The Extensive Needs Service, or ENS, is here to simplify access to care for families of children and youth living with multiple medical, social, physical and neurodevelopmental health needs.
Funded by the Ministry of Health and the Ministry of Children, Community and Social Services, ENS has been jointly developed and implemented by three pediatric health centres in Ontario: CHEO, Holland Bloorview Kids Rehabilitation Hospital and McMaster Children’s Hospital.
The program is designed to reduce barriers that families sometimes face when navigating the health care system with complex needs and provide access to individualized treatment that is timely, evidence-based and trauma-informed.
Our interdisciplinary care team includes physicians, nurses, nurse practitioners, mental health professionals, behaviour support clinicians, OT, SLP, Dietitians, Psychologists, respite workers, intake workers and service planning coordinators.
What to expect from ENS
Our services help children and youth build important, life-long skills such as communication and emotional regulation. We also support siblings and caregivers, local service providers and educators by equipping them with the skills and strategies to support children and youth with extensive needs in their home, school or community
When you are accessing Extensive Needs Service, you will be connected to an interdisciplinary care team who will collaborate with you to create a personalized treatment plan to improve skills, mitigate challenging behaviours and address underlying health issues.
Who is ENS for:
CHEO’s Extensive Needs Services provides care to children and youth up to 17 years of age who need:
- Multiple medical, neurodevelopmental and mental health supports
- Help with challenging or interfering behaviours that impact theirs or others safety, or their school and family life
- Supports for needs that are currently unmet by resources in the community
What we do:
- Bring together experts from many different disciplines and services cross CHEO to help assess and understand your family’s needs
- Work with you to create and action your integrated treatment plan
- Provide treatment and support to help you meet your goals, in collaboration with health experts across CHEO and in the community
- Support you in accessing any other health services that you may need, with the goal of preventing further deterioration of health
- Reduce high-risk behaviours and the likelihood of escalation to a crisis
Services we offer:
| Outpatient wrap-around care | ||||||||||||||
| Our Outpatient services provide wrap-around, interdisciplinary care for children, youth and their families. The care team works with children, youth and their families to set 1-3 individualized ENS goals, and then supports them to meet those goals before returning to community services.
Each child or youths’ needs are different. This may include:
Steps of your journey with ENS:
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| ENS Medical Clinic | ||||||||||||||
| Our ENS Medical Clinic provides medical care for neurodiverse children and youth who require extra support during routine medical check-ups and more. We offer regular clinics with our physician and nurse practitioner.
Eligibility requirements:
Referrals are made through 1Call1Click.ca. Families can self-refer, or community provider can submit the referral on behalf of the family with their consent. |
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| Supported Visits to CHEO clinics | ||||||||||||||
| We recognize that children and youth with complex neurodevelopmental health needs may experience barriers to attending clinical or medical appointments. Our Supported Visits Team works alongside families to make hospital visits more predictable, supportive, and successful.
We focus on understanding each child’s individual strengths, preferences, and needs. Together, we develop a plan that helps your child or youth access care that is safer and more manageable.
Do you have an upcoming appointment in one of CHEO’s clinics and would like to request a supported visit?
Vaccine ClinicsChildren and youth with complex neurodevelopmental health needs may face barriers to receiving routine or seasonal vaccines. The Supported Visits Team can offer options to make vaccination appointments more accessible. If you are seeking vaccination and would like support with tolerance training or support on the day of the appointment, please contact 1Call1Click.ca.
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| Inpatient care | ||||||||||||||
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| Speciality Care | ||||||||||||||
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Looking for support?
Children, youth, families and community providers can now refer to the Extensive Needs Service through 1Call1Click.ca:
Self-refer: children, youth and families
Make a referral: community providers
Stay up-to-date
If you would like to stay informed about the development progress of this service, please subscribe to this page by entering your email in the "Receive Email Updates" field on the bottom left side of this page.
Are you planning a visit to CHEO’s Neurodevelopmental Health Medical Clinic?
Come along with us as we walk you through what to expect. Told from the perspective of the patient, this video can help children prepare to visit our clinic.
News and stories
03/09/2023: Connecting children and youth with specialized care




