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HomeClinics, Services & ProgramsA-Z DirectoryExtensive Needs Service

Extensive Needs Service

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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:

  • Specialized behaviour services
  • Mental health assessment and treatment
  • Social work, including supports for parents and caregivers
  • Short-term in-centre respite services (provided in tandem with therapies)
  • Care coordination
  • Medication management
  • Consultation with community services to support and build their capacity to support kids with extensive needs
  • Discharge/transition support and planning to help children and youth return to school and community services, or transition to adult services
Steps of your journey with ENS:

1. 1Call1Click.ca intake

You will meet with a 1Call1Click Intake Worker, who will help determine if ENS is the right fit for you.

2. Client assignment

You will be assigned to an Interdisciplinary Care Pod! This core team will support you throughout your time with ENS.

3. Meet your care team

You will meet with your care team for an initial assessment where you can share your story and health journey with us. We’ll keep this information on file so that you only need to share your story this one time!

4. Develop your care plan

Your care team will work with lots of other experts across CHEO to deliver your care plan and help you meet your goals.

5. Working together to implement your care plan

Your care team will work with lots of other experts across CHEO to deliver your care plan and help you meet your goals.

6. 3-month ENS care plan review

Every 3 months your care team will review your Care Plan and progress towards your goals. That will help your care team make recommendations, support you and plan for discharge into community supports when ready

7. Discharge to care in the community

When the time comes, your care team will facilitate transfer of your care to community services. They can meet with you 3-months after discharge to check-in and offer support, as needed.

ENS Medical Clinic

Our ENS Medical Clinic provides medical care for neurodiverse children and youth who require extra support during routine medical check-ups, vaccinations and more. We offer regular clinics with our physician and nurse practitioner.

Eligibility Requirements:

  • Clients must have a confirmed neurodiversity diagnosis (required).
  • There must be an identified mental health need within the family unit.
  • Clients must have an unmet medical need, which may include:
    • No Primary Care Provider (PCP)
    • Inability to access their PCP due to behavioural challenges

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.

Supported visits to CHEO clinics

We know that children with extensive neurodevelopmental health needs sometimes have difficulty attending medical clinic appointments. Our Extensive Needs Supported Visits service helps create safer, more comfortable experiences at CHEO clinics.

Supported visits can include:

  • A pre-assessment to learn more about the child or youth and their upcoming appointment
  • Education or desensitization sessions before their clinic appointment
  • Parent/caregiver coaching to help them best support their child/youth through the appointment
  • Behavioural support before, during and after the appointment based on individual support needs

Do you have an upcoming visit in one of CHEO’s clinics and would like to request a Supported Visit?
Ask the clinic of your appointment to refer you to Neurodevelopmental Health’s Supported Visits Team!

Inpatient care

If you are admitted to one of CHEO’s medical and mental health units, your care team can refer you to ENS if needed.

ENS can offer consultations and direct support during your inpatient stay, as well as to parents, caregivers and siblings.

ENS can also provide on-unit behavioural treatment to ensure you have all the information and supports you need to be discharged home.

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.

Request a presentation

Are you a service provider, educator or other community member interested in a presentation to learn more about ENS?
To request a presentation on ENS for your group or organization, please complete and submit our form at least two weeks prior to the requested presentation date.


News/Updates:

03/15/2023: The Pathway for Children and Youth with Extensive Needs is building 'hopes and dreams' for children and youth with extensive needs

03/09/2023: Connecting children and youth with specialized care

 

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