results of the Ontario Autism Program (OAP) Advisory Panel’s work. I remained hopeful, but it was hard to be patient.
The Ministry seemed to constantly deflect any specific questions asked about the OAP over the past few months, touting the panel report as the eventual way forward from the current mess.
The panel. The panel. The panel.
Recommendations were being collected from across the province, but we’d have to wait for the panel report before we’d see any action or plan.
Minister Smith promised a needs-based program, and the Ministry seemed to be leaning heavily on the panel to make sense of all the noise, then direct the way forward.
No pressure or anything.
The 20 person Advisory Panel was appointed back in the spring by the former Minister responsible, Lisa MacLeod.
I’m not here to debate the selection of the panel, but it did cover a wide selection of voices and opinions. That much was clear.
I was willing to put my faith in the process.
A full list of the panel members can be found here.
Setting the stage
Try putting these 20 different voices into a room, and asking them to come to a consensus on how to move forward on a new program for such a complex file.
Now ask them to do it for free.
Then ask them to work for what ended up being 18 full days of meetings, countless hours on top of that analyzing data and collected submissions, and then get them to put together a report that summarizes the findings and recommendations. Remember too that this was time away from their jobs, family, and their lives in general.
I have the utmost respect for this group of people for the time they devoted to the cause. It must have been extremely draining, physically, mentally, and emotionally. It was a monumental sacrifice that we should not lose sight of. These were ordinary people, willing to put in the time and effort, so that thousands of autistic children might receive better support in the future.
So was it worth the wait?
Absolutely … assuming Minister Smith acts on it.
The full report can be found here.
The recommendations included in the report were extensive, well thought out, and surpassed my expectations, especially in terms of scope.
Let’s look at some of the highlights.
A great selection of “Core Services”
Expansion of available therapies was a welcome change. It was important to have some choice, but equally important that the therapies included were evidence-based and clinically appropriate.
I think this list was chosen well.
Priority Pathways
In addition to the Core Services, the panel recommended resources be allocated to the following pathways:
- Early intervention Services
- Mental Health Services
- Urgent Response Services
All three of these pathways have huge benefits. They also represent ways to support children and families while they’re on the wait list for Core Services.
The Urgent Response service is one that I agree should be implemented as soon as possible. There are families in real crisis that need help now.
Who would qualify for entry into this pathway, and how, is still to be determined, but it needs to be an early spot for the government to focus on.
I think this feature is a fantastic idea, and hope it’s execution is expedited.
I also fully support the inclusion of Early Intervention funding as part of the OAP, as I’ve seen firsthand the benefits of this type of program. My daughter was fortunate to be able to experience the QuickStart Early Intervention program in Ottawa, and it helped her (and us) tremendously.
The Implementation Committee should reach out to programs like QuickStart and others right away (Play Project, DIR Floortime, etc.), examine the data for evidence-based support, and start building capacity for their availability on a broader scale across the province.
Nova Scotia is currently working with a Quickstart pilot program. It would be interesting to find out more on how the program is doing.
It’s important to know that early intervention does NOT replace the need for more intensive therapy and ongoing support. Developmental therapies are a great first step in support for autistic children, aiming to improve their developmental trajectory early on, but the children participating in early intervention should continue to have access to the support they need throughout their childhood, in the form of core OAP services.
Foundational Supports
The autism service system can be confusing to navigate at the best of times, especially for families with newly diagnosed children, or families with language barriers, etc.
There are many that may feel lost.
Having a touchpoint, and an ongoing source of support/guidance is so important.
Targeted Supports
The report did a great job of outlining some of the unique issues that arise with certain communities requiring specialized approaches.
Indigenous families, Northern communities, Francophone families, and other marginalized groups will need special attention, and it was great to see the panel draw attention to that, including a large list of recommendations.
Capacity building was also highlighted, and is critically important.
There is much work to be done to ensure marginalized groups don’t get left behind.
Education
The section on education recommendations was incredibly detailed, which was great to see.
As a parent to two children who are still quite young, I’m not the right person to really tackle the specifics on this part of the report, as my children have not yet experienced the real struggles that older kids would have encountered in the school system.
I do understand the importance of getting kids the right kind of support in school, to help give them the tools they need to succeed. If kids are properly supported in the classroom, their need for ongoing external therapy support would be lower, allowing more children to access needed support through the OAP.
I fully support the call for an Education Advisory Committee to help see the recommendations through, working together with the Ministry of Education.
Mental Health
This is also an incredibly broad and important topic, and one that was given ample time and consideration by the panel.
In addition to recommendations given in the main part of the report, the panel also included a larger section in the appendix, with the following recommendations:
- Expand autism expertise in the mental health sector to ensure full inclusion of autistic individuals
- Expand capacity by developing inter-ministerial approaches to support
- Create an autism and mental health working group for program development and evaluation
- Create wraparound and crisis supports
- Provide mental health service navigation
Mental health is an area that will need continued and ongoing attention, and must include the Ministry of Health.
Other Considerations
I think Direct Billing would incredibly helpful to families. Receiving a large funding cheque, and managing it correctly, can be daunting for families. Creating a mechanism for OAP therapy providers to bill the government directly for services would remove a huge burden, and help ensure money isn’t being mismanaged.
The “algorithm” used currently to pull children off the waitlist has been a nightmare. Getting back to sequential selection, based on date of referral, is essential.
Implementation
Given the scope of the panel’s mandate, and the need for a smooth transition from recommendation to implementation, their call for an Implementation Committee is perfectly reasonable, and I think necessary.
Remembering that this was an Advisory Panel and not a Clinical Expert Panel, it follows that designing specific guidelines on things like intensity/duration/best-practices should be done by discipline-specific experts.
The panel calls for:
… the establishment of subcommittees, including a clinical and scientific expert subcommittee, as required, to do more detailed work.
Final Thoughts
I think the Advisory Panel should be incredibly proud of the work they have done to create their report.
They were able to find common ground, and they produced an amazing collection of recommendations.
If implemented, this type of autism program would be leaps and bounds above what’s been available before. It provides choice, support, and the promise of sustainability.
There is still work to do, but the Advisory Panel Report provides a path forward to something that could be really great.
Minister Smith, if you’re reading this: It’s time for action.
The recommendations are good. They’re really good. There is a chance to create a program that all Ontarians can be proud of.
It’s time to get to work.
