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A COLLABORATIVE MODEL FOR
THE COORDINATION OF
ASSESSMENT SERVICES FOR
EXCEPTIONAL CHILDREN AND YOUTH
IN THE NORTHERN REGIONS OF ONTARIO

BY

Aubrey Grant Smith

A DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirement
for the degree of

DOCTOR OF PHILOSOPHY

Department of Adult and Continuing Education

1986

ABSTRACT
A COLLABORATIVE MODEL FOR
THE COORDINATION OF
ASSESSMENT SERVICES FOR
EXCEPTIONAL CHILDREN AND YOUTH
IN THE NORTHERN REGIONS OF ONTARIO
BY

Aubrey Grant Smith

The Ontario Government's Social Policy Field, was
established to ensure interministerial collaboration on
policy development. Northern Ontario has been
identified as a priority area for program development
and/or consolidation within the Social Policy Field.
This assessment-needs study was the result of a
c00perative effort on the part of the staffs of the
Ministry of Education, Community and Social Services
and Health in developing an interministerial policy
position which clearly identified the role and
responsibility of each ministry. Participating
Ministries have agreed to the following:

1. That Education conduct relevant assessments

for purposes of diagnosing children's learning needs,

and providing programs and/or services to respond to
these needs.

2. That Community and Social Services ensure
provision of relevant assessments of children for
purposes of diagnosing children's social, emotional and
children's mental health problems, defining children's
psychosocial needs, and providing programs and/or
services to respond to these needs.

3. That Health ensure provision of
assessments for purposes of diagnosing children's
health problems, defining children's health needs,
and providing programs and/or services to meet these
needs. This report details the gap between what is, and
what should be. It offers recommendations which, if
implemented, would achieve the creation of an
integrated and reSponsive service for children in need
between the ages of two and twenty—one years.

The major assumption behind the project was that
children's needs in the North could be served most
effectively by a model that was developed to coordinate

the delivery system, and make it more accessible.

ACKNOWLEDGMENTS

I would like to recognize the individuals who were
instrumental in my program. Dr. Richard Gardner served
as chairman of my committee and was my program advisor.
His counsel and commitment were constant.

My advisory committee was composed of Dr. Benjamin
Bohnhorst, Dr. Howard Hickey and Dr. Charles Mange.
Each challenged and encouraged me academically, and
were an ongoing source of assistance.

In addition I would like to acknowledge the
support provided by Dr. George Burns, Claude Emery,
Sirje Harmatare and Louise Vitols. Their contribution

was greatly appreciated.

ii

TABLE OF CONTENTS

Chapter Page

I INTRODUCTION . ............ .. ............ 1
Background .............. ... ............ 1
Statement of the Problem .............. . 8
Objectives ..... . ........... . ........ ... 10
Research Questions ..................... 12
Rationale for the Study ..... ........... 13
Project Development Stages ... ..... ..... l4
Scope and Limitations of the Study ..... 17
Definition of Terms ..... . .......... .... 19
Overview of the Study . ....... . ....... .. 22

II REVIEW OF THE LITERATURE ... ..... . ...... 23
Section 1 - Introduction ... ............ 23

Section 2 - Coordination, Collaboration
and Organizational Change .. 48

Section 3 — Needs, Assessment/

Evaluation ................. 65

Section 4 - Assessment ...... ........... 69
Section 5 — Summary .. ................. 98

III THE MODEL .............................. 100
Introduction ... ........ . ............... 100
Design Considerations .................. 109
Project Team .... ....................... 112

iii

Page

Model .................................. 113
Coordinating Procedures ................ 132
Basic Implementation Tasks ... ..... ..... 140
Instrument Development ................. 142
Findings ...... ..... .................... 149
PILOT .................................. 158
Pilot Selection ........................ 160
Agency Procedures Manual ........ ..... .. 162
I.M.A.P.T. Procedures ..... .......... ... 163
Evaluation Instruments ................. 164
Information ....... ..... . ....... ........ 165
Training Sessions .......... ............ 166
Pilot Data ........... ..... ............. 173
Communication ......... ............ ..... 175
Roles and Dates . ....................... 177
Results . ............................... 173
SUMMARY, CONCLUSIONS, RECOMMENDATIONS .. 188
Introduction ... ........... . ....... ..... 188

Summary of Findings from the

Instrument . ...... ..... .......... ....... 191
Summary of Findings from Pilot ..... 199
Conclusions .... ......... ... ......... ... 202
Recommendations . ........ ... ..... ....... 206
Reflections . ........ .... ............... 208

iv

APPENDICES Page

A: Definitions

Assessment Questionnaire

Northern Assessment Task Force ..... 211
B: Individual Child

Assessment Questionnaire

Northern Assessment Task Force ..... 231
C: Co-ordinating the Delivery of

Assessments

Agency Procedures Manual ........... 256
D: Training Session

Evaluation Form .................... 288
E: Evaluation Form

Implementation — Pilot Project

Co-ordination of the Delivery of

Assessment Services ................ 295

BIBLIOGRAPHY 0.00.0........OOOOOOOOOOOOOOOOOO 301

LIST OF TABLES

Work Plan ..............................
Numerical and Percentage distribution
of recorded referrals by Ministry

and agency type for the districts of
Timiskaming and Thunder Bay ............
Evaluation of Training Session .........
District of Timiskaming - Summary

of Pilot Project Data ..................
District of Thunder Bay - Summary

of Pilot Project Data .... ........ . .....

Evaluation of Pilot Project .......... ..

vi

Page

101

151

170

184

184

185

CHAPTER I - INTRODUCTION
Background

The Ontario Government's Social Policy Field was
established to ensure interministerial collaboration on
policy development among its constituent Ministries.
The Deputy Minister's Ad Hoc Committee on Children's
Services was one of the processes established to ensure
compatible and complementary program delivery.
Northern Ontario has been identified as a priority area
for program development and/or consolidation within the
Social Policy Field. As a result, the participating
Ministries launched several new initiatives within the
Northern Region. One was a proposal developed by the
Ministry of Education in 1979 for "The Provision of
Assessment and Psychological Services in Northern
Ontario". Of significance in this proposal was the
recommendation that:

The availability of in-depth assessment and

treatment services throughout the North be

reviewed at an Interministerial level involving

the Ministries of Education, Community and Social

Services and Health to ensure that:

1. Resources currently available in existing

centres can accommodate the full range of

exceptionalities referred to the centres;

2. Children in all communities within the

catchment area of existing centres are provided

equality of access;

3. Where necessary, additional resources are

provided in accordance with a well-defined,

phase-in plan.

It was noted in this report, that while community
schools are able to provide for the majority of
children's needs, there are still those children whose
needs warrant additional servicing by other agencies.
Therefore the need for coordination of service delivery
was recognized.

As a result of this report, the Deputy Minister's
Ad Hoc Committee directed the Ministries of Education,
Community and Social Services and Health to formulate a
long range strategy for the development of assessment
resources in Northern Ontario. To accomplish this, a
Steering Committee comprised of Senior Managers within
the Ministries' operations at the regional level was
established. The Steering Committee subsequently
appointed an Assessment Task Force to design a system

of assessment resourcing.

 

’r-v

This initial Task Force (the "Northern Region
Interministerial Task Force on Assessment Resources")
which met from October 1980 through June 1981,
presented their final report to the Deputy Minister's
Ad Hoc Committee in the fall of 1981. The following
recommendations defining jurisdictional responsibility
were accepted from that report:

1. That Education conduct relevant assessments
for purposes of diagnosing children's learning
problems, defining children's learning needs, and
providing programs and/or services to respond to these
needs.

2. That Community and Social Services ensure
provision of relevant assessments of children for
purposes of diagnosing children's social, emotional and
children's mental health problems, defining children's
psychosocial needs, and providing programs and/or
services to respond to these needs.

3. That Health ensure provision of assessments
for purposes of diagnosing children's health problems,
defining children's health needs, and providing

programs and/or services to meet these needs.

Although it was acknowledged that psychosocial
assessments were primarily the responsibility of the
Ministry of Community and Social Services, it was
agreed that for clients showing mild to moderate
dysfunction, the Ministry first presented with the case
would act as its own assessment agent. (Elaboration of
the terms "mild”, "moderate", "severe", and "very
severe" appear in Appendix A).

The underlying philosophy for this assignment of
assessment responsibility is that the Ministry of
Education (usually through their Boards) is fully
responsible for provision of educational assessment and
the Ministry of Community and Social Services is
responsible only for the behavioural (i.e.,
psychosocial) assessments of children which cannot be
performed within the normal community setting (i.e., by
schools, family doctors, clergy, etc....).

The deliberations of the Task Force were guided by
a philosophical approach that favoured service
provision to the total child within the context of
his/her environment to ensure that each child shall
have access to assessment services to meet his total
needs. The "whole child" approach favours service

provision from a client's point of view which is

holistic, taking an ecological view of the child. In
addition, the Task Force determined that the service
delivery system should be developed in such a way as to
maximize the use of existing resources and results
between Ministries. While it was important that the
mandate for responsibility for assessment services be
clearly defined for each Ministry, it was equally
important that the integrity of the concept of the
holistic child approach be maintained. Therefore,
while there may be separate and distinct
responsibilities assigned to each Ministry, these
should be of consequence only at an administrative
level, with the actual assessment process being
conducted in as united a manner as possible.

Through an initial review of the assessment data
available from Education and Community and Social
Services, it became apparent that the formats for data
collection varied greatly, to the point where it became
difficult to determine what the impact on both systems
would be with the adoption of the above
recommendations. Since a common data base was
critical, approval was given to the Steering Committee
to field test the recommendations through a process of

data gathering and consultation. In short, a data

collection process was required to document the status
of assessment services currently functioning within the
Northern regions of the province. It was also
recommended that the process of consultation be
extended to, and include participation by the Ministry
of Health.

As a result of the above direction from the Deputy
Minister's Ad Hoc Committee, a study to focus on the
implementation of the recommendations of the Task Force
and the issues raised by it was initiated.

Although agreement for jurisdictional
responsibility for each Ministry in relation to
assessment services to children was achieved at the
senior level of government, considerable work and
consultation was required to refine and operationalize
a comprehensive assessment system. Through the
collaborative efforts of the three Ministries and their
respective delivery agents, an integrated and
responsive assessment service system for children and
families in Northern Ontario is presently being
proposed. This study has operationalized the
recommendations of the Task Force Report accepted by

the Deputy Minister's Ad Hoc Committee and has provided

terms of reference for their successful implementation.

The following discussion is a result of these efforts.

Statement of the Problem

In the past, the North has suffered from a lack of
resources and services for children. Historically,
those services that were available, have tended to be
located in major urban areas. However, with this
advantage little formalized coordination has developed
among the various providing agencies to ensure that
children's needs were being met. The following factors
were identified as having contributed to this
situaiton: small communities sparsely located and
unable to support full-time service provisions; vast
distances between any "major" centres; small enrollment
schools; limited resources; limited provision of
specialized personnel; distances that limit the
provision of in-service training; cultural and
linguistic differences; and insufficient Francophone
and Native services in some specialized areas of need.

Ministries serving our child population have
eXperienced mandate problems in relation to specific
children as described by D. McKinnon in her report

(Needs of and Resources for Children of Two Northern

 

Ontario Boards, 1976). Children not clearly the

 

responsibility of a single ministry have been difficult

to serve. This has resulted in the duplication of

services in some situations, and a dearth of services
in other situations.

The scarcity and unequal distribution of
assessment services for children in Northern Ontario
necessitates a need for a systematic approach on the
part of Ministries and their agencies to provide
opportunities for exceptional children. This need was
documented by a committee composed of the three
Regional Directors of Education for Northern Ontario,
and three members of the Provincial Special Education

Branch. The report, entitled (A Proposal for the

 

Provision of Assessment and Psychological Services in

 

Northern Ontario was submitted to the Deputy Minister

 

of Education, on November 29, 1979).

To prevent a duplication of services between
Ministries and their agencies, services need to be
delivered as much as possible by the appropriate
ministry and agency in the local area according to a
role definition agreed upon by each ministry and its
agencies.

Therefore the research problem is to develOp and
pilot a coordinated interministerial model for the
delivery of assessment services to exceptional children

and youth in the Northern Regions of Ontario.

10

Objectives

To develop a long range, coordinated,
interministerial model for the delivery of assessment
services to exceptional children in the Northern
Regions of Ontario, a number of distinct tasks were
undertaken. These were:

1. To compile an inventory of existing
assessment resources within the Northern region through
the completion of a comparable
data- collection exercise by all three Ministries in
order to identify the amount and type of assessment
activities being done by each Ministry.

2. To analyse the data and make recommendations
for the develOpment and/or realignment of assessment
resources consistent with statements of assessment
responsibility which are acceptable to all three
Ministries involved in the exercise.

3. To define and to document the scope and level
of assessment requirements for each Ministry in order
to achieve this realignment. To identify decision
points and procedures in the assessment system where
inter-agency coordination should take place, including
the development of a mechanism for conflict resolution

in the system.

11

4. To prepare a long-range strategy for the
implementation of the recommendations presented to the

Steering Committee.

ff)

 

12

Research Questions
To proceed with the development of the model the
following exploratory questions of a qualitative
dimension were delineated:
1. What model will best provide this service
given the whole child philOSOphy and the respective

mandate of each ministry?

2. Who are the children that will require the

services?
3. What services do children require?
4. Can the model be designed collaboratively?

5. Who will provide the service?

13

Rationale for the Study

This study describes the tasks completed to meet
the identified objectives. A project of this scope
when fully operational will bring to the Northern
Region a number of necessary assessment services that
presently do not exist. The prOposed delivery system
will facilitate the sharing of information and
assessment resources. Each participating Ministry will
become more knowledgeable about, and have greater
access to, the other's differing and complementary
assessment capability. As a working model, the system
may be duplicated by other provinces to provide

services for their children in need.

(v

‘53

VNI

14

Project Development Stages

A work plan was developed by the researcher for
the purposes of cataloguing and sequencing the
objectives. A planning guide in the form of a critical
path bar chart was initially constructed to display the
scheduling of the many activities involved in the
project. Project goals were achieved through the
following sequence of developmental stages:

1. The collection of data on assessment
activities, capabilities and needs from M.C.S.S.
agencies, Ministry of Education school boards, and the
Ministry of Health was collected by the project team.

2. The preparation of an integrated
interministerial model for the delivery of assessment
services was carried out by the researcher and amended
by the project team members.

The work plan provided a summary of activities and
a review of the tasks to be completed. Not all
objectives were achieved in precisely the same manner
or sequence as was initially intended. Revisions in
dates were necessary as a result of delays in
resolution of provincial policy issues of an
interministerial nature, and because of a longer time

period needed for data collection and analysis. As

15

will be discussed in Chapter III, it was necessary to
re—do the data collection phase. This necessitated a
new questionnaire and definitions which were
cooperatively established by the participating
Ministries.

Throughout preliminary discussions and activities,
representatives of Education and Community and Social
Services acknowledged the need to include
representation from the Ministry of Health. At that
time, however, it was felt that this would occur only
after Ministry of Community and Social Services and
Education, the two Ministries primarily involved with
the assessment of children, had achieved agreement on
their respective responsibilities for assessment
services and resource requirements. The extent of the
Ministry of Health's involvement in the preliminary
stages of this project could be termed "process
partnership" or "passive involvement" as Health was
provided with updates as decisions were made.
Generally, these decisions were considered fait
accompli unless Health had a concrete counter proposal.
Nevertheless, Health initially met with the project

team to determine the applicability of both the

16

categories of dysfunction and the operational
definitions to their service system.

Overall, as matter progressed there were a number
of operational policy issues that required resolution
and that had implications for the assessment services
provided by the Ministry of Health. For the proposed
model to be truly reflective of the activities and
needs of the Northern Region, a higher degree of
support and participation was eventually required and

obtained from the Ministry of Health.

17

Scope and Limitations of the Study

The findings of the study are limited in
application to the time specific to the completion date
of the assessment survey. However, it should be noted
that while the volume of referrals/assessments made by
agencies/boards may change, general patterns may still
remain. In addition, the findings may or may not be
generalized to geopolitical settings other than
Northern Ontario.

In theory, the effectiveness of enterprises of
this nature are limited by the goodwill present among
the participants at all levels. At the corporate or
ministry level a great deal of goodwill was required to
establish a positive feeling about cooperative efforts
and to build rapport for cooperative agreements. This
goodwill present among Ministries extended to determine
the extent of the "rapprochement" among the various
professionals involved and was a determining factor in
whether successful collaboration in formulating and
implementing a new service delivery model could be
achieved. While ideally the emphasis is directed to
the common good (i.e. providing assessment services for
children in need), goodwill is essential in promoting

linkage efforts and resolving questions about the

18

status of standing practices and agreements and complex
administrative issues. Goodwill affects differing
outlooks, perspectives, interests, ideologies, and
professional rivalries (turf protection relating to
which ministry provides what service or which ministry
incurs the costs of servicing), all potential factors
and which could limit a multidisciplinary, cooperative,

interministerial project of this kind.

19

Definition of Terms

Education Act (Bill 82)

 

Provincial legislation ensures that all
exceptional children in Ontario have available to them
appropriate special education programs and services
without payment of fees by parents or guardians. Bill
82 provides for the parents or guardians the right to
appeal the appropriateness of the special education
placement. It requires school boards to implement
procedures for early and ongoing identification of the
learning abilities and needs of pupils, defines
exceptionalities and prescribes classes, groups or
categories of exceptional pupils. And it also requires
school boards to employ such definitions or use such
prescriptions.

Exceptional Child

 

An exceptional child is a child whose behavioural,
communicational, intellectual, physical or multiple
exceptionalities are such that he or she is considered
to need special services.

Hard-To-Serve

 

A pupil who is deemed to be unable to profit by

instruction offered by a board due to a mental handicap

20

or to a mental and one or more additional handicaps is
Hard-to-Serve.
Identification, Placement and Review

Committee (I.P.R.C.)

 

The I.P.R.C. places exceptional pupils in special
education programs and services, and reviews such
placements yearly or on parents' demand (Ministry of
Education Regulation).

Ministry

 

Is a government department established to enact a
given area of legislation.

Special Services

 

These are facilities and resources, including
support personnel and equipment, necessary for
developing and implementing a special program.

Unusually Difficult Service Situation

 

Committee (U.D.S.S.)

 

This is a committee that examines unusually
difficult service situations due to multihandicapping
conditions or needs outside of the normal service
system (Ministry of Community and Social Service

Memorandum).

21

Inter-Ministerial Assessment Planning Team
(I.M.A.P.T.)

The I.M.A.P.T. is composed of the Director of
Education, the Area Manager for Community and Social
Services, and the Area Program Planner for the Ministry
of Health.

Service Stream Agency

A service stream agency is any agency funded by a

ministry to carry out the services dictated by the

mandate of that particular ministry.

22

Overview of the Study

The following is an overview of the remainder
of the study. Chapter II will contain a Review of the
Literature. Chapter III describes the model for
coordinating interministerial assessment. It will offer
a model for coordinating the delivery of assessment
services which identifies decision points in the
assessment system where interministerial coordination
should take place at an agency level, and the
development of procedures for how this will happen. It
provides a mechanism for conflict resolution in the
system, and suggests an implementation plan. It also
presents sources of data, data analysis, and procedures
used in the research of the study. Chapter IV
describes the Pilot, and Chapter V presents a summary,

conclusions and recommendations.

23

CHAPTER II - A REVIEW OF THE LITERATURE
Section 1 - Introduction

1.1 Background of the Review

 

The primary thrust of the literature review was to
gather information regarding possible models for
coordinated assessment service delivery. Despite the
significance of the topic, the literature in this area
was somewhat modest with general lack of attention
being given to the complex organizational and decision
making processes within systems and between systems.
Much of the research on child assessment has generally
"focused its attention upon the learner and the
teacher" (Gallagher 1978, p. 25). Initially, the
investigation sought to gain an impression of the work
outside Ontario in order to identify major trends and
issues in the field. In tracing information about
coordinated assessment work in Canada, except Ontario,
secondary sources were scarce and primary sources such
as provincial government policy statements and programs
were not readily available.

The reporting itself is not difficult but one runs

the risk of reporting something which may be

completely out of date by the time the completed

24

document is in the hands of interested

professionals (Kelsey 1978, p. 5).

Nevertheless, a brief survey and description of the
present Canadian situation has been attempted.

While this process has produced scant Canadian
data, there is an overabundance of American sources
from which to choose. Woodill provides perspective to
this situation by stating:

Cultural domination from our neighbour to the

south is not just a matter of an overabundance of

American books, records, and movies. It is seen

whenever we Canadians lose our sense of history

and identity and look to the 0.8. for our models
and precedents in any area of endeavour. This
would seem to be the situation in the field of
working with exceptional children. Most of the
textbooks on special children used in Canadian
universities and colleges are American. The
majority of journals and books in our libraries
are from the United States. Most of our large
conferences are dominated by non-Canadian speakers

(Woodill 1981, p. l).

The literature suggests that research and

development is an area neglected by all provincial

25

governments. Educators are aware that little money is
being spent in Canada on basic and applied research
concerned with improving services to the handicapped.
However there are examples of some provinces that have
assigned money to policy—making and administrative
research (Perkins 1975, p. 22). Since Canada does not
have a national centre for the study of special
education, we have become very dependent on American
research.
When will Canada have a national coordinated
research and development focus in special
education? We still suffer from a frontier
mentality both at the federal and provincial level
when it comes to making a full commitment to
handicapped children and to ensuring comprehensive
and quality services based on sound planning,
research and management (Perkins 1979, p. 33).
Thus, the intent of this review is to focus on the
general aspects of service delivery which could lead to
possible action guidelines in developing and supporting

the model presented in a later section.

fL

14

Va

mt.

f u

Fl

26

1.2 History and Problem

 

The following is a general historical perspective.

According to Korteweg (1983) the current problems
and issues in special services in Canada exist because
of our historical and political develOpment and because
of our attitudes and values.

One problem in Canada is the dispersion of
responsibility among the vast array of unrelated and
independently functioning helping agencies for
children. Each agency offers its own unique set of
services and is often unaware of duplicate efforts and
sometimes, even, of the existence of sister agencies
involved in providing similar services to the same
client groups. Separate services have acted
independently and fragmentation of effort has resulted.

A document of particular significance to Canada in
the area of special service delivery is "The Report of
The Commission on Emotional and Learning Disorders in
Children", the Celdic Report (1970), entitled One

Million Children. The Celdic Report made numerous

 

recommendations affecting all aspects of special
service provision for children and youth. The Report

noted that:

27

The lack of integration is largely a reflection of
the fact that these services were established as
an individual, a voluntary association, a private
group or a government department saw a particular
need and acted to develop programs to meet the
need as they perceived it (p. 294).
In short, legislation involved piecemeal social
engineering, which has resulted in a variety of
services fragmented in terms of departmental
responsibility and objectives. Services developed in
this manner were capable of meeting only a part of the
total community need in a quantitative sense. 'In most
instances service programs were so designed that they
offered only a part of the range of programs required
to solve the problems presented around any particular
child' (Lazure & Roberts 1970, p. 294). Today, it is
generally agreed that a wide variety of services and 'a
total spectrum of service delivery capabilities is
essential' (Gearheart 1980, p. 53).

Closely related to the lack of coordination in the
planning and delivery of services, and a part of the
same problem, is the fragmentation at the provincial
government level into departments of education,

welfare, corrections and, in some provinces, manpower.

28

The lack of coordination among these various agencies
in their efforts to plan and implement services was
outlined in the Celdic Report as a major reason for
duplication of, and gaps in, services to handicapped
children in Canada (p.295). While many of the various
service providers do perform some highly specialized
functions, in large part they are not significantly
different from those performed by many other helping
services. 'This unnecessary specificity of function
only fragments the delivery of services to the child
and his family' (p. 296).

Therefore, complementary and alternative services
are administered by separate ministries with different
policies and practices. These different ministries and
agencies are influenced by different helping
professions with different outlooks and ideologies.

The end result is that the problems of children in need
have been, and are being, treated in a piecemeal
fashion.

1.2.1 The Problem of Service Delivery in the Smaller

Towns and Rural Areas

 

There is basic agreement that services are
seriously underdeveloped in the smaller towns and rural

areas, and tend to be concentrated in the larger

29

centres of population (Perkins, 1979; Korteweg, 1983).
Even where services do exist in more adequate numbers,
they often lack coordination and are characterized by
overlaps and gaps. Wide variations have existed, and
continue to exist, from one jurisdiction to another
(Goguen and Leslie, 1980; Perkins, 1979).

According to Korteweg (1983) it is vital that the
problem of service provision and adequate support
personnel in the marginal areas be faced and tackled.

Ontario and other provinces with a large northern

hinterland as well as the territories, must

establish special units for the provision of
support services in those regions. The least
policy makers and implementors can do is to ensure
that travelling resource teams and teachers are
regularly available to schools along a northern
railroad track or within the flight path network

of bush planes (p. 8).

Perkins (1979) notes that while children in
isolated and remote parts of a province should be able
to obtain special services similar to those obtained by
children living in urban areas of the same province, to
deliver such service may require "differential

financing of special education because of the low

30

incidence of handicaps in sparsely populated areas" (p.
35). In sum, the problems of geography and distances
demand "a higher staff-to-student ratio to deliver
comparable service" (p. 35). The author concludes that
this requirement does not appear to have been
recognized probably because of the politics involved
(p. 35).

1.2.2 Geopolitical Boundaries

 

The geopolitical boundaries of the various
servicing agencies was recognized to be an important
issue in the Celdic Report. The report recommends that
geographic boundaries of the education, health and
welfare components of the network of service programs
be the same (p. 310). It is generally recognized that
ill-defined and ambiguous boundaries in service
districts generate confusion and friction between
departments and their staffs (Williston 1971, p. 92).
This is seen as a major obstacle in providing service
since it creates difficulties for the parent who is
trying to find help for a child, and also creates major
barriers to communication between the helping
professions (Lazure & Roberts 1970, p. 310). Moreover,
variations in service district boundaries can

frequently provide an easy out or an excuse "for

31

administrative confusion, for lack of cooperation or
for failure to provide services" (Lazure & Roberts

1970' p. 310).

32

1.3 Trends in Special Service Delivery in the 0.8.

 

The shortcomings in the present delivery of
services in Canada also exist ”in varying degrees in
other countries, throughout the world" (Perkins 1975,
p. 19). In the U.S., education, social service, and
health service agencies share common mandates and
common clients. A broad range of services are
duplicated. Services lack coordination, and are
provided by "... scarce personnel which compete for
their employment" (Lacour 1982, p. 265). Hagebak
(1982) indicates that some state governments in
response are attempting consolidation of local delivery
systems "in the interest of cost effectiveness, to
assure that those in greatest need continue to receive
adequate care" (p. 73).

In the U.S., Public Law 94-142 mandates the
nationwide provision of assessment and individualized
education plans(IEP's). School boards must provide
comprehensive, nondiscriminatory and multidisciplinary
evaluations of exceptional needs; provide programs and
develop education plans for these needs; provide
services, personnel and facilities to identify, plan
and program for exceptional needs (Posno 1981, p. 16).

In Ontario the issue appears to be not so much whether

33

assessment and individualized education is called an
IEP or a PEP (Personalized Education Plan), rather it

is that such a plan must be provided.

34

1.4 Trends in Ontario: Bill 82

In Canada, organizations such as The Association
for Children with Learning Disabilities, The Canadian
Association for the Mentally Retarded, The Council for
Exceptional Children, and various others, not only
created public awareness but also began to lobby and to
exert sufficient political pressure to set a
legislative process into motion for the protection and
extension of the rights of children in need (Korteweg
1983, p. 4).

In Ontario The Education Act (1974) contained only
permissive legislation for Special Education. A school

board could, if it wished, provide special education

 

programs and special education services for its
exceptional pupils. Although most boards provided some
programs, the passage of Bill 82 (1980) recognized that
the development of a child with special needs is best
promoted when treatment and education programs are
viewed as interdependent and planned together. It
removed the "optional" status of special education and
made it the definite responsibility of school boards to
offer services which were not offered or were offered
by other agencies. School boards in Ontario must now:

(a) identify children with exceptional needs

35

in the areas of behavioural, communicational,
intellectual (including the gifted), physical or
multiple exceptionalities;

(b) provide a special education program that
is based on and modified by the results of continuous
assessment and evaluation and that includes a plan
containing specific (learning) objectives and an
outline of educational services that meets the needs of
the exceptional pupil;

(c) provide special education services,
meaning facilities and resources and including support
personnel and equipment necessary for develOping and
implementing a special education program (Posno 1981,

p. 15-16).

36

1.5 Trends toward COOperation/Collaboration

 

in Canada

 

In Canada, where human services are primarily a
provincial responsibility, several provinces have
introduced various forms of reorganization of services
in an effort to assure greater rationalization and

coordination (An Experiment in Progress ...,, 1977, p.

 

6).

1.5.1 The Atlantic Provinces

 

The interest and support from the Ministers of
Education of the Atlantic provinces resulted in a
comprehensive study of the needs of children with
low-incidence handicaps and led to expanded programing
and services and increased c00peration among the four
provincial governments. Through the creation of a new
administrative structure in 1975, the APSEA (Atlantic
Provinces Special Education Authority), cooperative
efforts on behalf of low—incidence handicaps (visual,
hearing, multiple handicapped) were ensured. With
relatively small populations in the Maritimes, this
type of cooperation has 'greatly benefited the
handicapped pOpulation and at the same time has
permitted more fiscally efficient programing‘

(Gearheart 1980, p. 88).

37

1.5.2 Quebec
In 1969 an Interministerial committee was formed
which included the ministries that were most directly
concerned with children in difficulty (Education,
Social Affairs, Health, Justice and Labour). The
Committee defined and described the responsibilities of
the various governmental agencies as they related to
such children. Developments in Quebec parallel those
in Ontario.
Since 1975, school boards have gradually expanded
their services so that today they are accepting a
number of students with more severe handicaps who
might have earlier been the responsibility of the
Ministry of Social Affairs or specialized private
institutions (Gearheart 1980, p. 93).
With the increasing responsibility of the schools to
provide direct services to the more severely
handicapped population, many school districts could not
effectively or efficiently provide services within
their local schools and, therefore, have entered into
agreement with other school districts or private
institutions to provide appropriate schooling
(Karagianis and Nesbit 1980, p. 7). Educational

provisions for the handicapped student have become an

38

educational responsibility, not a social or welfare
responsibility even though the Ministry of Social
Affairs "is the agency other than education with major
involvement with handicapped students" (Gearheart 1980,
p. 93).

The Office of the Minister of Education in 1978
issued a document entitled "Quebec Schools; Children
with Adjustment and Learning Difficulties. Statement
of Policy and Plan of Action" (Morin 1979).

The government's official position is that
children who had previously been described as
exceptional or maladjusted now be referred to as
"children with difficulties in learning and
adaptation". The province of Quebec saw this as a
"positive" change in the perception of children with
learning and adjustment difficulties (Karagianis and
Nesbit 1980, p. 7). Implementation of the program is
presently underway with both financial and program
planning support from the provincial level. Gearheart
(1980) cautiously warned that how well the local school
districts carry out the intent of the provincial
government ”remains to be seen", although an expanded

and improved program is "certainly under way" (p. 94).

39

1.5.3 Saskatchewan

 

Saskatchewan, has seen certain pilot projects
underway with a growing number of cooperative programs
within departments of the government being contemplated
(Gearheart 1980, p. 98).

1.5.4 British Columbia

 

In B.C., a number of special education programs
other than the residential programs receive joint
support from various ministries, and therefore require
coordinated planning at the provincial, regional, and
local levels. Such planning has taken place for some
time. In 1978 an Interministry Children's Committee
(IMCC) was formed, linking the ministries of the
Attorney General, Education, Health and Human
Resources. These four ministries have attempted to
provide additional assistance and guidance in
determining how needs may best be met. They appear to
have been of most assistance to the severely
handicapped, and in planning services in sparsely
populated areas. Procedures have been established
whereby in problem situations attempts are first made
at the local level, then if necessary, at the regional

level. If the regional IMCC cannot arrange for the

4O

needed resources, the provincial IMCC is consulted
(Gearheart 1980, p. 101).
The Inter-Ministry Children's Committee system may
prove to serve an advocacy role for students who
are not being appropriately educated (Gearheart
1980, p. 101).
Gearheart (1980) however cautioned that in B.C.,
certain of its programs are relatively new and the
effectiveness of the IMCC has yet to be fully
established (p. 101).
1.5.5 Alberta
The activities of the Institutional (Educational)
Services Divisions of the Edmonton and Calgary public
school boards provide an excellent example of
cooperative effort.
In this cooperative model, interdisciplinary
divisions (health, psychology/psychiatry, social
welfare, justice and education) have devised a
plan through which they jointly serve the needs of
individuals in regional or provincial sheltered
settings, treatment centers, or detention homes,
with appropriate authority and responsibility
delegated to planners of the various program

components (Gearheart 1980, p. 102).

41

1.5.6 Summary

Provincial statements supporting the idea of
interministerial cooperation and the existence of
effective cooperative programs have illustrated the
current trend in Canada. In many places throughout all
provinces, local and provincial governmental agencies
have made an additional effort to work together to be
of service to children with special needs. These
programs may in the future provide models for those who
need guidance in planning or reshaping their own
programs. An investigation of the trends and practices
in Canada led Gearheart (1980) to conclude that:

Much improvement is needed in certain areas of the

nation. Nevertheless, it appears that there may

be more deliberate planning and cooperation
between agencies serving handicapped students in

Canada than has sometimes been the case in the

United States (p. 103-104).

42

1.6 Regional Self Sufficiency

 

The literature has strongly favoured regional
self-sufficiency in the delivery of services to
communities. The Warnock Committee realized that many
severely handicapped youths might be ignored given the
sparse geographic distribution of such children in some
areas. The Celdic Report indicated that only when a
problem is so complex that it requires a combination of
expert resources from outside the community, should "it
be necessary for a child to be referred out of the
normal stream of his home community" (p. 316).

While provincial governments have exercised and
should continue to exercise their role in establishing
controls and setting standards, services Operated by
governments remote from the scene cannot quickly,
effectively and efficiently be responsive to the
changing needs of a local community (Lazure & Roberts

1970, p. 303).

L, A. \

43

1.7 Incidence of Disabilities

 

Incidence estimates vary considerably.
Accordingly, most writers carefully acknowledge the
limitations of their methodology in reporting incidence
rates. There are variations in estimates because of a
failure to either include or exclude certain types of
conditions. "The major source of variation in the
estimates in the literature is the narrowness or
breadth of the defining criteria" (Rawlyk 1977, p. 45).
Those groups generally referred to as "learning
disabled" and "emotionally disturbed" tend to be the
most contentious because there is little agreement over
definitions which can be quantified.

In general, there is fairly consistent agreement

on the incidence of sensory impairments (e.g.

blindness and deafness) compared to the functional

disorders (e.g. learning disabilities, emotional
disturbance) since the latter are frequently based

on the judgment of the estimator (p. 45).

Overall, there is a paucity of research in the

area concerning incidence rates in Canada.

Few systematic incidence studies have been

conducted in Canada, and estimates of need in the

Canadian population at present tend to be based on

 

 

 

 

44

rates established in the United States (Rawlyk

1977, p. 45).

The Celdic Report (1970) estimated "that one child
in eight has an emotional or learning disorder that
will prevent optimal development unless some
intervention takes place" (p. 5); the Warnock Report
(1978) suggests that services for children and young
people be based on the assumption that:

One in six children at any one time, and as many

as one in five at some time during their school

career, will have difficulty to the extent that
will need some type of Special Education provision

(p. 41).

Karagianis and Nesbit (1980) point out that "the
implication for such an increase in the accepted number
is profound in terms of both manpower, and cost" (p.
7). Instead of 12% per cent of our school age
population requiring special help, they estimate that
16% per cent fit into this category (p. 7).

Rawlyk (1977) raised the question of variation in
incidence of handicapping conditions in different areas
of geographic responsibility. For some school

districts, the provision of services (particularly for

45

more severe handicapping conditions), can actually

raise the incidence level in that district (p. 45).
The lower the prevalence of the condition in the
school population, and the higher the costs of an
appropriate program, the more likely that families
with such handicapped children will move to school
districts with established programs thus raising
the incidence rate for the ... jurisdiction. If
these variations are indeed valid, some way of
allowing for them needs to be incorporated into a

funding formula (p. 45).

46

1.8 Services to Minority Groups

A number of writers have discussed the problem of
providing special services to minority status children.
Professionals can no longer ignore the demand for
special services to minority groups since legislation
and the greater assertion of rights by minority groups
have made the provision of special services to meet the
needs of children, a "societal expectation"' (Korteweg
1983, p. 9). Minority or low socioeconomic status
children may, in practice, present unusual problems in
assessment. The provision of services to children in a
culturally and linguistically appropriate manner may
have considerable significance for children in those
areas with Special needs, according to Warnock (1978,
p. 69). Special care must be taken where this may be a
factor (Gearheart 1980, p. 58). Writing about the
ethnic diversity in the U.K., Warnock (1978)
recommended that:

Wherever a child's first language is not English,

at least one of the professionals involved in

assessing his needs must be able to understand and

speak his language. The assessment of the needs

and the placement of children from ethnic

47

minorities may be a matter of special sensitivity
(p. 69).
In short, the danger is equating "different"
with "deficient" (Korteweg 1983, p. 5).
Indeed, any tendency for educational
difficulties to be assessed without proper
reference to a child's cultural and ethnic
background and its effect on his education can
result in a category of handicap becoming
correlated with a particular group in society
(Warnock 1978, p. 69).
In this regard, Korteweg (1983) asserted that
minorities in Canada, whether for economic or for
cultural differences, "have reason to believe that
their children do not get a fair deal from the school

to which they send them" (p. 5).

48

Section 2 - Coordination, Collaboration
and Organizational Change

2.1 Introduction

 

This section reviews, condenses and synthesizes the
literature on coordination and collaboration, limiting
itself to some of the characteristics, issues,
problems, factors, guidelines and practices that are
worthy of consideration when planning and implementing
a collaborative model for coordinated delivery of
services. An understanding of the factors revealed in
the literature is important to successful local service
integration and sound management practice.
2.1.1 Definitions: Collaboration and Coordination

The body of the literature associated with the
collaborative school of thought tends to support
certain generalizations about the process of
collaboration, which may occur between agencies or
within a single organizational unit such as an agency
(Roberts 1980, p. l). Surprisingly, there is no clear
consensus on the definition of the term "cooperation"
in the literature. A collaborative framework is often
called a "network", "consortium", or "coalition".

In the broad sense the definitions of parity,

cooperation, problem solving, bargaining, shared

49

decision making, consortia, cooperatives and

collaboration, as they are used interchangeably in

(the various) disciplines, are remarkably similar

(Reed 1977, p. V).

I do not propose to develop a specific definition of
collaboration, but rather to summarize some of the
definitions as presented in the literature.

Croan and Lees (1979) define a collaborative
framework as 'a formalized association of
not-for-profit organizations with the stated purpose of
furthering common goals and objectives through combined
resources, and leverage' (p. 2). Similarly, Reed
(1977) defines collaboration as:

An active process practiced by voluntary

associates who would not normally choose to work

together except in situations where mutual benefit
can be expected through the collaborative
association. The associates represent
organizations working toward objectives which
benefit the new collaboration, but more
importantly benefit each of the component
organizations. Each component part views each
other component part as a necessary entity in

reaching the mutually held objective (p. 1).

50

On the other hand, coordination is defined by
Mulford et a1. (1979) 'as a process of decision rules
to deal collectively with a shared environment' (p.
III). Various elements may be coordinated at various
levels of an organization and these may include
information, clients, program develOpment, and

resources (p. II). Decision rules 'can be mandated by

 

a third party or be created by the participants'
themselves (p. 8-9). In the latter case, collaborative
efforts usually result from organizational stress
caused internally or externally. The decision to
coordinate is made either to maximize resources, or to
respond to mandates from superordinate organizations
(Mulford et a1. 1979, p. 12). Commitment to such a
change results from inside stimulus such as mutual
desire of individuals or local groups, or by outside
stimulus such as official or governmental bodies, or
changes of mandate as a condition of funding (Croan &

Lees 1979, p. 5).

51

2.2 Coordination

 

Those sources that address the problem of
fragmentation of services emphasize the need for
rational coordination, both for continuity of care and
for accountability in programs for children in need.
The concern for finding models of coordinated service
delivery for meeting children's needs has grown at an
accelerated pace in recent years (Reed 1977, p IV).

2.2.1 Advantages of Coordinated Approaches

 

Coalitions increasingly are viewed as a
cost-effective means to help agencies offer
comprehensive services in a more coordinated manner
(Croan & Lees 1979, p. l).

The cooperative and coordinated approach is
recommended as EEe management tool, and EEe answer to
problems of maximizing services while minimizing costs
in these times, which are characterized by limited
funds and resources. By working cooperatively,
'community agencies, or organizations are also able to
share information, skills and resources to make their
own programing more responsive to the needs of youth'
(Croan & Lees 1979, p. iii). Although our society as
whole looks with favour on consensus, compatability,

and unity, it was however disconcerting to Mulford et

52

a1. (1979) that "very little systematic work is
available that demonstrates the actual outcomes or
consequences of coordination" (p. 16). The literature
on collaboration has been dominated by assumptions
favoring the notion, although research that provides
hard data on the positive benefits of coordination is
difficult to find" (p. 1).

Regardless of whether special services are
mandated or whether they are provided within the
framework of enabling legislation, many of the issues
which legislators and administrative staffs face
concerning the allocation of resources remain the same
(Rawlyk 1977, p. 44). Fragmented delivery of services
creates duplication and gaps in service for those to
whom it is directed, besides dissipating money and
manpower (p. 44). According to Cash (1970), increased
"personnel alone may not provide solutions to
malfunctioning issues as well as not being a viable
alternative under current fiscal restrictions" (p.
580).

Evidence has been provided regarding the
advantages of collaboration and coordination to both
service providers and to recipients. Possible benefits

are:

53

. A potential for expanded scope and range of
service delivery in a cost effective, efficient
way (Croan & Lees 1979, p. i; Brolin 1982, p. 10;
Tindall et a1 1981, p. 13).

. A systematic reduction of service duplication and
the maximizing of available resources (Croan &
Lees 1979, p. 4; Tindall et a1. 1981, p. 13;
Cranley 1981, p. 7).

A potential for simplified referral and intake
procedures which ensures better transition of
children into agencies or service streams (Croan &
Lees 1979, p. 4; Tindall et a1. 1981, p. 13).
Greater awareness of other agencies' role,
commitment, problems and solutions which enhances
staff awareness concerning linkages and improves
relationships among agencies (Tindall et a1. 1981,
p. 13).
"Availability of additional and improved physical
facilities, staff, and funding resources"
depending on political circumstances (Croan & Lees
1979, p. 4).
In sum, there is general agreement that the
process of collaboration is the most efficient means to

meet service needs without adding personnel and

54

financial resources. Although the benefits of
coordination are thought to be many, the collaborative
processes for developing and maintaining coordination
are, on the other hand, more difficult (Croan & Lees
1979, p. iii). Lacour (1982) concluded:
The process of interagency agreement is neither
easy nor a sure fix: it does enhance the
opportunity for more profound discussion of goals
and functions. It promotes c00peration instead of
competition: it broadens our understanding of the
ecology of human service systems: it encourages
rational responses to conditions most noted for

irrationality ... (p. 266).

55

2.3 Collaboration

 

2.3.1 Inhibitors or Barriers

 

While cooperative approaches have gained wide
acceptance, unforeseen difficulties may inhibit them
from developing as planned (Cash 1978, p. 580).
Cooperative agreements with affiliates are often
difficult to plan, implement and maintain. There are
many reasons for their ineffectual operation or
collapse (Croan 8 Lees 1979, p. 24). The history of
the coordination issue briefly overviewed in 53

Experiment in Progress ... (1977) suggested that

 

coordination cannot be achieved either quickly or
painlessly (p. 7). Anticipated barriers may involve
external and internal pressures and/or individual
motivation and support. These barriers can be
overcome, and the intended outcomes enhanced, if
facilitating factors and strategies are present or
utilized.
Interorganizational linkages and collaborative
ventures are inhibited by:
. Differences in participant characteristics such as
image, history, values, resources, mission,
organizational and staffing patterns, operations

and management styles (Croan & Lees 1979).

56

Differences in service population and definitions
(Tindall et a1. 1981, p. 37).

Inconsistent service standards (Lacour 1982, p.
266).

Differing agency regulations that complicate the
process of coordination (Brolin et a1. 1982, p.
8).

Differing agency priorities (Lacour 1982, p. 266).
Lack of awareness of policy or priorities (Croan &
Lees 1979, p. 24).

Negative attitudes among agencies cooperating
(Tindall et al. 1981, p.12).

Lack of belief in new collaborative efforts or
preference for the status quo (Roberts 1981, p.
15).

Failure to establish operating procedures that
ensure equal power and participation, leading to
”top down" imposition and coercion (Roberts 1981,
p. 15).

Fear of domination by another agency (Croan & Lees
1979, p. 29).

An unwillingness by participants to relinquish
power in shared decision making (resulting in

subtle sabotage such as postponed decisions,

57

withheld information, failure to invest staff with
adequate authority and responsibility) (Croan &
Lees 1979, p. 25).

Overlapping geOpolitical designations (Mulford et
a1. 1979, p. 15).

Confused and conflicting loyalties (Croan & Lees
1979, p. 24).

Unclear lines of accountability (Mulford et a1.
1979, p. 15).

Responsibility without authority (Roberts 1981, p.
12).

A lack of realistic expectations about roles and
responsibilities (Croan & Lees 1979, p. 24).

A lack of clarity of job descriptions (Tindall et
a1. 1981, p. 12).

Failure to recognize that coordination involves
costs and some degree of internal disruption
during an initial period of adjustment (Mulford et
a1. 1979, p. 13).

Prior unsuccessful efforts to promote linkages
(Mulford et a1. 1979, p. 15).

Problems relating to the status of standing

agreements (Tindall et a1. 1981, p. 39).

58

The expectation of agency personnel that wholesale
disruption of organizational functioning will
occur (Mulford et a1. 1979, p. 15).

Attempting to achieve too many purposes and a lack
of adequate purpose (Croan & Lees 1979, p. 24).
Contradictory mandates or lack of mandates
(Tindall et a1. 1981, p. 38).

Failure to coordinate budgets with service
mandates (Lacour 1982, p. 265).

Lack of clarity on "first dollar responsibility"
(Lacour 1982, p. 265).

Lack of funding or perceived lack of funds
(Tindall et a1. 1981, p. 36; Croan & Lees 1979, p.
111).

Difficulty in reaching an agreement to share
resources (Tindall et a1. 1981, p. 38).

Inadequate appraisal of the amount of time and
energy required by participants for development
and maintenance (Tindall et a1. 1981, p. 39).
Overloads on existing staff (Tindall et a1. 1981,
p. 12).

Lengthy delays in the publication of guidelines

for implementing legislation and delays in

59

receiving funds for program develOpment (Tindall
et a1. 1981, p. 36).

Lack of return for time and resources invested
(Croan & Lees 1979, p. 25).

Lack of visible successes, rewards or results
(Croan & Lees 1979, p. 25).

The unfavourable reputations (for dependability,
reliability) of those involved (Mulford et a1.
1979, p. 15).

Linkage attempts that substantially reduce the
independence or visibility of an organization
(Brolin et a1. 1982, p. 8).

Political conflicts over "turf" or territory
(Brolin et a1. 1982, p. 8).

The presence of vested interests (Croan & Lees
1979, p. 24).

Poor or limited interagency communication among
cooperating agencies (Tindall et a1. 1981, p. 38).
Conflicting views of the constraints on
confidentiality of information (Lacour 1982, p.
266).

Lack of knowledge of legislative trends (Croan &

Lees 1979, p. 24).

6O

. Vague language used in regulations, making it
difficult to clarify and understand intent, and
inconsistencies and confusion in regulations
(Tindall et al. 1981, p. 36).

. Lack of knowledge about implementing interagency
cooperation (Brolin et a1. 1982, p. 8).

. Mistrust among individual agencies who View other

agencies as competitors (Croan & Lees 1979, p.

10).
. Personnel turnover (Tindall et al. 1981, p. 38).
. Midstream changes in personnel and policy (Roberts

1981, p. 12).

. Lack of strong central leadership, organizational
and management skills (Croan & Lees 1979, p. 24).
Lack of cooperation among advocacy and consumer
organizations (Brolin et al. 1982, p. 8).

. An overemphasis on existing systems (e.g. time
and effort spent on inventories) and the
postponement of future-looking activities (Croan &
Lees 1979, p. 10).

2.3.2 Facilitators and Postulates for Successful

 

Collaboration: Introduction

 

Many authors have sought to offer constructive

advice on how to overcome the barriers to cooperation

61

or collaboration. Literature suggests a set of key
conditions and strategies that enhance the probability
of successful interagency collaboration.

If successful coordination of services is the
objective, effective interorganizational groups need to
be established. Schermerhorn, Hunt and Osborn (1982)
list characteristics associated with highly effective
work groups:

1. The members of the group are attracted to it
and are loyal to each other, including the leader.

2. The members and leaders have a high degree of
confidence and trust in each other.

3. The values and goals of the group are an
integration and expression of the relevant values and
needs of its members.

4. All the interaction, problem-solving,
decision-making activities of the group occur in a
supportive atmosphere. Suggestions, comments, ideas,
information, criticisms are all offered with a helpful
orientation.

5. The group is eager to help members develop to

their full potential.

62

6. The group knows the value of constructive
conformity and knows when to use it and for what
purposes.

7. There is strong motivation on the part of
each member to communicate fully and frankly to the
group all the information which is relevant and of
value to the group's activity.

8. Members feel secure in making decisions which
seem appropriate to them (p. 242).

2.3.3 Characteristics of Participating Organizations

It has been speculated "that rural projects are
more likely to be successful than are projects
attempted in urban communities" (Cranley 1981, p. 7).
However, research by Tindall et al. (1981) showed that
of eight factors that had a bearing on linkage efforts,
locality was last in summed rank order in terms of
importance (p. 8). The explanation put forward was
that locality may not be considered critical when
developing linkages since such concerns as the needs of
clients and the identification of appropriate services
would be more pressing (p. 10). In any case physical
proximity is an important factor facilitating

collaboration (p. 40).

63

Before the participating components become
involved in a collaborative endeavor, they should be
clear about their own goals or organizational role
definition. A clear perception of their own objectives
will enable them to better meet their own mission. The
greater the similarity of purpose, the easier the task
at hand. There should be a focus on external issues
since participating administrations must understand the
weaknesses of their own programs (Reed 1977). These
organizations should enjoy a level of stability since
'interorganizational arrangements cannot be formed or
broken on a rapid basis' (Yin & Gwaltney 1981, p. 104).

Collaboration takes place in the context of an
organized social system and traditions. Standard
operating procedures, organizational rituals or
customs, and the avoidance of role changes ought not
dominate a participating agency (Reed 1977, p. 14).

The required historical patterns include cooperation
and broad participative goal setting because
collaboration is accomplished through responsiveness to
the older settings or suprasystems in the environment.
While similar administrative structure facilitates

linkages (Tindall et al. 1981, p. 40), bureaucratized

64

organizations are less likely to successfully
coordinate (Mulford et al. 1979, p. 15).

One other point is also important: Organizations
should have some slack in their resource base if any
c00perative venture is undertaken, as a portion of the
current resources (financial base and administrative
time) of each must be devoted to the learning of new
roles and new methods of working together. Resources
must be realloCated to allow for:

information sharing; the learning of new roles;

freedom from legal, political, or financial

constraints; devotion of sufficient administrative
time; adequate financial base; cooperative
funding; start-up funds; involvement of all
components in proposal writing; and new rewards

and penalties (Reed 1977, p. 17).

65

Section 3 - Needs, Assessment/Evaluation

3.1 Introduction

 

Special service programs which serve children with
special needs can be conceptualized at three levels:

(a) an individual program designed for one pupil

(e.g. an IEP...);

(b) a group program designed for more than one

pupil (e.g. a remedial-reading class); and

(c) an organizational program, considered as a

service delivery system ... (Maher & Barbrack

1979, p. 415).

The last concept is the focus of discussion.

The following, based on the above-mentioned
organizational programs, outlines some of the
considerations in selecting a methodology and reviews
the strategies seen as helpful in conducting needs
assessment in a service delivery system. It is a
discussion of special-service program evaluation as a
means for providing an objective and rational basis for

making decisions about program design and delivery.

 

66

3.2 Rationale

 

The climate of austerity existing at all levels
of government has forced a re-examination of many
activities, programs, and policies (Bozeman 1982, p.
264). The past decade has witnessed an increased
demand from legislators, taxpayers, and funding
agencies for effective and efficient programs (Maher 8
Barbrack 1979, p. 413). Evaluation of social welfare
programs has in recent years received priority
attention (Johnson, Nutter, Callan and Ramsey 1976, p.
279). Special service programs are no exception to
this phenomenon (Maher & Barbrack 1979, p. 413). The
rationale for program evaluation is twofold: first,
professionals in the field 'have an obligation to
assess effectiveness of service'; secondly, taxpayers
have a right to know whether the funds they invest in
programs are producing the desired results efficiently
(Johnson, Nutter, Callan and Ramsey 1976, p. 280).
Indeed, interrelating needs assessment strategies with
program planning and evaluative efforts is seen in the
literature as aiding organizations in meeting demands

for accountability (Marrs & Helge 1978, p. 143).

67

3.3 Definitions: Program Evaluation and Needs

Assessment

 

Fundamental to program evaluation is a clear
definition of what it is. Special-service program
evaluation is described by Maher (1979) as "... a
process of obtaining and reporting information on a
program's adequacy, process, efficiency, and impact"
(p. 413). Whelan (1979) defines evaluation as "... a
set of observable, sequential procedures which are used
to determine if a planned program is functioning below,
at, or above expectations" (p. 349). It enables
"detection of gaps between what is and what should be"
(p. 349).

According to Johnson, Nutter, Callan and Ramsey
(1976), program evaluation is the study of programs to
ascertain effectiveness in fulfillment of defined
goals. It provides evidence and information to the
practitioners, administrators, clients and policy
makers who must decide "whether what a program has
accomplished is 'good' or 'bad', and what steps should
be taken to improve its level of 'success'"(p. 280).

The major purposes for evaluation proposed by
Brinkernoff (1979) are:

1. To clarify and communicate the

68

expectations, or standards, for the program;

2. To document operation of the program,
particularly those phases of operation requiring legal
compliance;

3. To assess impact of the program on its
intended recipients; and

4. To provide information to revise and
improve the program (p. 356).

According to Marrs and Helge (1978) a perceived
need is typically the stimulus for such an enterprise
(p. 144). A need can be defined as 'a situation which
occurs when what is actually happening is below that

which is expected' (p. 144).

69

Section 4 - Assessment

4.1 Introduction

 

The abundant research and literature dealing with
the assessment of children is purposely circumscribed.
For example, this section will not concern itself with
the many technical measurement issues, the validity of
assessment instruments, nor the plethora of tests that
can be used in assessing children with learning or
emotional difficulties. Rather, the following will
attempt to identify the basic elements of the
assessment process which can be found in actual
practice and to describe a framework for assessment
which is congruent with the philOSOphy and mandate of
the various servicing ministries in Ontario.

The discussion deals with a broad definition of
assessment and related issues and brings together the
elements in the process which are seen to be essential

from both an academic and a pragmatic viewpoint.

70

4.2 Definitions: Assessment

Dictionary definitions of "assessment" indicate

that for centuries the term has been used in the

estimation of taxable property, of possessions, or

”any useful quality". It would seem to follow

that when the term is applied to examination of an

individual's personality and behaviour it refers

to an accounting of particular qualities,

including both assets and liabilities, strengths

and weaknesses, achievements and failures (Hood &

Anglin 1979, p. 9).

Assessment is broadly defined by Ysseldyke (1983)
'as a process of collecting data for the purpose of
making decisions about individuals' (p. 226). Data are
used to help make decisions about eligibility for
special services, to help plan intervention, and
finally to monitor the progress of those receiving
special services (p. 226).

Harbin (1977) defines assessment as

the systematic process of (l) collecting

 

information both on a child's level of functioning
in specific areas of development ... and (2)

carefully interpreting the information which is

 

collected (p. 35).

71

The various definitions clearly indicate that
assessment is above all a process. In this regard Hood
and Anglin (1979) comment that

unfortunately, there is a common tendency to

attempt to identify it concretely as a thing, and

the assessment process is often confused with the

 

assessment report. As a result, a few sheets of

 

paper can take on magical symbolic significance

and, in being separated from the assessment

process, can be used inappropriately in making

important decisions for a child (p. 11).

Assessment can either be formal or informal in
nature. Formal assessment involves the use of
standardized assessment instruments. '"Assessment" is
often used to refer to a discrete, standardized and
clear routine procedure or entity that has a generally
understood form and purpose' (Hood & Anglin 1979, p.
5). Informal assessments, on the other hand, are
activities which may involve a set of procedures, but
unlike formal assessment, these cannot be validated and
the results cannot be measured against established

norms .

72

4.3 Characteristics of the Assessment Process
Assessment refers to a process involving:
collecting information
making direct observations
weighing the facts and developing hypotheses about
the problems
understanding the individual's needs and deficits
estimating the nature and the degree of assistance
which can promote healthy functioning and
continuing development
arranging for the provision of such assistance

(Hood & Anglin 1979, p. 10).

73

4.4 Areas of Assessment Inguipy

 

Developmental areas when assessing needs include:
Physical development and health

Sensorimotor development and skills
Communication development and skills

Emotional development and social skills
Educational/vocational skills

Independent living skills

Recreation/leisure (Annual Review... 1984, p.

 

52-53).

Gearheart (1980) identified the following facets:

'assessment of auditory and visual abilities,

educational (achievement) level, adaptive behaviour

level, speech and language development, level of

intellectual functioning, and general develOpment

level'.

While it will not be necessary to have all this

information in all cases, Gearheart (1980) noted that

these types of assessment data are the most commonly

used (p. 58).

 

74

4.5 Types of Assessment

 

Three general types of assessment were
distinguished:

1. Screening assessments which are usually done
when a child first comes in contact with the service
system. They are used to establish eligibility for a
program or service.

2. Functional assessments are carried out on a
continuing basis as a part of training and
habilitation. The individual's progress towards
specific objectives is monitored, and results determine
whether a change in either objectives or approaches is
required.

3. Specialized assessments are conducted when a
screening or functional assessment has identified
particular areas of concern. They are typically
carried out by professionally trained staff (e.g.
medical specialists, speech therapists etc.). They are
directed at providing specific and detailed information

(p. 52) (Annual Review... 1984, p. 52).

 

75

4.6 Purposes and Factors Leading to

 

the Assessment Process

 

Hood and Anglin (1979) listed some purposes and

factors leading to the initiation of the assessment

process:

. to gain a fuller understanding of a child and
family

. to help a child and family obtain an appropriate
service

. to enable an agency to decide how to help

. to address the complicated issues perplexing the

service providers

. to comply with the administrative demands of an
organization
. to ensure that "no stone has been left unturned"

. to obtain further opinions as alternatives to

those already considered

. to enable a service to accept or reject referred
children

. to delay making a decision

. to pass on or share responsibility for

decision—making
. to determine if a child's situation has altered

since a previous contact

76

to determine the degree of structure or security

needed for a child (p. 5).

77

4.7 Stages

 

There are many alternative ways of conceptualizing
the assessment process. The literature clearly
demonstrates that assessment ideally constitutes a
graduated range of operations. The stages or steps
described are often very closely related and, in some
cases, overlapping. In Ontario, the overall process of
assessment has varied considerably in different
ministries, social, institutions and disciplines. There
are many reasons for this: 'differing legislated
mandates, differing target population, differing nature
of service provided, differing professional
orientations and traditions' (Hood & Anglin 1979, p.
1).

Hood and Anglin (1979) view the assessment
process as

'problem identification, information gathering,

integration of information, ranking of possible

solutions, and planning of assistance' (p. 19).

The levels identified by Illerbrun and Greenough
(1983) are: identification, diagnosis, management, and
follow-up (p. 25). This "interactive diagnostic model"
is seen by the authors as a most useful approach for

all children suspected of having a disability or

78

disabilities (p. 27). Interaction would include
follow-up consultation, observations, program
evaluation and possibly modification (p. 27).

A particularly useful format was developed by TEe

Annual Review ... (1984), consisting of six basic steps

 

proceeding in a logical flow.

1. Identification of assessment needs
2. Assessment referral

3. Conducting the assessment

4. Synthesis and Formulation

5. Reporting
6. Follow-up (p. 21).

4.7.1 Identifying Assessment Needs

 

At this initial stage, decisions are usually made
regarding whether assessments are required to provide

information for:

. a placement decision;

. planning training or habilitation goals and
approaches

. program and placement change (Gearheart 1980,
p. 53).

While such a preliminary review is not a substitute for
assessment, it may prevent further unnecessary efforts.

Assessment is the next logical step when preliminary

79

review indicates that a definable handicap may exist
(Gearheart 1980, pp. 56, 57).

Casefinding and screening can both be included in
this initial phase. Information resulting from
casefinding simplifies the screening process (Cross
1977, p. 4). There are numerous benefits to screening.
Screening indicates the possible presence of an
impairment although intervention should not be
determined or planned without diagnostic study.
Therefore, screening should provide information about a
child to decide if he or she should undergo a thorough
diagnostic study. Information gained in screening
should help facilitate the diagnostic process to follow
by indicating the strengths and weaknesses of a child
(Cross 1977, p. 6). Screening also avoids expensive
and time-consuming diagnostic procedures "for those who
will not benefit from early intervention". In
addition,

The purpose of the screening program and the

procedures to be used therein should be explained

to the parents, as should the results of the
screening and their implications for further
testing. In the case where a child fails the

screening, the parents should be made aware that

80

the child needs further diagnosis before any
conclusive decisions can be made about his

suspected condition (Cross 1977, p. 6).

81

4.8 Issues of Concern

 

Having discussed assessment in general process
terms, a series of specific and interrelated issues
dealing with the topic of assessment is the focus of
the discussion to follow. Their existence thus far has
either been inferred or summarily discussed. Although
these issues were seen as highly interrelated, they are
considered at this point separately. These issues are
now considered since they have for some time been the
topic of heated debate.

4.8.1 Three Conceptual Approaches

 

The present focus is a brief discussion of the
three main conceptual approaches or frameworks by which
professionals carry out their practice in dealing with
children in need.

4.8.1.1 The Medical Model

 

The medical model (sometimes called the "clinical"
model because it is often carried out by professionals
other than physicians) is essentially a disease model
where ”deviance defines the disease" (Miller 1981, p.
92). It assumes that for each disability there is a
specific cause and specific cure (MacIntyre 1980, p.
117). This conceptual approach is a biologically

derived model of etiology and pathogenesis with the

82

notable tendency to "blame the victim" (Miller 1981, p.
92). The emphasis is focussed on the deficits inherent
in the child while giving little consideration to his
environmental context (MacIntyre 1980, p. 117).

If a placement decision is the only goal of the

assessment process, the medical or clinical

diagnostic approach may appear to work, since it
provides a label for the child which can be used
to group him with similarly labelled children

(MacIntyre 1980, p. 118).

According to Miller (1981) difficulties accrue
when such an approach is applied to problems involving
human behaviors

since the etiology is frequently vague and largely

unknown and the cures (drugs, hospitalization,

psychotherapy) are utilized rather freely with
relatively little consideration for the many

variables operating in a particular situation (p.

92).

Frequently, a diagnosis is based on only partial data
and "creates particular perplexity when the problem is
lifestyle or behavioral deviance, since the latter are
contextual and defined socially" (p. 92). The author

further noted that the medical model often complicates,

83

and is complicated by, the organizational structure and
the roles occupied within health and mental health
services. For example, it conceals the many
differences between medicine and psychiatry and "...
provides the psychiatrist the protection and support of
the same community attitudes that protect the
physician" (p. 92).

(The) model disguises education, moral guidance,

personal consultation, social control, and other

forms of guidance disguised as medical

intervention (p. 92).

The medical model has been extensively used in the
mental health establishment, and in health and welfare
agencies (Miller 1981, p. 93). It has generally
created criticism 'not only from scholars in psychology
and sociology, but also from within the mental health
establishment itself' (Miller 1981, p. 93). At
present, medical and psychiatric viewpoints are
considered to be obsolete by most professionals in the
field (Epstein 1977, p. 424). Miller (1981) noted that
the personality theories that are most consistent with
the clinical approach are "... psycho-biological,

psychoanalytic, ego-psychology, and some of the

84

self-theories, particularly those of Rogers and Maslow"
(Miller 1981, p. 93).

4.8.1.2 The Learning Model

 

The learning model, the second approach to be
discussed, emerged from "the application of learning
theory to intervention with individuals, groups, and
institutions" (Miller 1981, p. 94). The learning model
was largely derived from contemporary behaviorism and
Skinnerian learning theory and has been influenced "by
social learning theorists who emphasize modelling,
developmental psychologists - especially those who
emphasize socialization and expectancy theories"
(Miller 1981, p. 94). According to Miller (1981) the
model assumes that both adaptive and non—adaptive
behaviour is learned and can be unlearned (p. 94).
"Reinforcers" and "contingencies" vary, and it is
hypothesized that behaviour "is acquired and mediated
as a result of stimuli from the environment" (p. 94).
Among some of the social institutions that would appear
to find learning theories highly acceptable and
consistent with their values are public schools,
prisons, mental hospitals, and schools for the mentally

retarded (p. 94).

85

4.8.1.3 The Ecological Model

 

Advocacy of this approach is in no short supply as
the need for an ecological "total child" perspective in
assessment is well documented. In this regard the
Celdic Report (1970) expressed the following concern:

Our present point of disagreement with the present

pattern of delivery of services, however, is that

it fragments the child. He is viewed as student,
patient, ward, or offender depending upon the
department or service system through which he is
receiving help. No one sees or is concerned with
the whole child as he interacts with his
environment. We diagnose and treat and sometimes
label for life, on the basis of a small segment,
the problem part of the total child. When
attention is concentrated on only that part of the
child that isn't functioning, that is on the
negatives, the pathology, the illness; citizen's
groups, parents and all too often the
professional, develop a vested interest in the
child's disability. Understandably, in this
situation where no one has an investment in the

child as a whole with his strengths as well as his

86

weaknesses the child frequently cannot afford to

get better (p. 296).

Gearheart (1980) noted that the ecological model is
neither as systematized nor organized as other models
since it has been the focus of research for a
relatively short period of time (p. 304).

Knowledge of epidemiology, both as a knowledge
base and as a practical model is central to this
approach. Another major concept is that of prevention,
"which is elaborated by the subconcepts of primary,
secondary, and tertiary prevention" (Miller 1981, p.
93). An important basic tenet is that the root of the
problem is not perceived to be within 'the individual
alone or the environment alone but rather in the
interaction of the two, since the theory recognizes
that each individual is an integral part of separate
yet interrelated ecosystems' (Gearheart 1980, p. 304).

Thus, assessments and intervention focus on the

exchanges between the child, the settings in which

he participates, and the significant individuals

who interact with him (Hobbs 1975, p. 114).

Accordingly, assessment must be flexible, broadly
based, and ongoing. Assessment should tap information

from all possible sources (Gearheart 1980, p. 53).

87

Assessment should therefore provide a rich, descriptive
data base (Heron & Heward 1982, p. 118). Areas of
ecological inquiry include 'family develOpment,
personal development, social adjustment, and school
achievements' (Hood & Anglin 1979, p. 16). Sources of
data include student records, interviews, formal and
informal tests, daily observation (Heron & Heward 1982,
p. 123).

A comprehensive, integrated ecological assessment
considers not only the child's weaknesses, but also
strengths, and the areas of satisfactory functioning
(Walkenshaw & Fine 1979, p. 15).

Each child is unique, the center of a unique life

space. To design a plan to help him grow and

learn requires much specific information about him
and about his immediate world. The best way we

have discovered to get information needed for a

good program planning is to construct a profile of

assets and liabilities of the child in a

particular setting and at a particular time (Hobbs

1975, p. 104).

The relatedness and interdependence of helping
agencies in the total service delivery system, as well

as continuity of care within that system, are

88

conditions inherent in the ecological model (Miller
1981, p. 93). The ecological framework avoids the
simplistic and negative labelling process (Hood &
Anglin 1979, p. 15). This holistic service-based
approach avoids two severe limitations of other
schemes: the fixed diagnosis with diagnosis being an
end in itself, and the separation of diagnosis and
treatment, often to the neglect of treatment. The
ecological model does not propose abandonment of
classification, but rather it clarifies and takes into
account the many variables for the purpose of improving
service delivery. The ecological approach takes into
account the situational, develOpmental and
transactional character of demands on a service
delivery system. Individuals are classified on the
basis of the services required to achieve specific
goals at a particular period in the life of the
individual. The services required are specified to
ensure that the individual will be able to function
adequately.

Systems analysis is relevant to and consistent
with this model (Miller 1981, p. 93). Similarly Hobbs
(1975) remarked that the ecological model belongs to no

one discipline.

89

Its use requires someone who can move freely among
and communicate with diverse disciplines in the
performance of a liaison function-linking up all
the individuals concerned about the child and
coordinating the planning and programing on his
behalf (p. 121).

Since the model places a heavy emphasis on the
importance of environmental conditions, and does not
"blame the victim"; it would therefore appear to be
highly consistent with the philosophy of the social
work profession.

Social workers have had a major input in the

community mental health movement and have, through

their understanding of crisis intervention and
systems analyses, contributed greatly to the
operationalization of the ecological model in the

community mental health movement (Miller 1981, p.

93).

Primarily social-work influenced agencies have
attempted to deliver services based on the ecological
model (Miller 1981, p. 93). The ecological approach
would appear to be consistent with the fundamental
principles adopted by the Children's Services Division

of the Ministry of Community and Social Services (Hood

9O

& Anglin 1979, p. 1). The ecological perspective has
also entered educational practice for exceptional
children (Heron & Heward 1982, p. 117).

In sum, a rather extensive literature has
documented the importance of this approach in
assessment, as EBB management information system and
egg way of conceptualizing the problem of delivering
services. While the system makes use of traditional
assessment procedures, it is not limited to them.

4.8.2 Assessment Teams

 

Effective interagency teams need to be established
to ensure interministerial cooperation. Teamwork has
become valued and well established in children's
services. It has frequently been assumed or implied in
the literature that effective assessment requires the
services of interdisciplinary teams. At this point, it
is necessary to give a cursory consideration to aspects
of the teamwork approach.

Korteweg (1983) commented that past and even
recent practices have fallen short of societal
expectations. "Only a concerted, coordinated team
effort will regain the public trust " (p. 9).

In the past twenty-five years the field of our

concern has been divided up between a variety of

91

specialists and professions giving each its own

area of responsibility and competence.

Unfortunately the child and his family do not

divide into the same neat compartments. In an

effort to 'put Humpty-Dumpty together again' the
concept of teamwork has developed (Lazure &

Roberts 1970, p. 401).

It has been suggested that interdisciplinary
understanding and cooperation enriches the services
offered to children with emotional and learning
disorders, but much that is described in current
literature as teamwork dealt with teachers and support
personnel and had little relationship to the
achievement of interdisciplinary team practice among
servicing agencies or ministries.

4.8.3 Early Identification

 

A persistent theme in the literature on assessment
was the adage "a stitch in time saves nine", or the
notion of early identification and prevention.

"Paralleling the educational movement for early

screening, assessment, and programming is a

similar movement at the community mental health

level for early screening, diagnosis and

treatment" (Barr & DelFava 1980, p. l).

92

The Warnock Report (1978) in England cited as a
major recommendation the provision for children under
five with special educational needs. The report
suggested that age not be a factor in providing
appropriate services for children; in fact, education
should start as early as possible with no minimum age
limit (p. 73). It was pointed out that for some
children educational help should be required below the
age of two.

4.8.3.1 Legislation

 

Perkins (1979) critically commented that in
Canada, far too many pre-school handicapped children
were not receiving any kind of intervention program,
while in the U.S.,

Early intervention is considered so important for

handicapped children ... that Public Law 91—142

includes an incentive to states which do not have

a pre-school program for handicapped children.

Such states are being encouraged to start

pre-school programs for three-to-five year-old

handicapped children (p. 36).

Public Law 94-142 sets educational age levels at five
to eighteen years, but makes provisions for school
boards to begin services for special students at age

three (Karagianis 1980, p. 8). Nesbit and Karagianis

93

(1980) on a more Optimistic note, commented that in
Canada the need to begin programs with the pre-school
handicapped child has been recognized.

According to Wanczycki (1983), in the initial
years in Ontario, a kindergarten and pre-kindergarten
identification program was "innocuous ..." (p. 25). It
may also have been beneficial in many instances, as
certain children may have, for example, benefitted from
early intervention for speech and hearing problems (p.
25). At present, the Kindergarten Early Identification
Program (KEIP) has now become mandatory throughout the
province and has become part of Bill 82. However,
research by Davidson (1981) would seem to indicate that
"early identification tends to be conceptualized more
as an "extra", than an attachment to the education
system ..." (p. 66).

4.8.3.2 Justification

 

Fossey (1973) suggested that the earlier the
child's needs are identified, the greater the return
for energy spent. Since problems in early development
can multiply upon one another and create even more
serious problems in the future (p. 102). With early
identification and intervention, needs eventually

require less extensive special services (p. 102).

94

Communities should be aware that an investment in

a child's educational program at an early stage

can often alleviate the necessity of tremendous

financial commitment at a later stage - to say
nothing of the lost potential which results from
lack of adequate, early intervention. Positive
attitudes toward exceptionality fostered in
communities can result in savings - both in lives
and in money. "An ounce of prevention ..." In
many instances, prevention of maladjustment must
commence long before a child reaches school age.

Health services and educational services must work

co-operatively with parents to ensure that

information and assistance is provided at the

appropriate time (p. 102).

Prevention where it is pursued is said to require
cooperative efforts with other agencies to collect
health, education and social data in a
multidisciplinary assessment (Gearheart 1980, p. 53).
According to Mittler (1978), "the needs of under fives
cannot be parcelled up among different government
departments simply because it is administratively
convenient" (p. 11). In other words, services for

pre-school children should not be planned from any

95

single departmental or professional perspective.
Rather it should be planned from a 'genuinely
multidisciplinary sharing of skills and resources' (p.
13).

While early intervention is highly desirable, 'the
disadvantages of misidentification and labelling must
be considered (Gearheart 1980, p. 53). The difficulty
in identifying accurately "exceptional" children is
compounded at the pre-school and kindergarten level
"due to developmental lag, language and cultural
background, and other factors" (Wanczycki 1983, p. 25).

Early identification can be successful only if

it adopts the position that a broad range of

factors are involved ... and that any one of these

factors or any small clustering of them is

unlikely to account for or be predictive of a

subsequent general (problem)... (O'Bryan 1976, p.

1).

According to O'Bryan (1976), early identification is
most desirable when it is directed towards "a general
assessment of the child's current capabilities,

performance, behaviour patterns, prior experience and

ability ..." (p. 2).

96

In fact it is arguable that early identification
should not be used to predict future problems but
to discover the child's current difficulties,
strengths, deficits and needs - the better to
provide for a program beginning at the level of
his available competence (p. 2).

4.8.3.3 Suggestions

 

Perkins (1979) suggested that provincial
governments need to establish well organized programs
of "periodic developmental surveillance" for all
children between birth and date of entering school. As
soon as a child is diagnosed as having a developmental
disability, an appropriate program to meet the child's
needs should be implemented (p. 36). The Warnock
Committee recommended that a "named" person (a health
visitor should assume the functions of the "named"
person) be the point of contact for the parents of
pre-school children (p. 79).

In sum, we have witnessed in Ontario a shift in
the early identification process to one of prevention
rather than confirmation of a particular handicapping
condition. This necessitates increased and more
efficient delivery of assessment resources. With the

increase in mental health and educational mandates to

97

service the young child, new expansions are imminent.
Without a sufficient funding base, "services to these
young children will most effectively be drawn together

through interagency cooperation" (Barr & DelFava 1980,

p. l).

98

Section 5 - Summary

Conceptually, the proposed model for service
delivery is based on, and supported by, the accumulated
knowledge, attitudes, general theory and empirical
research found in the literature. The literature
survey provides the project with an
information/experiential base from which to draw and
gives the project a conceptual framework in regards to
process, method and structure.

The review of the literature deals with the
following aspects: the problems and trends in special
service delivery, selected aspects of assessment,
collaboration and organizational change, needs
assessment, and other issues tangentially related to
our objectives. The purpose is to simplify, summarize
and organize the main aspects of the project as found
in the literature. No claim is made to present a
complete or exhaustive perspective of relevant issues
and schools of thought. Specific theories are not
extensively critiqued and analyzed in order that the
focus be kept on understanding conceptual guidelines.
Moreover, the final recommendations do not negate the
need to look further for ways to more effectively and

efficiently serve the needs of children in Northern

99

Ontario. Searching the literature for model programs
(frequently quoted) which seemed promising in terms of
structure and outcomes proved most disappointing,
because, as mentioned at the very beginning,
documentation is not readily available. Although
simplified for the sake of brevity, this review should
adequately serve to frame the remaining components of
this study. The literature clearly indicates the need
for coordination and buttresses the recommendations and
guidelines in the chapters to follow. With a coherent
theoretical foundation and general framework, a
conceptual system against which to build a model is now

available.

100

CHAPTER III - THE MODEL
Introduction

The purpose of the study is to develop an
Interministerial Model for the delivery of assessment
services for children and families in Northern Ontario.
It is felt that children's needs in the North could be
served effectively by a coordinated approach using a
delivery system that was cooperatively designed,
closely coordinated, refined and easily accessed.

The model was developed using the work plan

presented in Table l.

101

TABLE 1

WORK PLAN

Overall Goal - To implement an interministerial model for the

 

delivery of assessment services in the northern regions.

1. COMPONENT - To collect data on assessment activities,

capabilities and needs from MCSS and education agencies.

ACTIVITIES TASKS

 

 

1.1 Develop a (common) 1.11

data collection tool.

Identify factors to be

measured.

 

1.12 Establish (common) terms of
reference for measurement.
i.e. - for categories
- operating definitions
1.13 Develop formats for data
collection.
1.14 Review approval by Steering
Committee.
1.2 Establish implementa- 1.21 Identify agencies to be
tion plan for data surveyed.
collection exercise. 1.22 Establish process for

bilingual duplication and

102

TABLE 1 (cont'd.)

 

distribution of data

collection tool.

 

1.23 Establish mechanism for
providing resourcing to
agencies as may be necessary
and deliver questionnaires.

1.24 Establish process for
monitoring return of
questionnaires.

1.3 To analyse data from 1.31 Identify components to be
questionnaires. analysed.

1.32 Complete initial analysis as
per components identified in
number one.

1.33 Integrate data from MCSS and
EDUCATION - initial analysis.

1.34 Summarize major findings from
initial analysis.

1.35 Validate data through random

sampling on an individual

board/agency/child basis.

103

TABLE 1 (cont'd.)

 

1.351 Identify gaps in data
collected between MCSS
and EDUCATION.

1.352 Establish criteria for
identifying random sample
selection.

1.353 Develop format for analysis.

1.354 Identify resources to
perform analysis.

1.355 Do analysis.

1.356 Summary analysis of data.

1.36 Review of data collection
procedures used by Steering
Committee.

1.37 Establish hypothesis based
on findings.

1.38 Test hypothesis against data.

1.39 Modify hypothesis as necessary.

1.310 Summarize major findings.

104

TABLE 1 (cont'd.)

 

1.311

1.312

1.313

1.314

Presentation of major
findings to Steering
Committee.

Identify areas for
improvement in questionnaire
for subsequent years.
Develop plan for integrating
changes into the data
collection tool.

Approval of plan by

Steering Committee.

 

issues.
Develop draft policy

statements.

2.11

2.15

COMPONENT - To develop joint positions on operational policy

Identify policy issues.
Priorize policy issues.
Establish set of principles
for policy resolution.
Identify linkages between
issues.

Establish format for policy

presentation.

105

TABLE 1 (cont'd.)

 

2.16

2.110

2.111

2.112

2.113

Establish responsibility
centre for specific
policies.

Prepare initial policy
drafts with all options
provided.

Establish consultation
process.

Conduct consultation process.
Review and determine
preferred options based on
consultation.

Draft position paper.
Present position paper to
Steering Committee for
decision.

Revisions as necessary and

preparation of final

paper.

106

TABLE 1 (cont'd.)

 

2.2

Joint acceptance of 2.21
operational policy

positions. 2.22

Identify individual Ministry
review processes.

Review feedback and revise.
Establish mechanism for
integration of feedback
from individual Ministries.
Review of revised policies.
Approval by respective
Ministries.

Notify all relevant
agencies of operational

policy positions.

 

COMPONENT - To develop an integrated interministerial model

for the delivery of assessment services in Northern Ontario.

To establish 3.11
options for

models.

3.12

To determine and priorize
basic parameters of the
model - i.e. terms of
reference.

Review of literature for

possible options.

107

TABLE 1 (cont'd.)

 

3.14

3.15

3.16

3.17

3.18

3.19

3.110

3.111

3.112

Develop potential models.
Integrate data findings
and policy directions with
options.

Review options from
financial perspective.
Identify impact on existing
resources and need for
future resources.

Identify preferred option.
Review and approval from
Steering Committee.
Determine consultation
process.

Do consultation.

Integrate feedback from
consultation process into
final document.

Review and approval of
final document by

Steering Committee.

 

108

TABLE 1 (cont'd.)

 

4. COMPONENT - To implement integrated model.

4.1 To implement preferred

model.

4.11

Establish criteria for
selection of pilot area
(if pilot project to be
done).

Develop plan for introduction
of model.

Establish process for
monitoring.

Implement plan.

Review feedback and
identify areas for
adjustment.

Adjust model as necessary.
Review and approval by

Steering Committee.

109

Design Considerations

The delivery of assessment services does not take
place haphazardly. Delivery is structured and
organized. At the present time, there is a tendency
for the delivery system to be structured and organized
by individual ministries in isolation. The particular
approach taken by this study is that the assessment
delivery systems in Northern Ontario can be improved by
inter-ministerial and inter-agency collaboration. In
attempting to clarify the innovation, it is fair to say
that it involves relationships between Ministries and
between service stream agencies. It is apparent, then,
that the innovation is collaboration in the delivery of
assessment services. The developed model addresses
these facts.

According to the literature, collaborative
organizations exhibit the following characteristics:

- They are a result of shared power and

responsibility.
- They involve a high degree of participative
decision-making.

- They are non-hierarchial in nature.

110

They focus less on roles and more on
functions.

They involve decisions by function rather
than role.

They foster decisions being made by those who
must implement them.

They are operated as open systems._

They recognize the uniquely ordered
perceptual field of each individual.

They have built-in mechanisms for
self-renewal, both individual and
organizational.

They recognize the need for continual ongoing
processes of feedback, evaluation, and
modification, both individual and
organizational.

They recognize the importance of process as
well as input and output.

They foster mechanisms for building and
supporting interdependence.

They utilize conflict resolutions strategies
based on problem solving methodologies rather
than arbitrary resolution or political

methodologies.

111

They foster a high degree of individual
control over the immediate decision-making
and work environments.

They function with a common value base that
influences organizational and individual
behaviour.

They share a common frame of reference with
regard to appropriateness and utility of a

collaborative mode of operating.

112

Project Team

The model was developed by the researcher as an
integral part of the study, and was revised by
representatives of the Ministry of Education, Health,
and Community and Social Services, members of the
Project team. Each member reflected the interest and
concerns of his respective ministry. The model was
again reviewed and approved by the Steering Committee
which was Interministerial by composition. Finally it
was forwarded to the Deputy Minister's Ad Hoc

Committee, and approved for implementation.

113

Model

Model Assumptions

 

In developing the model, there were specific
assumptions made about the basic characteristics that
it should contain. These are:

1. All three Ministries will use common
terminology for classification and level of severity of
problem which will relate to the level of service
provision.

2. Each Ministry will assume the responsibility
for ensuring that their agencies fulfill their
assessment mandate.

3. Each Ministry will provide assessment
services either directly or indirectly, for those areas
of agreed-upon responsibility.

4. There will be a sharing of information among
the agencies of various service streams providing
assessment services to a child and his/her family.

5. The model will have an evaluation/feedback
component.

6. The model will have identified decision
points in the process, requiring a coordinated approach

to assessment provision.

114

Model Objectives

 

1. To ensure efficient use of existing
assessment resources.

2. To ensure that each child and his/her family
has access to a range of assessment services to
identify his total needs.

3. To provide a coordinated approach to
assessment with a clearly outlined centre of
accountability.

4. To provide a mechanism for the identification
and resolution of service gap issues.

5. To provide for coordination at the local
level.

6. To ensure that assessment systems remain
sensitive to changes in assessment strategies and
technologies.

Model Principles

 

The model will also function according to the
following principles.

1. Assessments will be conducted focussing on a
whole child approach.

2. Assessments will be conducted within the

local area as much as possible.

115

3. The family will be an active partner in the
process.
4. The outcome of an assessment will be a

clearly defined course of action with responsibility
for follow through assigned.

5. Services will be provided, as much as
possible, in a linguistic and culturally appropriate
manner.

6. Given an adequate level of staffing, the
model assumes that assessment will be completed within
30 days of identification of needs.

Statement of Assessment Resppnsibility

 

The following have been agreed to by each
Ministry.

1. That Education conduct relevant assessments
of children for purposes of diagnosing children's
learning problems/defining children's learning needs
and providing programs to meet these needs.

2. That Community and Social Services ensure
provision of relevant assessments of children for
purposes of diagnosing children's social, emotional and
children's mental health problems, defining children's
psychosocial needs, and providing programs and/or

services to respond to these needs.

 

116

3. That Health ensure provision of assessments
for purposes of diagnosing children's health problems,
defining children's health needs, and providing
programs and/or services to meet these needs.

Procedures for Provision of Services

 

Assessment services will either be provided
directly through agencies of the responsible Ministry
or through a purchase—of—service approach. This
purchase of service will be between agencies of the
same Ministry or from agencies of another Ministry.

Psychosocial assessment of mild and moderate level
difficulty will be handled by the agency or board
involved with the child and will not be referred to an
M.C.S.S. agency of the Ministry of Community and Social
Services for assessment.

The local boards of education must provide all the
necessary documentation verifying the need for
assessment by an outside agency when a referral is
made. This will usually entail providing details of
standardized assessments completed by appropriate
educational personnel confirming that the cause of the
child's difficulties in the classroom is not

educational in nature.

117

These same principles of providing all the
documentation verifying the need for an assessment by
an outside agency will also apply to Ministry of
Community and Social Services and Ministry of Health
agencies when a referral is made.

Provincial policy positions acceptable to
Education, Health and Community and Social Services
have been developed around the ability of Boards of
Education to purchase programs and services from
agencies of other Ministries.

It is not economically feasible or efficient for
all Ministries to have the capacity within themselves
or through their funded agencies to meet all their
assessment needs. The pooling and sharing of resources
is the most appropriate path to follow.

Points of Coordination

 

Each agency within the various service streams has
a role to play in case review and coordination as part
of their basic operation. In order to ensure the most
efficient use of resources as well as the appropriate
use of a broader range of assessment resources, this
case coordination role must be used effectively, and

within an established operational framework.

118

There must be clearly defined decision points
during an internal assessment process when outside
agencies, still at the local level, should be involved
in a coordinated process to develop a plan of action
for certain children.

Since Boards of Education are responsible for
education of all children they are as a consequence
involved in any assessment used in determining an
appropriate placement. Assessment may be provided by
other agencies of other ministries or properly fall
within their mandate. Because of the large number of
assessments used for identification and placement, the
focus has been to identify those decision points where
resources of other ministries should be involved.

During the Identification, Placement and Review
Committee, (I.P.R.C. process) initial activity will
focus on determining if the difficulties that a child
is experiencing are educational in nature or are, for
example, psychosocial in nature, and to such an extent
that the specialized assessment resources of a
children's mental health program will be needed. A
need would be for further assessment to determine the

exact nature and extent of the difficulty as well as to

119

identify the potential need for support services to
maintain the child in the school system.

If the I.P.R.C. has documentation to indicate a
psychosocial basis for the difficulty as just
described, then a referral should be made to the
appropriate M.C.S.S. agency for assessment and
consultation in determining the most appropriate course
of action to meet the child's needs. If, through
further assessment, it is determined that the child's
problem is basically educational in nature and not
psychosocial, then the Board making the referral may be
charged for the assessments done by the M.C.S.S.
agency. Similarly, the same principle would apply in
terms of an identified physical need, and the charge
from a health agency.

For the most part, children who are being
considered for placement in a self-contained classroom
would be the type who require a broader
multi-disciplinary approach to assessment, although,
depending upon the service approach of any particular
board, a resource withdrawal program may also be under
consideration as a placement. The common element would
be the considered psychosocial or physical nature of

the child's difficulties and the potential need for

120

M.C.S.S. or Health resources to maintain the child in
an educational situation.

In addition, the child who is being considered for
the category of unable-to-profit would also require a
coordinated approach to assessment. Once the principal
has determined that a child is unable to profit, a
referral should be sent to the I.M.A.P.T. (Inter
Ministerial Assessment and Planning Team). The role
and function of this group will be discussed
separately. This referral would be in addition to the
referral to Section 34 as required under the Education
Act.

In the assessment process undertaken by an
M.C.S.S. or Health agency, difficulties that are
identified as basically educational in nature would be
referred to the local board of education for assessment
and consultation in developing a plan. If the
psychosocial or health assessment indicated a treatment
approach that would impact on education, joint
consultation and assessment would take place in order
to determine the most appropriate course of action.

In summary, a coordinated approach to assessment

involving agencies in the community would be used when:

121

1. Through the I.P.R.C. process documentation
indicates that the child's difficulties are primarily
psychosocial or physical and that the resources of an
M.C.S.S. or Health agency may be needed to maintain the
child in the classroom.

2. Through the I.P.R.C. process, there is an
indication that a child will be identified as unable to
profit.

3. Through an M.C.S.S. assessment, the plan to
meet the child's psychosocial needs will have impact on
his educational program, for instance his residential
placement.

4. Through M.C.S.S. assessment, documentation
gathered indicates that the nature of the child's
difficulties are basically educational or physical.

5. Through Health assessment, the plan to meet
the child's health needs will have impact on his
educational program (e.g. residential placement).

6. Through Health assessment, documentation
gathered indicates that the nature of the child's
difficulties are basically educational or psychosocial.

In addition, the use of community resources in an
informal way for consultation would also be encouraged.

Although not involving the formality of a referral

122

because the nature of the difficulty is not severe
enough to warrant that level of involvement, early
consultation ought to assist in preventing the

escalation of difficulties to a more severe level.

Conflict Resolution and Service Gaps - I.M.A.P.T.

 

This body is the major link-up with all components
in the system to resolve major service conflicts and
gaps. In the procedures just described, situations may
arise where the agencies at the local level are unable
to come to an agreement on the needs of a child. There
also may be situations where there is agreement on what
the child needs but there is nothing available to meet
the needs. Then I.M.A.P.T. will play a major role in
attempting to solve the problem. An interministerial
decision making paradigm is included at the end of this
section.

Within the M.C.S.S. process, the Unsually
Difficult Service Situations Committee (U.D.S.S.) will
have been involved in service gap issues related to
M.C.S.S. services both in situations involving only
M.C.S.S. agencies and in situations involving agencies
from other service streams. This group will provide
information to I.M.A.P.T. on M.C.S.S. service gap

issues involving agencies from other Ministries.

123

Within Education, the I.P.R.C. will provide
information to the Regional Office on service gaps in
situations involving agencies from other Ministries.
If this does not bring resolution, it will be referred
to I.M.A.P.T. The agency performing the case manager
role will notify I.M.A.P.T. of service conflict issues.

Since I.M.A.P.T. is composed of upper management
people, it has the authority and impact to effect
change in the system. For education, it will be
officially designated as the Province of Ontario for
all cases of Hard to Serve and will play a major role
in developing a plan of action for these children.

I.M.A.P.T., as the focus for data, will also play
a major planning role in ensuring that assessment
resources are available and utilized in the most
efficient and effective manner possible.

Responsibilities of I.M.A.P.T.

 

1. To ensure that consistency is maintained
regarding agreed upon areas of assessment
responsibility.

2. To ensure that all children receive
assessment services as needed.

3. To resolve conflict issues in the service

delivery system.

124

4. To develop an Interministerial planning
mechanism for developing new services and or
realignment of existing services.

5. To act as the Province of Ontario in

Hard-to-Serve cases as designated by the Section 34

Tribunal.

125

Role of I.M.A.P.T.

 

1. To review cases and direct agency activities
as may be necessary to meet the needs of specific
children and their families.

2. To monitor the overall functioning of the
assessment model.

3. To develop a plan to be followed to remediate
service gaps, duplication, etc.

4. To provide advice and direction to the
Section 34 Tribunal and to the U.D.S.S. Committee.

5. To develop a plan of action for Hard-to-Serve
cases from Boards of Education.

Inter-ministerial Assessment Service Decision-Making
Steps in rational decision-making and their symbols.
1. Ask an Open-ended question regarding O

the service gap or conflict issue

referred to I.M.A.P.T.

2. Make a two dimensional chart CH
3. Generate alternatives A
4. Generate criteria C
5. Rank the alternatives R

6. Make a summary statement SS

126

The basic decision-making model

-—-———)CXA

tné—m qut—mlbfidé—O

 

127

Example of a Possible Referral and Application of the
Decision-Making Model by I.M.A.P.T.
Scenario:

A superintendent of education informs I.M.A.P.T.
that an I.P.R.C. has established the need for resources
potentially available from agency B for student X who
is having severe emotional problems.

Question: What service agency is going to provide

resources required by student.

 

Alternatives

 

Criteria A B C D

 

 

 

 

 

 

 

 

 

Total

 

 

 

 

 

 

Alternatives:

128

Ministry of Education, Ministry of Health,

Ministry of Community & Social Services,

private practice ...

 

 

 

 

 

 

 

 

 

 

Criteria: Policy, practice, funding, availability
of service, responsibility ...
Ranking: Once the alternatives and criteria have
been placed on the chart - the alternatives
are ranked by applying the criteria
against the alternatives and assigning
the lowest number to the preferred
alternative, then adding them up.
Alternatives
Ministry of Ministry of Ministry of Private
CRITERIA. Education COMSOC Health Practice
Responsibi- 1 3 2 4
lity
Practice 3 2 4 1
Funding 2 3 1 4
Policy 3 l 2 4
Availability 3 4 2 1
Total 12 13 11 14
Ranking 2nd 3rd lst 4th

 

 

 

 

 

 

Summary:

129

Having considered various alternatives in
the context of relevant criteria -
I.M.A.P.T. recommends that the required
services be provided by the Ministry of
Health. Note - Having arrived at its
decision, I.M.A.P.T. would refer the

case to the appropriate agency for action.

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132

Co-ordinating Procedures
This section is a guide to the innovative process
of inter-agency collaboration in co-ordinating the
delivery of assessment services at the local level. It
is intended as an easy reference in the planning and
day-to-day management of this innovation. This section
is designed to be helpful in a number of ways:
- It sets out expectations for agencies.
— It provides criteria for referrals across
Ministries.
- It clarifies agency responsibilities relating
to inter-ministerial referrals.
- It describes agreed upon areas of assessment
responsibilities.
- It presents options for the provider of the
assessment.
- It provides guidelines for the purchase of
assessment services from another agency.
However, the section does not give all one needs
to know about the innovation. It will not replace
experience and the detailed understanding of
inter-agency collaboration in co-ordinating the
delivery of assessment services; these come from years

of experience with many people in many situations.

133

There is an expectation that the procedures will become

increasingly refined as individuals gain experience in

operationalizing them. It is sufficient to point out

here that the literature and the experience of others

during the pilot phase of the current project suggest

the following approaches:

Expectations of Agencies

 

Each agency will be responsible for
co-ordinating the services needed by its
clients.

All agencies will adopt a holistic approach
to service.

Each agency will provide for the needs of its
clients with mild psychosocial difficulties.
Each agency will work co-operatively with
other agencies of all Ministries at the local
level to ensure that the assessment needs of
children and their families are met in an
effective and efficient manner.

Each agency will assume responsibility for
providing assessment services that fall
within its mandate either directly or through

a purchase of service approach.

134

Each agency will ensure that the assessment
process results in the development of a
clearly defined course of action with

responsibility for follow-through assigned.

135

Criteria for Referrals Across Ministries

Although not all children will require assessments

inter-ministerial, inter-agency collaboration should

take place in cases of the following nature.

(1)

Initial assessment activity by one agency

indicates difficulties present in areas beyond its

mandate.

The following are presented as examples of

these types of difficulties.

(2)

M.C.S.S. agency during assessment of a child
uncovers indicators of intellectual
functioning either below or above the norm or
indications of a potential physical basis for
present difficulties. Case records do not
make any mention of these possibilities.
Educational assessment for learning
disabilities uncovers the presence of
significant psychosocial dysfunctioning which
is having an impact at home and school.
Physical assessment uncovers indicators of at
least a moderate level of psychosocial
dysfunctioning or intellectual
exceptionality.

Assessment of multi—handicapped children:

 

 

in:

the
re

to

w}
tr

tr

136

- Because of the nature of their difficulties,
these children should be assessed by agents
from all three Ministries to ensure that a
complete picture of strengths and weaknesses
is available.
(3) All children being considered by a school
board for the Education designation unable to profit.
Agency Responsibilities in Cases of Inter-Ministerial

Referral

 

The referring agency assumes responsibility for
information gathering and case co-ordination.

By information gathering, we mean the compiling of
the necessary documentation required for making a
referral. This documentation would include the
following.

- Formal results from assessments to date.

- The identification of factors which indicate

the need for the referral.

- A statement of expected outcomes.

By case co—ordination, we mean the referring
agency will assume responsibility for case management
which covers such areas as service plan development,
brokerage and follow through. This function can be

transferred to another agency if the final assessment

137

results indicate a more appropriate focus of primary
responsibility. An inter-agency case conference will
be the vehicle through which the appropriate focus for
case management responsibility will be determined.

The receiving agency, on the other hand, assumes
responsibility for analyzing information carrying out
assessment functions and ensuring confidentiality of
records. The following provides a fuller description
of these responsibilities.

Information analysis includes the review of all
documentation provided to determine the appropriateness
of the referral. The assessment function is carried
out on the assumption that the referral is appropriate.
As well, the required assessment should be conducted on
the basis of the specific needs identified by the
referring agency. The case planning function results
in the development of a plan of action by the receiving
agency through participation in a case conference. On
occasion, there may be a need for the receiving agency
to carry out the case management function. This, of
course, will depend on the outcome of the assessment.

Finally, it is the responsibility of each agency
to ensure that the privacy of the client and his family

are safeguarded to the fullest extent possible. When

138

reviewing records to determine which information to
send with the referral, decisions should be based on
its relevance to the specific situation which prompted
the referral. In all cases of an inter-ministry
referral, a signed consent form specific to the
referral must be obtained. The original should be
retained on file and a copy should accompany the
referral. If the referral material does not include a
consent form, it must be provided prior to the
receiving agency involving itself with the case.

Management of the Assessment Process

 

Each ministry has agreed to a set of clearly

defined assessment responsibilities.

- Education will conduct relevant assessments
of children for purposes of diagnosing
children's learning problems, defining
children's learning needs and providing
programs to meet these needs.

- Community and Social Services ensure
provision of relevant assessments of children
for purposes of diagnosing their social,
emotional and their mental health problems,

defining their psychosocial needs, and

139

providing programs and/or services to respond
to these needs.

- Health will conduct relevant assessments

for purposes of diagnosing children's health
problems, defining their health needs and
providing programs and/or services to meet
these needs.

While the above statements are useful for
establishing the basic parameters of assessment
responsibility, there is a need for some specific
statements on areas where definition of responsibility

has been somewhat problematic.

140

Basic Implementation Tasks

The implementation of the inter-ministerial
approach to co-ordinating the delivery of assessment
services in Northern Ontario, including the I.M.A.P.T.
functions, entails a process not to be construed as a
product or an event. One can agree with the literature
that informs us that the science of implementation
still needs to be develOped. The basic problem still
remains the formulating of a theory of change linked
with changing practices. Notwithstanding these
limitations, this section will focus on a four-phase
process leading to the implementation of the
inter-ministerial approach to co-ordinating the
delivery of assessment services in the Northwestern,
Midnorthern and Northeastern regions of the province.

Pilot Phase

 

- Conduct a pilot study to determine the
efficacy of the model.

Adoption Phase

 

- Provide feedback on the overall project
including the findings of the pilot to
participating agencies (e.g. executive

report).

141

- Disseminate information regarding the
finalized approach to inter-agency
collaboration in co-ordinating assessment
services.

— Decide to proceed with the implementation of
the interministerial model at the local
level.

Implementation Phase

- Monitor implementation, for instance by
soliciting feedback from agencies on problems
of implementation.

- Interact with directors of agencies and
service stream personnel.

Improvement Phase

- Gear strategies to ongoing problems of
implementation.

- Change policy as required (if any).

- Assess implementation and its effectiveness.

- Improve implementation as required.

An Agency Procedures Manual was develOped to

assist in implementation (see Appendix C).

142

Instrument Development

It was determined that a questionnaire would be
the most effective manner for gathering needs
assessment data. The format of the questionnaire would
be directed toward retrieving individual student data.
This determination provides the following advantages:

i) it keeps the number of items to a minimum,
ii) it eliminates the need for the agencies to
provide aggregate data,

iii) it links the child directly to the amount of
assessment he/she received in the various
categories,

iv) it clarifies the picture and expands the
information received.

The individual child format was also selected
because of its ability to facilitate the collecting of
large volumes of information. The individual child
identifiers were used in order to track a child from
agency to agency, and across service streams.

The survey instrument comprised thirty-five
questions (see Appendix B). The following are the
leading topics addressed by the questionnaire. The
headings for the different clusters of data are as

follows:

143

i) Demographics
ii) Language of Instruction and Assessment
iii) Referrals, Reasons and Placements
iv) Assessment Relations
v) Degree of Severity
vi) Intellectual/Academic Assessment
vii) Sociocultural Assessment
viii) Physical Assessment
ix) Communication Assessment

Problems of long standing in survey research have
to do with language usage. As a result of this, a
common terminology for classifying assessment problems
and their degree of severity has evolved. This common
usage strengthened the reliability of responses.

The questionnaire was validated by a panel of
judges comprising members of the Steering Committee.
The Steering Committee was made up of three Regional
Directors of Education for Northern Ontario, the
Regional Director for Northern Ontario, Ministry of
Community & Social Services, and the three area
managers for M.C.S.S. The Ministry of Health was
represented by a Northern Ontario planning officer.

This panel of judges had access to the resources

of their ministries prior to approving the

144

questionnaire. The questionnaire was also vetted by
representatives of the Ministry of Education's Special
Education Branch prior to final approval being given by
the Steering Committee.

Results of field work indicated that most school
boards preferred the data collection time frame to
cover a period from September 1, 1982 to November 30,
1982. This time frame took into account the boards'
greatest number of referrals and ensuing assessments.
The revised questionnaire was to be hand-delivered in
all cases between March and June 1983. The deadline
for completion by all school boards was June 30, 1983.
The return deadline for M.C.S.S. agencies was extended
to August 5, 1983. Analysis of the data took place
during the following spring and summer.

Validity of the Instrument

 

The decision to conduct a survey was made after
having taken into consideration various alternatives.
According to Orlich (1978), in far too many cases,
persons conduct a survey to obtain data which could
have been collected or abstracted from primary source
reports, forms submitted to coordinated agencies or

other available records.

145

As mentioned in Chapter I, an initial review of
assessment data available from M.C.S.S. and Education
indicated that data collection formats varied greatly.
As a result, an alternative data collection process (a
survey) was required to accurately document the status
of assessment services currently functioning within
Northern Ontario.

The merits of conducting personal interviews and
telephone interviews as alternatives to carrying out
survey research were considered. However, since the
size of the representative sample group was
comparatively large and since the sample population was
scattered throughout the vast region of Northern
Ontario, both the personal interview technique and the
telephone interview were deemed inappropriate. Many
writers have commented on the advantages of the survey
questionnaire as an information-collecting technique.
Orlich (1978) articulates the general advantage of
using written questionnaires of the type administered
in this study, in the following way:

- many individuals can be contacted at the same

time

— written questionnaires are less expensive

than personal interviews

been

146

each selected respondent receives identical
questions

responses can be easily tabulated
respondents can answer at their own
convenience within the alloted time
persons in remote or distinct areas can be
reached

interviewer biases are avoided

uniform, measurable data can be gathered
which allows for research investigation

a written questionnaire requires a much

shorter time to complete

The disadvantages of this approach have similarly

described by Orlich (1978):

the investigation is prevented from learning
the respondents' motivation for answering
questions

respondents are limited in their free
expression of opinions/information
questions can have different meanings to
different people

there are no assurances that the intended
respondent will actually complete the

instrument

147

- the return of all questionnaires is difficult
to achieve

Reliability and Validity of Data

 

To improve the reliability and validity of the
data gathered, a decision was made to have Ministry of
Education staff visit each school board. The purpose
of this was to clarify questions and concerns of
respondents. The same personal approach was planned
for the Ministry of Community and Social Services, as
their personnel were also to conduct workshops for
their agencies, hand deliver the questionnaire, and
assist in completing the forms. However, time
constraints prevented M.C.S.S. from taking an approach
similar to that taken by the Ministry of Education. As
a result, the M.C.S.S.- related questionnaires were
administered by mail. To offset the methodological
weakness of simply mailing out the questionnaire,
M.C.S.S. personnel were made available to visit their
agencies and assist in completing the questionnaires,
when possible.

The objectives, purposes and methods of the
Northern Assessment Task Force project were initially

presented at Regional Education Council

148

meetings to the Directors of Education of each school
board in the three regions in the early spring of 1983.
Directors of Education were asked to inform their
superintendents, who in turn would inform their special
education personnel of the impending data collection
exercise. Ministry of Education personnel held work
sessions with each board's special education staff, and
aided the boards in completing the questionnaires. To
ensure that the participants prOperly completed and
returned the questionnaire, personal follow-ups were
conducted, and telephone follow-ups were initiated.
Board personnel filling out the questionnaires
included only those Special education
teacher-diagnosticians, psychologists, psychometrists,
special education consultants or speech consultants who
were directly involved in formal student assessments
and who were familiar with case loads and any pertinent
information that was required to complete the

questionnaires.

149

Findings

Findings generated by the assessment questionnaire
for the period between September 1 and November 30,
1982 within Ministry of Education and Ministry of
Community and Social Services agencies in the
Northwestern, Midnorthern, and Northeastern regions of
Northern Ontario present data and highlight some themes
which appear to run through the data. These themes
need to be taken into account in considering
decision-making, collaboration practices, and
realignment of services for service stream agencies in
the Timiskaming and Thunder Bay districts. Both
quantitative data - reporting frequencies and
percentages, and qualitative data are reported. For
the purposes of this study, the data are displayed and
discussed in the context of each individual district
since each of the geographic regions is unique. The
data to date, involving the districts of Thunder Bay,
and Timiskaming reflects information derived from a
total of 745 individual questionnaires. The data
reveal that 119 questionnaires were completed in the
district of Timiskaming, and 626 in the district of

Thunder Bay. There were approximately 164,332 students

150

enroled in schools in the two districts involved in the
survey.

Table 2 presents information on the distribution
of referrals by Ministry and agency type, for the
districts of Timiskaming and Thunder Bay.

Within these two districts, Ministry of Education
referrals represent approximately 69% of all cases.
The data reveal that in the district of Timiskaming
M.C.S.S. has been involved in 14 of the 119 referrals.
This suggests that education referrals represent
approximately 89% of the total referrals. In the
district of Thunder Bay, the rate of M.C.S.S. referral
involvement is 34%. This is considerably higher than
in the district of Timiskaming. While education was
involved in 406 referrals in the district of Thunder
Bay, M.C.S.S. is shown to have been involved in 220 of
all cases (n 626).

Information on the respondent population and
methodology discussed in the summary section of Chapter
V is intended as a perspective to the overall study.
It includes the presentation of more detailed
information concerning the questionnaire data as they

relate to the districts of Timiskaming and Thunder Bay.

151

 

 

 

 

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Agreed Upon Assessment Responsibility

 

The data were examined in relation to mandated and
agreed-upon assessment responsibility outlined below.
This will serve to frame the ensuing discussion.

The assessment responsibilities of each ministry
are found in the following statements:

. Education will conduct relevant assessments
of children for purposes of diagnosing
children's learning problems, defining
children's learning needs and providing
programs to meet these needs.

. Community and Social Services will conduct
relevant assessments of children for purposes
of diagnosing children's psychosocial needs
and providing programs to meet these needs.
Health will conduct relevant assessments for
purposes of diagnosing children's health
problems, defining children's health needs
and providing programs and/or services to
meet these needs.

It was agreed that psychosocial assessments of

mild level difficulty would be handled by the school

board involved with the child. A board would not, in

156

this case, make a referral to an M.C.S.S. agency (i.e.
C.M.H.C.) for assessment.

The Ministry of Health's mandate would be to
provide assessment services for the entire range of
health-related problems regardless of the degree of
severity or difficulty,

As was outlined in the survey questionnaire, the
categories of assessment activities include the
following:

(1) primarily psychosocial;

(2) primarily educational;

(3) primarily physical;

(4) combined educational and psychosocial;

(5) combined educational and physical;

(6) combined psychosocial and physical; and

(7) combined psychosocial, educational and

physical.
These categories describe the various activities
provided by the Ministry of Education, the Ministry of
Health and the Ministry of Community and Social
Services either individually or collectively.

While M.C.S.S. can be expected to provide
assessment services for psychosocial categories (1),

(4), (6) and (7) listed above (as prescribed by

157

mandate), its responsibility is primarily in relation
to cases which are moderate, severe and very severe.
The Ministry of Education on the other hand can be
expected to provide assessment services for educational
categories (2), (4), (6) and (7). When categories (4)
and (7) involve psychosocial difficulties beyond the
mild level of severity, the Ministry of Education is
to receive support from a sister M.C.S.S. agency.
Finally, the Ministry of Health can be expected to
provide assessment services in relation to categories
(3), (5), (6) and (7). The combined categories (5),
(6) and (7) would necessitate the involvement of either
the Ministry of Education or Health, or both, depending

on the particular problem.

158

CHAPTER IV - PILOT

Two significant sources of support existed for
pilot testing the ideas, assumptions, and activities of
the inter-ministerial model for co-ordinating the
delivery of assessment services in Northern Ontario.

As one would expect, the findings of the survey and the
recommendations derived from these findings provide
such support. Secondly, support was also provided by
members of the Northern Assessment Task Force Steering
Committee. After examining the preliminary findings of
the survey and considerable consultation, the steering
committee was advised of the development of a pilot
project proposal. As a result of this, approval was
given by the Ministries of Education, Health, and
Community and Social Services under the direction of
the Deputy Ministers' Ad Hoc Committee on Children's
Services to field test the general framework.

The purpose of the pilot was to field test the
model and the feasibility and effectiveness of the
operational procedures. The inter-ministerial model to
which we refer can be viewed as a set of constructs for
organizing, co-ordinating, and executing both
inter-lintra-ministry and inter—lintra-agency

collaboration in the delivery of assessment services

159

within clearly defined agreed upon areas of assessment
responsibility. It also comprises a process to resolve

issues where conflict occurs.

160

Pilot Selection

A modified random selection process was used to

determine the districts to be involved in the pilot

project.

The figure, on this page provides an

illustration of the clusters of districts, by region,

comprising the total population. Close examination of

districts, within regions, revealed the existence of

significant differences between regional

 

characteristics.

A Northeastern
Cochrane
Muskoka
Nipissing

Parry Sound
Timiskaming

Midnorthern

 

Algoma
Sudbury
Manitoulin

Northwestern

 

Kenora
Rainy River

Thunder Bay

161

As a result, two new clusters were derived by the
application of agreed upon criteria to the
characteristics of each sample. Factors such as
ethnicity, the presence or absence of specific types of
M.C.S.S. facilities, both types of boards and schools
within districts, linguistic characteristics of
schools, and so on served as a basis for reclustering
the eleven districts.

Once stratified, two districts (Thunder Bay and
Timiskaming) were randomly selected from normal
populations.

Pre-Pilot Activities

 

Prior to conducting the pilot, members of the
project team carried out four distinct sets of tasks.
Here, we present an inventory of pre—pilot activities

by task topic.

162

Agency Procedures Manual

An agency procedures manual was developed by the

researcher in concert with project team members to be

used by local agencies throughout the course of the

pilot project. The manual (see Appendix C) had five

major objectives:

i)

ii)

iii)

iv)

V)

To delineate assessment responsibilities for
areas of uncertainty.

To identify points in the assessment
process where inter-agency co-ordination
should take place.

To establish procedures to be followed in
making an inter-agency referral.

To establish criteria and procedures for
charge back and purchase of service
situations.

To establish criteria and procedures for
referrals to the conflict resolution body

(I.M.A.P.T.).

163

I.M.A.P.T. Procedures

Procedures were developed to provide guidelines

for conflict resolution. These procedures discussed in

the model have the following objectives:

i)

ii)

iii)

iv)

v)

To establish criteria and processes for
decision making.

To provide detailed procedures for
implementing decisions once decisions have
been made.

To establish procedures for monitoring
I.M.A.P.T. cases.

To develop procedures for establishing an
ongoing data collection mechanism.

To establish procedures for joint ministry

planning.

164

Evaluation Instruments

A third task involved developing a set of

instruments for evaluating the pilot project and its

effectiveness. The instruments included:

i)

ii)

iii)

iv)

V)

Checklists of procedures to be followed at
the local level relating to inter-agency
referrals, charge backs, and purchase of
service(s).

Interview schedules for assessing the
completeness and usefulness of the
procedures manuals, training sessions, and
outcomes.

Questionnaires for assessing the impact of
the pilot in the context of manpower, case
volume, clarification of agency mandate,
administrative, and financial issues and
concerns.

Financial cost analysis sheets relating to
the potential purchasing of services and
charge back costs.

A checklist to document I.M.A.P.T.
procedures, referrals, decision making,

manpower needs, and effectiveness.

165

Information

This aspect of the project involved the

development of an information dissemination strategy

likely to result in the implementation of the pilot

project in the randomly selected districts. The tasks

resulted in:

i)

ii)

iii)

iv)

V)

vi)

A set of criteria for selecting pilot
districts.

Procedures for communicating with agencies
involved in the pilot.

The development of training session
materials.

Plans for organizing and co-ordinating
training sessions involving ministry
personnel and agency staff.

Clarification of the nature and scope of
support to be provided to agencies during the
pilot period.

The development of a mechanism for the
early identification and resolution of

problems arising during the pilot.

166

Training Sessions
The project identified two distinct target
pOpulations that required training and orientation
prior to piloting the model. These distinct
pOpulations comprised agency staff and Ministry
personnel who interface with designated service stream
agencies.

Ideally, all staff involved with assessment in an
agency should attend an orientation training session.
This, however, was not always possible. As a result,
the focus of the training sessions was agency directors
and senior staff members having responsibilities
related to the monitoring of activities of their agency
and involvement in identifying and reviewing potential
cases requiring outside assessment. It was assumed
that each agency would conduct an in-house orientation
for other personnel involved in assessment and
inter—agency collaboration processes.

In each district the focus for agency training was
on the model, its purpose and the local level
procedures manual. Some discussion also took place
around the evaluation process and agency roles in

providing required data.

167

Within each of the two districts, Ministry
orientation training involved personnel directly in
contact with local service stream agencies. The
sessions drew attention to the importance of full
support and co-Operation. During orientation, members
of the training team reinforced the belief that
Ministry personnel would likely be the first to
experience the reactions of service stream agencies.
As such, they would be the link through which
operational issues would be identified prior to
becoming major issues or concerns.

In keeping with this perspective, the focus for
Ministry staff training was on ensuring that personnel
had an understanding of the intent of the initiative
and the processes to be followed. As well, some time
was spent discussing the organization of the project
and inter—/intra-agency linkages and communication
channels.

Full day training session were held in both
districts. All agencies across each Ministry attended
the same sessions. Each agency received a procedures
manual at the training session. The ideas of the

procedures manual were detailed, page by page, by the

168

researcher and members of the project team. These
sessions were designed to clarify issues related to:

i) The background of the project

ii) The pilot mandate
iii) The activities of the project team
iv) The logic and ideas of the model
v) Data collection procedures
vi) Inter-agency collaboration at the local
level
vii) Communication linkages
viii) The meaning of implementation
ix) Implementation considerations

Upon completion of the training sessions,
participants were provided opportunities to evaluate
their appropriateness and effectiveness.
Questionnaires were completed by each participant to
provide insight into the effectiveness of the training
and model, Table 3. This information was important as
it provided a basis for improving training sessions for
fostering inter-agency collaboration.

Ministry staff training sessions occurred the day
following agency related sessions. As a result of
this, concerns raised during the training of agency

personnel were addressed immediately by Ministry

169

personnel. This permitted the development of
strategies for COping with factors likely to impede

implementation.

170

TABLE 3

EVALUATION OF TRAINING SESSION

 

RESPONSES BY PERCENT

 

Yes No No Response
1. Was the overall purpose of this
project clearly explained to
you? 86 14 O
2. Was the model for coordinating
the delivery of assessment
services fully clarified? 79 21 O

SPECIFIC COMMENTS

 

A. Do you feel each of the following components of the process
were clearly explained?
1. Points where cross-Ministry
inter-agency referrals would
occur. 86 7 7
2. Definitions of general
assessment responsibilities

for each Ministry 71 22 7

171

TABLE 3 (cont'd.)

 

Specific areas of assessment

responsibility:

A) Psychosocial 64
B) Learning disabilities 64
C) Speech & Language 64
D) Developmental 64

Documentation needed for

local level cross-ministry

referral. 93
Responsibilities of all

parties in a cross-ministry

local level assessment. 57
Responsibilities of

agencies purchasing

assessment services. 86
Responsibilities of

agencies providing a

purchased service. 86
Documentation required

for purchase of service

agreements. 86

36

29

36

29

36

14

172

TABLE 3 (cont'd.)

 

 

 

 

 

 

9. Criteria and documentation
for a charge-back
situation. 93 0 7
10. Criteria for I.M.A.P.T.
referral. 86 7 7
11. Procedures for I.M.A.P.T.
referral. 93 0 7
12. Function of I.M.A.P.T.
committee. 93 O 7
B. The responses to the open ended question clustered as follows:
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1) Length of training session 7 21 7 l4 l4 7 29
ii) Method of presentation 29 7 14 21 29
iii) Group size/composition 29 7 29 7 29
iv) Resource materials 7 29 7 29 29

 

 

 

 

 

 

 

 

 

 

173

Pilot Data

A range of data were required in order to develop

an information base for determining the feasibility of

the model,

the effectiveness of the model, and

processes of implementation. In this connection, the

pilot project included carrying out the following data

related tasks:

i)

ii)

iii)

Data forms were to be developed by the
project team, and were to be completed by
each agency director. These data forms were
then returned to the researcher for analysis.
These forms identified the number of cases of
an inter-ministerial nature that were
serviced. These forms also indicated the
type/nature/extent of inter and
intra—ministerial purchases of service, and
chargebacks.

Agency personnel were to be interviewed

in order to determine the strengths and
weaknesses of procedural materials provided.
Cases referred to I.M.A.P.T. to determine
consistency of decisions, appropriateness of

decision making criteria; and the amount of

iv)

v)

vi)

174

time involved to resolve conflict situations
were to be analyzed.

The impact on manpower, case volume, and so
on, as a result of model requirements, were
to be analyzed.

Financial impact on funding as a result of
across ministry purchasing of services,
charge backs, etc., and reviewing the
legitimacy of costs being charged, will be
examined.

Overall agency interaction patterns relating
to the development of informal structures,
and general interactional patterns, will be

noted.

175

Communication

The method of entry once districts were randomly
selected was typically "top down". Immediately
following selection, agencies were informed of their
involvement in the pilot project through written
correspondence. Letters were forwarded to agency
personnel by local regional directors of education, the
regional director of the Ministry of Community and
Social Services, and a Ministry of Health official.
These letters identified the respective project staff
from each Ministry involved in the pilot project. They
also provided information concerning the date, time,
location, and purpose of the proposed orientation
sessions.

After the training sessions were completed, lines
of communication were established between Ministry
field staff, local agencies and the project staff with
a view to addressing ensuing issues. Although the
agencies were requested to contact a particular member
of the project staff when requiring further
clarification, a general situation developed whereby
agency personnel tended to approach Ministry personnel

with whom they were familiar.

176

In order to support Ministry staff in these
situations, a set of likely questions and responses was
prepared for their use. When a new issue arose which
had not yet been addressed, Ministry staff receiving
the result notified a member of the project team. It
was the responsibility of the project organizers to
develop strategies for coping with problems of
implementation. Such situations were communicated to
all agencies in the two pilot areas as well as Ministry
staff. Every attempt was made to attend to factors
affecting implementation within five working days.

After the pilot had been operating for
approximately three months, a progress meeting of
participating agencies and Ministry personnel took
place in each of the two districts. The purpose of
these meetings was to get feedback on how well the
project had been progressing from the perspective of
local service stream agencies. This provided
opportunities for issues requiring resolution to
surface and for agencies to share their collective
experiences. These meetings lasted a full day. The
expenses of service stream agencies involved in these

meetings were handled by agency-related Ministries.

177

Roles and Dates
The principal role of the project team was to organize
and co-ordinate implementation of the pilot and to
provide resource support to agency and Ministry
personnel throughout the duration of the pilot project.
The immediacy of this role proved important to the
overall success of the piloting phase of this dimension
of the larger project. A second important role
involved the systematic collection of data throughout
the pilot. This was achieved through the tabulation of
forms mailed to the researcher by each agency director
or the director's designate. At the completion of the
pilot, interviews were conducted with each agency
director or the director's designate. This information
was important as it provided a basis for evaluating the
effectiveness of the model. This field testing was

carried out during the period of April/August, 1984.

Training

 

178

Results

The leading topics to which members of the pilot

project training team devoted their attention include:

i)

ii)

iii)

iv)

V)

vi)

vii)

viii)

ix)

x)

rationale for study and the pilot;

the model, and its organizing constructs,
assumptions, objectives and logic;

survey data; 73 Tables were developed for
each of the pilot districts, and are
available from the researcher;

local level procedures manual (and
I.M.A.P.T. manual where applicable);
communication and linkages between service
stream agencies;

the meaning of
inter-/intra-ministerial/agency
collaboration;

implementation considerations;

the operational plan;

data collection procedures; and

the activities of the project team.

The following are some of the issues arising from

the pilot training sessions:

i)

ii)

iii)

iv)

v)

vi)

vii)

179

agencies in both districts indicated a need
to identify a maximum time frame for children
to remain on a waiting list prior to being
serviced;

the need for further clarification
regarding the manner in which Health
related agencies fit into the pr0posed
system of inter-agency collaboration and
I.M.A.P.T. processes;

the need for agencies to work out
implementation details such as time frames
that would be consistent with already
established procedures and within operating
principles underpinning the model;

the need for operational definitions of
terms such as formal assessment, informal
assessment, and referral;

procedures likely to result in the shifting
of activities reflecting agency related
responsibilities in the provision of
assessment and treatment services;

the need for a universal set of consent
forms; and

problems of identified service gaps.

180

General Findings

 

The interviews that were held with representatives
from agencies involved in the pilot focused on
information concerning the acceptability of the
assessment responsibilities as assigned, the level of
agreement with the procedures developed for
coordinating the delivery of assessment as well as a
general discussion regarding any changes required prior
to implementation of the model across Northern Ontario.
Attempts were also made to review selected files of
cases identified as inter-ministerial to determine if
apprOpriate documentation was on file and to determine
whether established procedures were implemented.

Table 4 and 5 present a summary of data gathered
in the pilot project carried out in the district of
Thunder Bay, and the district of Timiskaming. Totals
for cross-ministry referrals received should be the
same as for referrals made. However, the slippage in
the system has created a significant discrepancy. This
will be dealt with in Chapter V under mandate drift.

Table 6 presents a summary of the data gathered
from the Evaluation Form (Appendix E) mailed to the
agency director or their designates concerning their

experiences with the pilot project.

181

Although the data from the interviews will be

summarized in Chapter V, some of the direct comments

from the agency directors or their designates are as

follows:

Even though money is available, some
Francophone children are not being served
because of a lack of Francophone personnel.
(Timiskaming Roman Catholic Separate School
Board.)

We need a trained teacher diagnostician.
(Timiskaming Board of Education.)

Much more interested in meeting needs of the
District and filling the gaps in service,
than in worrying about Ministry
jurisdictional responsibility. (Timiskaming
Health Unit.)

Charge-backs have more or less been shelved
because cooperation within the district
precludes their necessity. (Kirkland Lake
Board of Education.)

The procedures manual is completely workable,
and a good reference in case a problem should

develop. (Kirkland Lake Board of Education.)

182

I must admit that I was a reluctant
participant in this project. However, the
close c00peration among the other agencies
and ourselves forces me to eat humble-pie.
The model is an excellent manual to fall back
on. (Kirkland Lake Roman Catholic Separate
School Board.)

There are definite gaps in the system even
though cooperation is at a high level.
(Child & Youth Services District of
Timiskaming.)

Service is now available in the psychological
area to serve the District.
(Cochrane-Timmins Resource Centre.)

The delineation of each Ministry's tasks and
roles should make accountability easier.
(Regional Children's Centre of Thunder Bay.)
At the local level, people see this as a
worthwhile and time-saving enterprise.
(Nipigon Red Rock Board of Education.)
Implementing these procedures has had a
positive effect on staff. (Geraldton Board

of Education.)

183

- The inter-agency referral form was good for
our use. Our board was not involved in any
charge-backs. (Lakehead Board of Education.)

- In our opinion, the definitions of assessment
responsibilities for the Ministries of
Education, Community and Social Services and
Health provided for the project are too vague
as operational guidelines, as they pertain to
mentally retarded children. (Northwestern
Regional Centre.)

Findings of the pilot will be summarized and

recommendations generated in Chapter V.

184

TABLE 4
DISTRICT OF TIMISKAMING

SUMMARY OF PILOT PROJECT DATA

 

 

 

Cross*Ministry referrals received 51
Cross-Ministry referrals made 61
Purchased assessments provided 0
Purchased assessments bought 0
Charge-back assessments made 0
Charge-back assessments received 0
TABLE 5
DISTRICT OF THUNDER BAY
SUMMARY OF PILOT PROJECT DATA
Cross-Ministry referrals received 33
Cross-Ministry referrals made 13
IPurchased assessments provided 12
INJrchased assessments bought 7
(Huarge-back assessments made 4
Cflqarge-back assessments received 0

 

185

TABLE 6

EVALUATION OF PILOT PROJECT

 

RESPONSES BY PERCENT

 

Yes No No Response
Are the points identified where
cross—ministry inter-agency
referrals should take place? 91 9 0
Are there other situations which
should be included for cross-
ministry referrals? 9 82 9
Were the specific Ministry
responsibilities for
assessment clear in each
of the following areas?
A. Psychosocial 73 18 9
B. Speech & Language 55 27 18
C. Learning Disabilities 55 27 18
D. Developmental 64 9 27

Are there other areas of
assessment responsibility

that need to be defined? 9 73 18

186

TABLE 6 (cont'd.)

 

5. Do you feel there has been
a positive effect on staff
as a result of implementing
these procedures?

6. Is material requested on
inter-agency referral forms
adequate?

7. Do the procedures for
Purchase of Service meet
your needs?

8. Do you feel the criteria
for charge-backs is
adequate?

9. Do you feel that costs
other than just for the
assessment should be
charged back?

10. Have you had experience with
an agency unwilling to

accept a charge-back?

36

100

64

46

27

18

18

64

73

46

36

36

18

187

TABLE 6 (cont'd.)

 

11.

12.

13.

Do you feel the criteria for

I.M.A.P.T. referral is

adequate? 54
Do you feel that the

I.M.A.P.T. procedures are

adequate? 64
Do you feel that I.M.A.P.T.

has been successful in

resolving service

difficulties? 0

46

36

100

 

188

CHAPTER V - SUMMARY, CONCLUSIONS, RECOMMENDATIONS
Introduction

The purpose of the study was to deve10p a long
range coordinated model for the delivery of assessment
services for exceptional children in the northern
regions of Ontario.

In this chapter provisions are discussed that
provide answers to the research questions cited in
Chapter I.

Procedures

 

Following proven procedures, in the study data
have been assembled using the principle of
triangulation. This involves assembling multiple data
sources and trying to assess consistency of findings
across the varying methodological modalities. Types of
procedure used to yield data underpinning the study
include (1) survey of the literature, (2) assembling of
archival data, (3) conducting limited ethnographics,

(4) survey data, (5) use of key informants, (6)
statistical data and (7) piloting of the model.

Reaching conclusions in interministerial
assessment service research is without a doubt a
tenuous business. Nevertheless, it is fair to state

that the conclusions and final recommendations reflect

189

the analysis of the questionnaire data, pilot results
and general indications of what would likely optimize
assessment service offerings in the Northwestern,
Midnorthern, and Northeastern regions of the province
of Ontario. Thus, the principal conclusions address
issues related to both the scarcity and unequal
distribution of assessment services in the Regions. In
some instances, scarcity and distribution are clearly
language related. In other instances, scarcity and
distribution are agency related. It is fair to say
that the data provide evidence that districts
themselves are not equally involved in the provision of
assessment services. The data also show that the
sophistication of placement services varies by district
and by regions within districts.

Method of Entry

 

The methods of entry can be characterized as a
"top down" approach. Permission from the Steering
Committee and senior administrators within agencies was
solicited prior to any data gathering. A similar
process was undertaken in the context of gaining entry
to two randomly selected districts involved in the
pilot aspects of the project. Both survey and pilot

related data are deemed to be sufficiently

190

representative as to warrant widespread implementation

of existing recommendations.

191

Summary of Findings from the Instrument

To simplify the presentation of findings, the data
for the most part have been grouped and organized in
accordance with clusters of questions on the survey
instrument. This, in turn, has resulted in the
tabulation of data under nine distinct headings. The
reader is urged to refer back to the questionnaire
should difficulties arise.

The purpose of this section is to summarize the
findings previously discussed. The last section of
this chapter draws implications or recommendations from
these results regarding service gaps, mandate drifts,
realignment requirements, and general issues.

The following summaries have been extracted from
the 73 Tables for the districts of Timiskaming and
Thunder Bay, and are available from the researcher.

- In many jurisdictions, referrals and
assessments among lower age group children
need to be increased.

- No comprehensive provisions are made in some
jurisdictions for assessing in French,
children whose language of instruction is

French.

192

The responsibility for providing appropriate
placements after assessment is generally
considered to be the responsibility of local
boards of education. In some jurisdictions,
the range of alternative placement
possibilities is limited.

Referrals and assessment activities are
expected to result in improved programs and
services. In some instances, referrals and
assessments do not result in improved
programs and services for students.
Psychosocial assessment is identified as one
of the assessment service areas which
increases among older group children. The
majority of children with psychosocial
problems should be referred for assessment at
an earlier age level.

The apprOpriateness of referrals is
contingent on screening processes. The rate
of inappropriate referrals tends to suggest
that personnel at the present time are
insufficiently trained to determine the

assessment needs of children.

193

- There is a widespread need to provide
assessment services in French to referral
children whose mother tongue is French.

- The rate of "already active cases" stands to
increase in the future. Increases will
result from the implementation of Bill 82 and
IPRC processes. Consequently, additional
assessment and placement resources will be
needed.

- The findings in this study relating to the
nature and scope of assessment services
available in different districts suggest a
pattern of unequal distribution.

- Public and R.C.S.S. boards are not equally
involved in referral and/or assessment
processes.

— The findings in this study regarding resource
gaps suggest the need for audiologists,
speech therapists, psychologists,
physio-therapists, French language health
care specialists, teacher diagnosticians, and
psychiatrists.

Summarizing statements must also be made regarding

Inandate drift. By mandate drift, we mean that a

194

ministry or agency within a ministry is providing
service in an area related to educational, health, or
psychosocial needs where another ministry or service
stream agency has jurisdiction. Where drift exists, it
is likely to occur as a result of a) lack of knowledge
and understanding of jurisdictional responsibility or
b) insufficiency of resources within service stream
agencies with assigned mandate. It appears to this
researcher where drift occurs, this situation could be
corrected by a) clarifying mandates b) realigning
services or c) purchasing services.

The evidence presented in this chapter suggests
the following summarizing statements relating to
mandate drift.

- The responsibility for mild and moderate
level assessments is typically within the
agency having a designated mandate.
Interestingly, school boards frequently
conduct psychosocial assessments belonging to
M.C.S.S., while M.C.S.S. agencies conduct
assessments within the realm of the
jurisdiction of education.

- The responsibility for physically based

speech assessment is typically within the

195

Ministry of Health. The Ministry of
Education is responsible for speech
correction. Some M.C.S.S. agencies continue
to provide assessment services in this area.

— In some instances, intra-agency referral

systems need to be examined. The preferred
approach is to institutionalize an
inter-agency referral system that is both
appropriate and effective. At the time of
the study, there was a high rate of
biological/physical referrals within the
M.C.S.S. referral system which resulted in
referrals to other agencies.

Summarizing statements must also be made regarding
realignment requirements. Information from the tables
suggest the need for realignment is an apparent product
of inappropriate referrals. This situation exists when
a referral for assessment service is made to one
Ministry or service stream agency when the
responsibility (agreed-upon mandate) for the provision
of assessment service is the responsibility of another
Ministry or agency. The data suggest the following

realignment issues:

196

The rate of psychosocial referrals to
M.C.S.S. at the severe and very severe levels
should be higher.

M.C.S.S. involvement in educationally related
referrals and assessments in some
jurisdictions is inappropriately high.
Numerous referrals made to M.C.S.S. agencies
by school boards result in no assessment
being carried out.

At the time of the study, M.C.S.S.
involvement in assessing clients with mild or
moderate level problems implies a need for
realignment relating to "level of severity".
From the point of view of the present study,
education is underinvolved in intellectual
assessments. Actually, what is happening is
that educational agencies frequently refer
clients requiring an intellectual assessment
to an M.C.S.S. agency.

Another area requiring attention is that
having to do with speech assessment. In at
least one district, speech assessment is

conducted almost wholly by M.C.S.S.

197

Examples of the various types of speech
activity suggest a need to refine both
inter-agency and intra-agency referral
systems.

The data indicate instances of M.C.S.S.
carrying out both educational and physical
assessments. These situations have
implications for education and health related

agencies.

In the context of other issues, summarizing

statements of a general nature are also in order.

Local agencies use various informal means
rather than formal means of coping with
charge backs when fee-for-service conditions
exist.

In many jurisdictions, the number of mild-
and moderate-level educational assessments
being conducted is noticeably high.

In most educational jurisdictions integration
is the preferred means of servicing
exceptional children.

In some regions, the correlation between
request for service and provision of

educational, physical or psychosocial

198

assessment service is directional and

positive.

199

Summary of Findings from Pilot

The following statements are brief summaries of
the findings from the pilot:

1. The ideas and logic of the inter-ministerial
model for co-ordinating the delivery of assessment
services in Northern Ontario result in beneficial
change in the assessment field;

2. The statements of assessment responsibility
are acceptable to service stream agencies;

3. The operational policies and procedures
through which local service stream agencies can meet
their agreed-upon assessment responsibilities are both
apprOpriate and effective;

4. Agencies that participated in the pilot phase
of the project tended to become increasingly supportive
of the notion of the need for inter-agency/ministry
collaboration in the delivery of assessment services;

5. The pilot project resulted in an escalation
of collaborative efforts geared to the provision of
assessment services;

6. The agency procedures manual is viewed as a

comprehensive document;

200

7. The volume of assessment activity of an
inter-ministerial nature varies by district and agency
tYPE;

8. Timing is important to the potential success
of inter—agency innovations;

9. Participants suggested the need for
additional in-service geared to ongoing problems of
inter—agency collaboration in the provision of
assessment services (as opposed to a single one-day
front-end training session);

10. When faced with charge back situations
agencies are capable of resolving issues without a
formal charge back mechanism;

11. The findings in this pilot regarding service
gaps suggest that the main problem is in professional
resource gaps;

12. The nature of professional resources and the
scope of their availability are district related;

13. Continued support is needed in the provision
of professional resources in French;

14. In some jurisdictions, a wider spectrum of
educational placements is desirable in the longer term.

Finally, the pilot study verified the existence of

professional resource gaps, institutional slippage, and

201

the need for ongoing realignment both within and

between agencies.

202

Conclusions

The conclusions below have been logically derived

from the summary of findings of the survey data and the

pilot. They convey judgements as to assessment needs

in Northern Ontario.

1.

That education service stream agencies conduct
relevant assessments for purposes of diagnosing
children's learning problems, defining children's
learning needs, and providing programs and/or
services to respond to these needs.

That Community and Social Services agencies
assume responsibility for the provision of
relevant assessments of children for purposes of
diagnosing children's social, emotional and
children's mental health problems, defining
children's psychosocial needs, and for the
provision of programs and/or services to respond
to these needs.

That health related service stream agencies ensure
provision of assessments for purposes of
diagnosing children's health problems, defining
children's health needs, and providing programs

and/or services to meet these needs.

203

That the Ministries of Community and Social
Services, Education, and Health assume
responsibility for ensuring that their service
stream agencies fulfill their assessment mandate.
That the Ministries of Education, Health, and
Community and Social Services use agreed upon
terminology and operational definitions relating
to types of assessment problems and levels of
severity of such problems.

That each agency provide for the assessment needs
of its clients with psychosocial problems at the
mild level.

That the provision of assessment services be
geared to the linguistic and cultural needs of
clients.

That once a referral is made, the resultant
assessment be conducted within an agreed-upon time
frame.

That where an agency of a Ministry having
responsibility for the provision of assessment
service is unable to provide an assessment
service, arrangements be made between an agency of
the same Ministry or from an agency of another

Ministry for the purchase of appropriate services.

10.

11.

12.

13.

14.

204

That local school boards provide all the necessary
documentation verifying the need for an assessment
by an outside agency.

That an in-service training program be implemented
to provide classroom teachers with opportunities
to develop required diagnostic and programing
expertise. Professional expertise in these areas
will reduce service gaps and will also have the
effect of reducing the nature and scope of
inappropriate referrals.

That the Ministries of Community and Social
Services, Education and Health engage in
inter-ministry collaborative practices in the
provision of assessment services in Northern
Ontario.

That service stream agencies within the Ministries
of Community and Social Services, Education and
Health engage in both intra- and inter-agency
collaboration practices at the district level in
the delivery of assessment services throughout
Northern Ontario.

That service stream agencies refine the criteria

utilized for referral decision making.

15.

16.

17.

205

That the quantitative and qualitative levels of
assessment staffing be assured in Northern Ontario
and that such staffing be geared to the nature and
scope of assessment needs.

That a set of agency-related procedures be
developed which provide the basis for inter-agency
collaboration in organizing and co-ordinating the
delivery of assessment services throughout
Northern Ontario.

That a set of procedures be developed that will
ensure inter-ministry and inter-agency
collaboration in the resolving of major service

conflicts and/or gaps.

Summary Conclusions

 

i)

ii)

iii)

both service and realignment gaps exist;
the project has evolved a defensible model
which addresses both service gap and
realignment issues;

the model and its procedures can be used
as a basis for expanding professional
resources and improving collaboration

practices.

206

Recommendations

In the context of these conclusions the following

recommendations are made.

1.

That the inter-ministerial Model for Co-ordinating
the Delivery of Assessment Service be implemented
in the Northwestern, Midnorthern, and Northeastern
Regions of the province, without further delay.
Co-ordination cannot be achieved either quickly or
painlessly nor will it automatically endure.
Strategies will be required to maintain a sense of
ownership and fair distribution of responsibility.
It is recommended that there be periodic frank
discussion and review of the Inhibitors or
Barriers, ”2.3.2", lest, having been overcome the
first time such barriers arise again to the
detriment of the co—ordination of the delivery of
assessment service.

It is recommended that successors to the original
participants in the project become oriented by
reviewing the documents related to the
establishment of the model, so as to be aware of
the factors that were considered before this

project was successfully launched.

207

Problems in a similar political context may land
themselves to similar co-operative solutions.
Where populations are sparse, ethnically,
linguistically, and culturally diverse, and
distances are great, the model may provide an

approach that will help to solve the problems.

208

Reflections

An interministerial study that requires a
collaborative effort is fraught with joy and sorrow.
To be able to work from a holistic point of view,
knowing that the three ministries and their agencies
collectively have the access to human and fiscal
resources necessary to bring to bear on any particular
child's problem is a dream. To make this dream a
reality for all types of problems all over Northern
Ontario was an onerous task. I have mentioned the
achievement of co-terminus boundaries and what a
benefit it was; however a problem we never could solve
was how to bring the steering committee together for a
decision in less than six weeks.

Another problem in a study of this duration was
maintaining continuity of participants. The director
representing the Ministry of Community and Social
Services on the steering committee changed three times,
in addition we had one acting director. There were
also three different representatives from the Ministry
of Community and Social Services on the project team.
From the Ministry of Health we had three different
planners on the steering committee, and two different

representatives on the project team.

209

The study began with one government and carried on
after the election of a new government.

These were factors to be dealt with in the course
of the study and did not have any great effect
positively or negatively except that it may have
lengthened the time frames as the study moved along.

The fact that this study operated without a budget
fostered collaboration between the Ministries since
c00peration was required every time the project faced a
resource requirement. Although I would recommend a
budget for a project of this magnitude, the fact that
it was financed out of existing revenues of each
Ministry did not detract from the project appreciably.

The variance of ministry policy within government
policy is worthy of note. The passive involvement of
the Ministry of Health initially caused some concern.
However as one watched the project develop, the
congruence between the policies of each ministry in
relation to the project's objectives gradually became a
fait accompli.

I knew that the job of creating a change in the
assessment services for exceptional children and youth

in Northern Ontario would be a long and difficult

210

process; but it's a job I would start on again

tomorrow.

211

APPENDIX A

 

DEFINITIONS

 

ASSESSMENT QUESTIONNAIRE

 

NORTHERN ASSESSMENT TASK FORCE

 

212

CHILD DATA
Please complete the following information on
each child referred to your agency/board between the
period September 1, 1982 and November 30, 1982.
Please read the following instructions before
completing this section.

Name Code

 

Enter the first and last letters of the surname
in the first two boxes and the first and last
letters of the given name in the next two. Do not
use a nickname, a diminutive, or a middle name. Use
the legal name which appears on the birth
certificate or OHIP form. Note that the two spaces
for the code of the given name are not for two
initials but for the first and last letters of the
first given name. In the case of a hyphenated or
two-part name, enter the first character of the
first part of the name and the last character of the
second part. This applies to given names and to
surnames.

Examples

Surname Given Name

David Robert Smith 1 D1 D J

 

213

Mary—Ann Armstrong-Jones

Bruce Van Dyck

Birthdate:

 

Enter the date in the order year/month/day.

 

Example: June 12, 1964 Y Y M M
6

Referral Date:

 

Enter the actual date that you received a
formal request for assessment in the order year,
month, day.

Mother Tongue

 

This refers to the language a person first
learned in childhood and still understands. In the
case of infants it means the language most often
spoken in the home. In this box please enter the

number code for the child's mother tongue.

214

Definitions
Please use the following definitions to assist
you in completing the questionnaire.

Referral

 

A formal request for information to assist in
determining an appropriate plan of action for a
client. For boards of education, this would mean
beyond the regular classroom situation, requiring
parental permission to conduct an assessment.

New Referral

 

This refers to a case that has not been
previously involved with the assessment services of
your agency/board.

Already Active Case

 

This refers to a case that has been receiving
programing services from your agency/board and a
decision has been made to reassess the child.

Previously Active Case

 

This refers to a case that has been closed and
is reopened with a new referral for further
assessment.

Assessment

 

For purposes of this questionnaire, please

include information on both formal and informal

215

assessments that your agency/board may be
conducting. For example, observing a child in
school or at home should be noted as part of the
assessment process which may also include more
structured procedures that may require specialized
tools or skills.

The following definition of assessment has been
included to assist in clarifying for you what is
meant by assessment.

Assessment refers to a thoughtful process
involving:

— collecting information

- making direct observations

- weighing the facts and deveIOping

hypotheses about the problems

- understanding the individuals' needs and

deficits

- estimating the nature and the degree of

assistance which can promote healthy
functioning and continuing development

— arranging for the provision of such

assistance.

216

52::

Within this framework, initial intake
activities such as a social history done to
establish why the referral has been made to your
agency/board would not be included in this exercise.
This would include general information on the
client, social history data, and any other
information collected to determine the
appropriateness of the referral prior to deciding on
any course of action to be taken. However, any
assessment undertaken as a result of this intake
activity would be included in the questionnaire.

As well, any ongoing monitoring activities done
to determine the impact of effectiveness of programs
implemented would not be included in this data
collection, as they are evaluative in nature as
opposed to assessment oriented.

Formal Assessment

 

Involves the use of standardized assessment
instruments that have been validated and provide
results which can be measured against a set of

established norms.

217

Informal Assessment

 

Activities that may involve a consistent set of
procedures but which have not been validated and
thus the results cannot be measured against a set of
established norms.

Psychosocial Assessment

 

The psychosocial area refers to those socially
learned aspects of one's life which relate to
emotional patterns, perception and thought patterns
and patterns in interpersonal relationships. A
psychosocial assessment is undertaken to determine
the psychosocial functioning of a child and to
assess the effects that disorders in these areas are
having on the child's overall ability to cope with
his/her environment. A psychosocial assessment
should provide measures of:

l. Intensity of child's disorder - the extent

 

of child's behavioural/emotional difficulty.

2. Duration of child's disorder - length of
time child has displayed behavioural/emotional
difficulty.

3. Frequency with which child demonstrates

 

behavioural/emotional problem.

218

4. Reactivity - responsiveness of child to

 

corrective intervention.

Levels of Psychosocial Difficulty

 

Mild

 

Intensity - behaviour is annoying or disruptive

 

to the immediate environment.

Frequency - from rare to occasional occurence.

 

Duration - short term from less than one day to
one week.

Reactivity - behaviour either disappears

 

without intervention or by giving some extra
attention, i.e. "talking it over".
Moderate

Intensity — behaviour threatens the general

 

ability of the child to benefit from the normal
environment, or it threatens the well—functioning of
the environment.

Frequency — occurs frequently: relationship

 

between cause and immediate behaviour is difficult
to identify.

Duration - semi-permanent; problematic
behaviour becomes more regular.

Reactivity — requires a treatment plan focused

 

on specific behaviour change.

219

Severe

Intensity - inability to benefit from the

 

normal environment even with in-house supports -
behaviour may pose significant risk to the
environment.

Frequency - has become the typical behaviour

 

pattern for the child.

Duration - behaviour permanently entrenched;

 

occasional problem free periods.

Reactivity - requires a multi-service treatment

 

program.

Very Severe

 

Intensity - behaviour presents imminent risk to

 

self, others and/or property.

Frequency - apparently permanent.

 

Duration - behaviour fully integrated into

 

child's personality.

Reactivity - requires a comprehensive

 

residential treatment program.

Educational Assessment

 

An educational assessment is undertaken to
determine the impact of a Specific exceptionality on
a child as it relates to his ability to learn in the

classroom. The assessment should provide some

220

indication of necessary teaching strategies,
specialized techniques required, curriculum
modifications, etc.

Levels of Educational Difficulty

 

Mild - child is in a regular classroom

situation.

 

Moderate - child is on a resource withdrawal
program.
Severe - child is in a self-contained special

education classroom.

Very Severe - child is in a provincial school

 

or specialized school program. Physical Assessment

 

A physical assessment is undertaken to
determine the impact of a particular medical
disorder on a child's physical capabilities.

Level of Physical Difficulty

 

Mild - Sporadic need for medication/therapy.
Generally does not disrupt daily routines and
activities.

Moderate - Medication or therapy on a
consistent daily basis. Minimal disruption to daily

routines and activities.

221

Severe - Need for specialized health support
services/treatment on a daily basis. Significant
disruption to daily routines and activities.

Very Severe - Constant medical attention

 

required to maintain child. Primary focus of daily

routine.

222

Assessment Categories
The following definitions are intended to
assist your agency/board in determining where to
categorize your various assessment activities.

Intellectual Assessment

 

Those assessment activities, usually of a
standardized nature, undertaken to determine an
individual's potential or capacity to learn.

Functional Academic Assessment

 

Those assessment activities undertaken to
determine the extent to which a person has mastered
the concepts, operations, skills, etc. directly
related to the school curriculum. While some of the
assessment activities in this area could be of a
standardized nature, as defined, the majority is
likely to fall into the category of informal
assessment. For boards of education, activities in
this area would likely be done for all children
being considered as exceptional.

Social/Cultural Assessment

 

A process undertaken to determine the extent to
‘which a person has developed appropriate adaptive
behaviours and to identify those environmental

factors contributing to the maladaptive behaviours.

223

Such specific areas as child and family,
psychiatric, and behaviour would be the focus for
this category. For boards of education, behavioural
assessment completed by the board for children
thought to be in the category of behavioural
exceptionality would be included. Assessing the
extent of an emotional or psychosocial basis for
speech and language difficulties would also be
covered in this category.

Biological/Physical Assessment

 

A process undertaken to determine the extent to
which a person is organically, physically and
neurologically sound.

Such specific areas as motor and neurological
would be the focus for this category. For boards of
education, physical assessment completed by the
board for children thought to be in the category of
physical exceptionality would be included here.
Assessing the physical extent of a speech and
language problem would also be covered in this

category.

224

Communication Assessment

 

A process undertaken to pinpoint the functional
difficulties a person may be having in one or more
communication modalities.

Such specific areas as assessing speech and
language capabilities would be included. For boards
of education, communicational assessments completed
by the board for children thought to be in the
sub-categories of autistic, hearing impaired,
learning disabled and speech and language impaired,
which fall under the general category of

communication exceptionalities, would be included.

Agency/Program Definitions

Use the following set of definitions to assist

you in selecting the appropriate response when

necessary.

C.M.H.C. - Residential

 

C.M.H.C. - Non—Residential

 

Probation and Aftercare

 

A Children's Mental
Health Centre that in
addition to providing
mental health services
to children on an
out-client basis also
has a residential
component where
clients live while
receiving mental
health services.

A Children's Mental
Health Centre that
provides services only
on an out-client
basis.

An M.C.S.S. operated
service dealing with

children placed on

226

Probation by the
Family Court.

Observation & Detention A short term

 

Service predispositional
service for children
who are involved with
the courts.

Training School A post dispositional

 

M.C.S.S. operated
residential program
for children in
conflict with the law
with a finding of
delinquency made by
the courts.

M.R. Schedule I An M.C.S.S. operated

 

facility for mentally
retarded children and
adults providing both
in patient and out
patient services.

M.R. Schedule II As per Schedule I

 

except that the

facility is operated

227

by a private board
rather than by direct
Ministry employees.

M.R. Schedule III As per Schedule II

 

except that services
are offered in various
locations in the
community rather than

in one centralized

 

location.
Developmental Programing An M.C.S.S. funded
& Assessment Services service that provides

 

assessment and program
planning services for
developmentally
handicapped persons.

Regular day nursery Half-day or full-day

 

program for normal
children licensed
under the Day
Nurseries Act.
iegregated day nursery Half—day program for
mentally retarded or

physically handicapped

228

children licensed
under the Day
Nurseries Act.

Integrated day nursery Half-day or full-day

 

program for normal and
mentally retarded or
physcially handicapped
children licensed
under the Day
Nurseries Act.

Preschool program for Half-day program for

 

the blind blind children

 

licensed under the Day
Nurseries Act.

Preschoolyprogram for Program offered by

 

the emotionally disturbed Children's Mental

 

Health for children
below the age of 6
years. This program
would 293 be licensed
under the Day
Nurseries Act.

Developmental Centre A full-day program

 

Regular Classroom

 

Resource or withdrawal

 

Self—contained

 

licensed under the Day
Nurseries Act for
school-aged children
who have been assessed
as being severely or
profoundly retarded.
School-age program for
normal children
operated by a board of
education.

Child is in a regular
classroom and
withdrawn from the
classroom on scheduled
basis for remedial
assistance. Program
is operated by a board
of education.

Special education
classroom operated by
a board of education
within the regular
school where a child

receives a special

230

education program for
50% or more of their
time.

Section 15 A Special education

 

classroom created as a
result of a formal
agreement between a
board of education and
a residential facility
for the residents of
that facility where
treatment is the
primary need for the
pupils.

Special Education A special education

 

Trainable Mentally Retarded program provided by a

 

board of education for
students assessed as
being trainable

mentally retarded.

231

APPENDIX B

 

INDIVIDUAL CHILD

 

ASSESSMENT QUESTIONNAIRE

 

NORTHERN ASSESSMENT TASK FORCE

 

232

ASSESSMENT QUESTIONNAIRE
Please complete one questionnaire for each child
up to and including 21 years of age who was referred to
your agency/board for assessment services during the
time period September 1, 1982 to November 30, 1982.
Refer to the accompanying set of definitions to assist

you in choosing the most appropriate response.

 

 

 

 

 

 

Child Data
Agency Code [w l j _] | 3 !
FFI 2 3 4
Child Number
E I j l
5 6 7

Surname

 

 

 

 

8 9
Given Name
10 11
Date of Birth
LJIITM
12 17
Sex
1. Male
2. Female {jg—J

Mother Tongue (select one)

 

1. English 3. German

2. French 4. Other 19

5.

6.

Agency Code Child#
233

 

 

L11153[J

Native Indian & Inuit 7. Unknown

Italian

Ethnic Group and Status (select one)

 

1.
2.
3.

4.

Caucasian 5. Asaian
Status Native Indian 6. Negro

Non Status Native Indian 7. Other 20
Metis

Referral Date

 

 

L l I 1
21 26

General Assessment Information

 

1.

Indicate the appropriate referral category for

this Chi1d.

1 New referral

2 Already active case requiring further 27
assessment

3 Previously active case reactivated and

requiring further assessment
If this child was a new referral or a reactivated
case, indicate the source of the referral; i.e.
the person or agency that requested the assessment
from you.
01 C.A.S.
02 C.M.H.C. - Residential 28 29

O3 C.M.H.C. - Non-Residential

04
05
O6
O7
08
09
10
11
12
13

14

16

17
18

19

21
22
23
24
25

26

Agency Code Child#
234

 

Llljl—AJLT

Probation & Aftercare
Observation & Detention Service
Training School

M.R. Schedule I

M.R. Schedule II

M.R. Schedule III

Association for the Mentally Retarded
Segregated day nursery
Developmental Centre

Integrated day nursery

Regular day nursery

Infant Stimulation Program
Developmental Programing & Assessment
Services

Court

Police

Crippled Children's Centre
General Hospital

Parent

Physician

Public Health Unit

School Board

Provincial School

Private School

I

27
28
29
30
31
32
33
34

(a)

Agency Code Child#
235

 

 

[—IJ ][3j[1

Private Psychologist

Private Psychiatrist

Private Speech Pathologist
Private Speech Therapist
Private Physiotherapist
Private Occupational Therapist
Psychiatric Hopsital

Other (please specify)

 

For Boards of Education only. Please

 

indicate the status of this pupil. Select one

option only.

1

2

(b)

Resident pupil of the board

Day pupil in Section 15 classroom

Facility pupil in Section 15 classroom

Pupil of another board

Pupil, the responsibility of the Province of
Ontario

Pupil, the responsibility of Canada [:::]

30
Other (please specify)

 

For M.C.S.S. Agencies only.

 

Does the child
Live within your catchment area

Live outside your catchment area 31

I

7

A .
236 gency Code Child#

 

 

[JTJI3III

Please indicate the present educational placement

of this child. Use the definitions provided to

assist you in selecting the appropriate placement.

For boards of education, please indicate the

placement after completion of the Identification,

Placement and Review Committee process wherever

possible.

01 Regular day nursery

02 Segregated day nursery 32 33

03 Integrated day nursery

O4 Preschool program for the blind

05 Preschool program for the emotionally
disturbed

06 Preschool program for the deaf

O7 DevelOpmental Centre

08 Regular classroom

09 Resource or withdrawal program

10 Self-contained classroom

11 Section 15 classroom

12 Special Education for the Trainable Mentally
Retarded

13 None

14 Other (please specify)

 

Agency Code Child#
237

 

I JTj|31LI

Please indicate the primary reason for this

referral

l Psychosocial assessment

2 Educational assessment g%::]
3 Physical assessment

Was the assessment activity that you carried out

1 Primarily psychosocial

2 Primarily educational 35

3 Primarily physical

4 Combined educational and psychosocial

5 Combined educational and physical

6 Combined psychosocial and physical

7 Combined psychosocial, educational and
physical

In terms of the criteria provided with this
questionnaire,
(a) would your assessment findings indicate the

child to be a:

1 Mild psychosocial problem g%:]
2 Moderate psychosocial problem

3 Severe psychosocial problem

4 Very severe psychosocial problem

5 Not applicable

A .
238 gency Code Child#

 

 

I ITWLAULI I

(b) would your assessment findings indicate this

child to be a:

l Mild educational problem
2 Moderate educational problem 37
3 Severe educational problem
4 Very severe educational problem
5 Not applicable
(c) would your assessment findings indicate this
child to be a:
l Mild physical problem
2 Moderate physical problem 38
3 Severe physical problem
4 Very severe physical problem
5 Not applicable

8. For M.C.S.S. agencies only, was this assessment
requested by a board of education to assist in
determining if the child is unable to profit from

instruction.

1 yes :1
39
2 no

3 unknown

Assessment Detail

 

Please provide the information requested in the

following specific areas of assessment. It is not

Agency Code Child#
239

 

l—IJ11311l

r_7

expected that every agency/board will provide
assessments in all the areas listed or that every child
will require assessments in all areas. Use the
definitions provided to assist you in recording your
assessment activities.

Intellectual Assessment

 

If this child was referred for, and/or received an

 

intellectual assessment from your agency/board, please
complete this section.
9. Select the appropriate status of the intellectual
assessment.
1 Assessment completed
2 Assessment partially completed with a IEEIJ
referral made to another agency/board
3 No assessment required in judgement of agency
4 No assessment was done with a referral to
another agency/board
5 No assessment was done with no referral
possible to another agency/board (i.e.
service gap)
6 Assessment in progress by your agency/board
7 Assessment pending by your agency/board

10. Where a further referral was made for intellectual

assessment, indicate the reason.

11.

Agency Code Child#

 

 

 

 

 

240
LIIIIBIIITW
l specialised assessment needed which your
agency/board was unable to provide
2 assessment needed that was outside of the 41
mandate of your agency/board
3 child moved away before the assessment was
completed
4 other (please specify)
Indicate the agency/board to which you made a
further referral.
01 C.A.S.
02 C.M.H.C. - Residential 42 43

O3 C.M.H.C. - Non-Residential

O4 M.R. Schedule I

05 M.R. Schedule II

06 M.R. Schedule III

07 Developmental Centre

08 Association for the Mentally Retarded

09 Segregated day nursery — M.R.

10 Integrated day nursery

11 Regular day nursery

12 Nursery for physically handicapped

l3 Preschool program for the emotionally
disturbed

l4 Preschool program for the blind

12.

15

16

17
18
19
20
21
22
23
24

25

27

28

29

30

31

Agency Code Chi1d#

F]? 173—II.) T?

241

 

 

Infant Stimulation program
Developmental Programing & Assessment
Services

Crippled Children's Centre
General Hospital

Public Health Unit

School Board

Provincial School

Private School

Physician

Private Psychologist

Private Psychiatrist

Private Speech Pathologist
Private Speech Therapist
Private Physiotherapist
Private Occupational Therapist
Psychiatric Hospital

Other (please specify)

 

Please indicate the number of assessment

activities completed on this child for each of the

following categories.

1

2

3

Standardized intellectual assessments

 

 

44 45
Informal in-home intellectual assessments l I j
46 47
Informal in-school intellectual assessments 1 #4] )

 

13.

4

Agency Code Child#
242

 

 

[lle3jl]

l

Informal other intellectual assessments [:::]:::J

50

Please indicate the primary reason for doing this

intellectual assessment

1

2

3

Educational purposes [:::J

52
Psychosocial purposes

Physical purposes

Functional Academic Assessment

 

If the child was referred for and/or received a

functional academic assessment from your agency/board,

please complete this section.

14.

Select the appropriate status of the functional

academic assessment.

1

2

Assessment completed [:::]
Assessment partially completed with a 53
referral made to another agency/board

No assessment required in judgement of agency

No assessment was done with a referral to

another agency/board

No assessment was done with no referral

possible to another agency/board (i.e.

service gap)

Assessment in progress by your agency/board

Assessment pending by your agency/board

51

7

15.

16.

Agency Code Child#

I] TIDTFIIW

243

 

 

Where a further referral was made for functional

academic assessment, indicate the reason.

 

l Specialized assessment needed which your
agency/board was unable to provide 54

2 Assessment needed that was outside of the
mandate of your agency/board

3 Child moved away before the assessment was
completed

4 Other (please specify)

Indicate the agency/board to which you made a

further referral.

Ol C.A.S.

55 56

02 C.M.H.C. - Residential

03 C.M.H.C. - Non—Residential

04 M.R. Schedule I

05 M.R. Schedule II '

06 M.R. Schedule III

07 Developmental Centre

08 Association for the Mentally Retarded
O9 Segregated day nursery - M.R.

10 Integrated day nursery

11 Regular day nursery

12 Nursery for physically handicapped

Agency Code Chi1d#

Llljl37FTTj

244

 

 

l3 Preschool program for the emotionally
distrubed

l4 Preschool program for the blind

15 Infant Stimulation program
16 Developmental Programing & Assessment
Services

17 Crippled Children's Centre
18 General Hospital

19 Public Health Unit

20 School Board

21 Provincial School

22 Private SChool

23 Physician

24 Private Psychologist

25 Private Psychiatrist

26 Private Speech Pathologist
27 Private Speech Therapist
28 Private Physiotherapist

29 Private Occupational Therapist
30 Psychiatric Hospital

31 Other (please Specify)

 

Please indicate the number of assessment
activities completed on this child for each of the

following categories.

Agency Code Child#

 

 

 

 

 

 

 

 

245
LIITDJIITW
l Standardized functional academic assessments
57 58
2 Informal in—home functional academic
assessments I I I
59 60
3 Informal in—school functional academic
assessments ‘ ”j
. 61 62
4 Informal other functional academic
assessments [ 1 ‘1
63 64
18. Please indicate the primary reason for doing this

functional academic assessment.

1 Educational purposes [-——1
65

2 Psychosocial purposes

3 Physical purposes

Social/Cultural Assessment

 

If this child was referred for and/or received a
social/cultural assessment from your agency/board,
please complete this section.
19. Select the appropriate status of the

social/cultural assessment

1 Assessment completed g%:]

2 Assessment partially completed with a

referral made to another agency/board
3 No assessment required in judgement of agency

4 No assessment was done with a referral to

another agency/board

20.

21.

246 Agency Code Child#

 

 

[ITIHjFTT

5 No assessment was done with no referral
possible to another agency/board (i.e.
service gap)

6 Assessment in progress by your agency/board

7 Assessment pending by your agency/board

Where a further referral was made for

social/cultural assessment, indicate the reason.

1 Specialized assessment needed which your E;::)
agency/board was unable to provide

2 Assessment needed that was outside of the

mandate of your agency/board

3 Child moved away before the assessment was
completed
4 Other (please specify)

 

Indicate the agency/board to which you made a

further referral.

 

01 C.A.S. [ I 1

 

02 C.M.H.C. - Residential

03 C.M.H.C. - Non-Residential
04 M.R. Schedule I

05 M.R. Schedule II

06 M.R. Schedule III

07 DevelOpmental Centre

08 Association for the Mentally Retarded

09
10
11
12

13

14
15

16

17
18
19
20
21
22
23
24
25
26
27
28
29

30

Agency Code Chi1d#

LTTIEFjlj

247

 

 

Segregated day nursery — M.R.
Integrated day nursery

Regular day nursery

Nursery for physically handicapped
Preschool program for the emotionally
distrubed

Preschool program for the blind
Infant Stimulation program
Developmental Programing & Assessment
Services

Crippled Children's Centre

General Hospital

Public Health Unit

School Board

Provincial School

Private School

Physician

Private Psychologist

Private Psychiatrist

Private Speech Pathologist

Private Speech Therapist

Private Physiotherapist

Private Occupational Therapist

Psychiatric Hospital

248 Agency Code Child#

 

LITJI3I[]J

31 Other (please specify)

 

Please indicate the number of assessment
activities completed on this child for each of the

following categories.

1 Standardized social/cultural assessments g%::E:;;

2 Informal in-home social/cultural assessments

3 Informal in-school social/cultural 72 73
assessments [:::I:::]

4 Informal other social/cultural assessments 74 75

Please indicate the primary reason for doing this 75 77

social/cultural assessment.

1 Psychosocial difficulties in school [:::J
2 Psychosocial difficulties in the home 78
3 Psychosocial difficulties in the community
4 Psychosocial difficulties in school and home
5 Psychosocial difficulties in school and
community
6 Psychosocial difficulties in home and
community
7 Psychosocial difficulties home, school and
community

8 Speech and language difficulties

Agency Code Child#
249

 

 

LI TjL‘ljl T

Biological/Physical Assessment

 

If this child was referred for and/or received a
biological/physical assessment from your agency/board,
please complete this section.

24. Select the appropriate status of the
biological/physical assessment.

1 Assessment completed [:::1

2 Assessment partially completed with a

referral made to another agency/board

3 No assessment required in judgement of agency

4 No assessment was done with a referral to

another agency/board

5 No assessment was done with no referral

possible to another agency/board (i.e.
service gap)

6 Assessment in progress by your agency/board

7 Assessment pending by your agency/board
25. Where a further referral was made for

biological/physical assessment, indicate the

reason.

1 Specialized assessment needed which your
agency/board was unable to provide l;::]

2 Assessment needed that was outside of the

mandate of you agency/board

26.

Agency Code Child#

 

 

 

 

 

250
LJFTHJFT‘T
3 Child moved away before the assessment was
completed
4 Other (please specify)
Indicate the agency/board to which you made a
further referral.
01 C.A.S.
10 ll

02 C.M.H.C. - Residential

03 C.M.H.C. - Non-Residential

04 M.R. Schedule I

05 M.R. Schedule II

06 M.R. Schedule III

07 Developmental Centre

08 Association for the Mentally Retarded

09 Segregated day nursery - M.R.

10 Integrated day nursery

11 Regular day nursery

12 Nursery for physically handicapped

l3 Preschool program for the emotionally
disturbed

l4 Preschool program for the blind

15 Infant Stimulation program

16 Developmental Programming and Assessment
Services

17 Crippled Children's Centre

27.

18
19
20
21
22
23
24
25
26
27
28
29
30

31

General

Agency Code Child#
251

 

 

[lijFI

Hospital

Public Health Unit

School Board

Provincial School

Private

School

Physician

Private
Private
Private
Private
Private

Private

Psychologist
Psychiatrist
Speech Pathologist
Speech Therapist
Physiotherapist

Occupational Therapist

Psychiatric Hospital

Other (please specify)

 

Please indicate the number of assessment

activities completed on this child for each of the

following categories.

1

2

Standardized biological/physical assessments) I I

12 13

Informal in-home biological/physical

assessments 14 15

Informal in school biological/physical

assessments [:::1:::j

16 17

Informal other biological/physical

assessments

18 19

1

Agency Code Chi1d#

[IT7F4711 Tj

252

 

28. Please indicate the primary reason for doing this

biological/physical assessment.

1 Vision difficulties [:::J
2 Motor difficulties 20

3 Speech and language difficulties

4 Intellectual difficulties

Communication Assessment
If this child was referred for and/or received a
communication assessment from your agency/board, please
complete this section.
29. Select the appropriate status of the communication
assessment.
1 Assessment completed [:::j
2 Assessment partially completed with a 21
referral made to another agency/board
3 No assessment required in judgement of agency
4 No assessment was done with a referral to
another agency/board
5 No assessment was done with no referral
possible to another agency/board (i.e.
service gap)
6 Assessment in progress by your agency/board

7 Assessment pending by your agency/board

Agency Code Child#
253

 

 

[11114jrl

Where a further referral was made for a

communication assessment, indicate the reason.

1 Specialized assessment needed which your [:::3
agency/board was unable to provide 22

2 Assessment needed that was outside of the

mandate of your agency/board

3 Child moved away before the assessment was
completed
4 Other (please specify)

 

Indicate the agency/board to which you made a

further referral.

 

01 C.A.S. [ ]

 

02 C.M.H.C. -Residential

03 C.M.H.C. - Non-Residential

04 M. R. Schedule I

05 M. R. Schedule II

06 M. R. Schedule III

07 Developmental Centre

08 Association for the Mentally Retarded
09 Segregated day nursery - M.R.

10 Integrated day nursery

11 Regular day nursery

12 Nursery for physically handicapped

32.

13

14
15

16

17
18
19
20
21
22
23
24
25
26
27
28
29
3O

31

Agency Code Child#

254

 

 

 

[117(41f

Preschool program for the emotionally
distrubed

Preschool program for the blind
Infant Stimulation program
Developmental Programing and Assessment
Services

Crippled Children's Centre

General Hospital

Public Health Unit

School Board

Provincial School

Private School

Physician

Private Psychologist

Private Psychiatrist

Private Speech Pathologist

Private Speech Therapist

Private Physiotherapist

Private Occupational Therapist
Psychiatric Hospital

Other (please specify)

 

Please indicate the number of assessment

activities completed on this child for each of the

following categories.

I

T

l

33.

34.

35.

Agency Code Chi1d#

 

 

 

 

255
l J 1 J l_4*] F I T
1 Standardized communication assessments I;;:I::;%l
2 Informal in-home communication assessments
3 Informal in-school communication assessments 27 28
4 Informal other communication assessments 29 30
Please indicate the primary reason for doing thiS3l_ 32

communication assessment.

1 autism r———1
. . . 33

2 hearing impairment

3 learning disabilities

4 speech and language impairment

Language of instruction (select one)

1 English [:j

34
2 French
3 Both English and French
4 Other
Language of assessment (select one)
1 English
2 French 35
3 Both English and French

4 Other

256

APPENDIX C

 

CO-ORDINATING THE DELIVERY OF ASSESSMENTS

 

AGENCY PROCEDURES MANUAL

 

257

Co-ordinating the Delivery of Assessments
Agency Procedures Manual

Purpose

The Ministries of Community and Social Services,
Education and Health have agreed to adopt a coordinated
procedure for the provision of assessment services to
children in Northern Ontario. The model outlines a set
of principles, which informs local agencies of the
extent of interministerial agreemert and a set of
procedures which will permit implementation. The model
is designed to encourage local cooperation and local
decision—making agencies in the provision of assessment
services to children.

Objectives

 

. To ensure efficient use of existing
assessment resources.

. To ensure that each child and his/her family
has access to a range of assessment services
to identify his total needs.

. To provide a coordinated approach to
assessment with a clearly outlined centre of
accountability.

. To provide a mechanism for the identification

and resolution of service gap issues.

258

To provide for coordination at the local
level.

To ensure that assessment systems remain
sensitive to changes in assessment strategies

and methods.

Expectations of Agencies

 

Each agency will be responsible for
coordinating the services needed by its
clients.

All agencies will adopt a holistic approach
to service delivery.

Each agency will provide for the needs of its
clients with mild psychosocial difficulties.
Each agency will work cooperatively with
other agencies of all ministries at the local
level to ensure that the assessment needs of
children and their families are met in an
effective and efficient manner.

Each agency will assume responsibility for
providing assessment services that fall
within its mandate either directly or through
a purchase of service approach.

Each agency will ensure that the assessment

process results in the development of a

259

clearly defined course of action with
responsibility for follow through assigned.

Management of the Assessment Process

 

1. Assessment responsibilities

 

The following have been agreed to by each

respective ministry:

. Education will conduct relevant assessments
of children for purposes of diagnosing
children's learning problems/defining
children's learning needs and providing
programs to meet these needs.

. Community & Social Services will conduct
relevant assessments of children for purposes
of diagnosing children's social, emotional
and children's mental health problems,
defining children's psychosocial needs and
providing programs and/or services to respond
to these needs.

. Health will conduct relevant assessments for
purposes of diagnosing children's health
problems/defining children's health needs and
providing programs and/or services to meet

these needs.

260

While the above statements are useful for establishing
basic parameters of assessment responsibility, the
following examples provide further definition:

(a) Psychosocial Assessment. The psychosocial
area refers to those socially learned aspects of one's
life which relate to emotional patterns, perception and
thought patterns and patterns in interpersonal
relationships.

A psychosocial assessment is undertaken to
determine the psychosocial functioning of a child and
to assess the effects that disorders in these areas are
having on the child's overall ability to cope with
his/her environment.

Within the broad area of psychosocial needs, it is
the expectation of the three ministries that referrals
will only come to an M.C.S.S. agency when the
psychosocial difficulties are at least at the moderate
level. The moderate level of psychosocial difficulty
is defined using the parameters of intensity,
frequency, duration and reactivity as follows:

Intensity: Behaviour threatens the general

ability of the child to benefit

from the normal environment, or it

261

threatens the well-functioning of
the environment.

Frequency: Occurs frequently: relationship
between cause and immediate
behaviour is difficult to identify.

Duration: Semi-permanent; problematic
behaviour becomes more regular.

Reactivity: Requires a treatment plan
focussed on specific behaviour
change.

In general, any psychosocial difficulty that
consumes large blocks of time resulting in major
disruptions in the environment or resulting in the
child being unable to continue his involvement in the
environment, would be considered a moderate level
psychosocial difficulty. Further evidence to support
this decision would be that the disruptive incidents
are occurring on a regular basis and that the behaviour
is extending itself into all aspects of the child's
environment.

Any psychosocial difficulties that are less
problematic than this Should be handled by the agency

with the Child.

262

(b) Speech and language assessment. The following

 

guidelines are designed to provide direction to local
school boards, health and community agencies in
creating Sharing arrangements for the provision of
speech and language programs for school-aged children.

The guidelines stress the unique advantages of
each setting in addressing the needs of children with
communication disorders. It is expected that local
school boards and agencies will determine the most
appropriate service delivery models
(withdrawal/integrated/intensity of support, etc.) and
will employ appropriately trained staff to provide
assessment and programing.

Ministry of Education (School Boards)

 

School boards will be primarily responsible in the
following circumstances:

i) when assessment or programing for the
communication disorder requires close
cooperation and liaison with the educational
team;

ii) when appropriate programing requires the
educational context for improvement;

iii) when communication programing can and

iv)

V)

263

should be part of the pupil's educational
program;

when communication problems are having,

or are likely to have, a Significant

impact on educational progress or school
adjustment; i.e. when educational development
will be impeded without communication skill
programing;

when liaison with a medical management

team is not essential.

Ministry of Health

 

i)

ii)

iii)

Health agencies will be primarily responsible:

when assessment and/or management of the
communication disorder requires the
involvement of and liaison with a medical
management team;

when co-ordinated efforts of other

services available within the health setting
are required;

when the assessment and/or management plan
does not require liaison with an educational
team; i.e. the goals of the
assessment/treatment plan need not become

part of the child's educational program;

264

iv) when no liaison with an educational team
is essential.
Ministry of Communityiand Social Services
M.C.S.S. treatment facilities will be primarily
responsible in the following circumstances:

i) when a child in residential care/treatment
does not leave the facility to attend an
educational program;

ii) when such services are provided as part of
a Section 16 agreement with a school board.
(c) Develgpmental assessment. Determination of
responsibility for assessing mentally retarded children
should be made within the following framework.

Education - responsible for both

 

standardized and functional
assessments of cognitive
comprehension and capacity to
learn. This would include such
areas as functional motor skills,
activities of daily living skills,
academic Skills and general
social/emotional functioning.

Health - responsible for assessments

M.C.S.S.

265

of a diagnostic nature related to
causality and physcial well being.
Such areas as physiotherapy because
of the direct relationship to
improvements in muscle tone
circulation, etc., would be viewed
as a health responsibility.

- responsible for assessments of

a phychosocial nature where the
presenting social/emotional
difficulties are outside of the
norm for the functioning level of
the child and at least at the

moderate level of severity.

(d) Learning disabilities

 

Education

 

- responsible for both
standardized and functional
assessments of cognitive
comprehension and capacity to
learn. This would include a
determination of the process used
by the child to learn and the
modality through which the child

learns best.

Health

M.C.S.S.

266

- responsible for assessments

of a diagnostic nature related to
causality and physical well being.
- responsible for assessments

of a psychosocial nature where the
presenting social/emotional
difficulties are at the moderate

level or above.

2. Inter-Agency (Interministerial) Referrals

 

(a) Criteria.

Although not all children will

require inter-agency referrals for assessments, they

should take place in cases of the following nature:

(i)

Initial assessment activity by an

agency indicates difficulties present in
areas beyond their mandate. The
following are presented as examples of

these types of situations:

M.C.S.S. agency during

assessment uncovers indicators of
intellectual functioning either
below or above the norm or
indications of a potential physical

basis for present difficulties.

(ii)

267

Case records do not make any
mention of these possibilities.

. Educational assessment for
learning disabilities uncovers
presence of significant
psychosocial dysfunctioning which
is having impact at home and
school.

. Physical assessment that
uncovers indicators of at least a
moderate level of psychosocial
dysfunctioning or intellectual
exceptionality.

Assessment of multi-handicapped

children:

. Because of the nature of their
difficulties, these children should
be assessed by agents from all
three ministries to ensure that a
complete picture of strengths and
weaknesses is available.

All children being considered for the

education designation unable to profit

by a school board.

Note:

(b)

268

While the predominant focus of these
procedures is on school-aged children, all
three ministries recognize the importance of
early identification/intervention and
therefore would support the use of these same
procedures for preschool children. This
would involve a referral for the younger
child who either displays learning patterns
characteristic of learning disabilities or
other complex learning patterns that require
a specialized assessment in order to deve10p
a program to maximize his learning potential.

Referring agencyiresponsibilities

 

. Documentation referral documentation
includes:

- Formal results from assessments
to date.

— The identification of factors
which indicate the need for the
referral.

- A statement of expected outcomes.

. Case coordination:

- The referring agency will retain

(C)

269

responsibility for case management
which covers such areas as service
plan development, brokerage and
follow through. This function can
be transferred to another agency if
the final assessment results
indicate a more appropriate focus
of primary responsibility. An
interagency case conference will be
the vehicle through which the
appropriate focus for case
management responsibility will be

determined.

Monthly reporting:

Referring agencies are

responsible for completion of the
monthly assessment activity sheet
(form - appendix VI). These sheets
are to be sent to the I.M.A.P.T.
representative of the respective
ministry to allow for evaluation

and monitoring of the model.

Receiving agency responsibility

 

Information analysis:

270

- The referral documentation is
reviewed to determine the
appropriateness of the referral.

. Assessment function:

- On the assumption that the
referral is appropriate, the
required assessment should be
conducted on the basis of the
Specific needs identified by the
referring agency.

. Case planning function:

- Participation in a case
conference is required to assist in
the deveIOpment of plan of action.
There may be a need to assume the
case management function, depending
upon the outcome of the assessment.

(d) Confidentiality of records. It is the

 

responsibility of each agency to ensure that the
privacy of the client and his family are safeguarded to
the fullest extent possible. When reviewing records to
determine which information to send with the referral,
decisions should be based on its relevance to the

specific situation which prompted the referral. In all

271

cases of an interministry referral, a signed consent
form specific to the referral must be obtained. The
original should be retained on your files and a copy
should go with the referral. If the referral material
does not include a consent form, it must be provided
prior to the receiving agency involving itself with the
case.

3. Provision of Assessments

 

(a) Options. While the preceding may assist in
determining more easily the locus of assessment
responsibility, there are a number of options regarding
the actual provider of the assessment. It is
recognized by all three ministries that while
responsibility may rest with a specific agency, that
agency may not have the resources required to carry out
the assessment. An agency with the responsibility for
the assessment may therefore either provide it directly
or purchase the assessment from another agency.

M.C.S.S. agencies may purchase services directly
from another agency. Costs are paid directly to the
agency providing the assessment.

Boards of Education must purchase services from an
individual professional rather than an agency, except
in the case of a board purchasing from another board.

This is to comply with the Education Act. Where the

272

individual professional is an employee of another
agency, it is expected that the payments will revert to
that agency if the assessment was done on agency time.
It is expected that the majority of assessments
arranged in this manner will be done during regular
business hours, rather than on a private fee basis.

Where health assessment services are not locally
available, the existing medical referral system to
other service centres will continue to be used.

(b) Purchase of service agreements. Purchase of

 

service agreements should address the following:

. Detailed outline of expected outcomes, i.e.
questions that are expected to be answered as
well as programing suggestions.

. Detailed breakdown of Specific activities to
be performed by the assessor, including
minimum expectation of programing ideas or
the development of a full service plan
whichever seems more appropriate.

. Cost breakdown related to the activities to
be completed.

. Expected completion date.

. Commitment to involvement in one case review

- evaluation of progress.

(C)

273

Payment procedures. For agreements between

 

agencies, payment should be made on the basis of an

invoice from the providing agency. In situations where

an individual professional is completing the assessment

an agency time and the payments will revert to the

agency, the following procedures must be followed:

(i)

(ii)

(iii)

Note:

The individual Should turn over the fee

to the agency as soon as it is received.

The employing agency should provide the
employee with a receipt stating that the
funds received were for professional
activities done on agency time, on behalf of
the board of education.

When filing on income tax form the

employee will submit the receipts as a basis
for explaining why no income taxes will be
paid on these monies.

Any agency that is providing purchased
assessment services in excess of twice a
month should ensure that their respective
ministry personnel are notified. This will
assist the ministries in planning to meet

service needs.

274

4. Conflict Resolution/Service Gap Issues

 

(a) Interministerial assessment andgplanning team

 

(I.M.A.P.T.). This body is the major link with all

 

components in the system to resolve major assessment
service conflicts and gaps. Situations may arise where
agencies of different ministries are unable to come to
an agreement about the provision of assessment services
to a child and his family. There may also be
situations where there is agreement on the needs of the
child but there is nothing available to meet the need.
These are the types of issues that would be referred to
an Interministerial Assessment Planning Team. It is
stressed that all local attempts to resolve problems
have been exhausted prior to a referral to an
I.M.A.P.T.

There will be three (3) I.M.A.P.T. groupings in
the Northern Ontario, corresponding to the Ministry of
Education regions: Northeast (North Bay, Timmins);
Midnorthern (Sudbury, Sault Ste. Marie); Northwest
(Thunder Bay, Kenora). Each team will be composed of
one representative of each of the three ministries.

(b) Criteria for referral to I.M.A.P.T.

 

. Only cases of an interministerial nature can

be referred.

275

. All local level procedures must be attempted
before a referral comes to I.M.A.P.T.
. Referrals to I.M.A.P.T. will involve:

- Resolution of a question of
responsibility for provision of a
specific type of assessment;

OR

- Resolution of a question regarding the

need for a specific type of assessment;
OR

— Request for assistance in the
identification of a source of or
facilitating access to a specialized
assessment resource not available at the
local level;

OR

— A child who has been designated unable
to profit by a school principal. This
referral will be for information only.

(c) Referral procedure

 

. In a conflict resolution situation, the
referral can come from either agency,
although if possible, it should be a

joint referral from both agencies.

276

. In a service gap situation, the
request for assistance must be a joint
referral from the agencies of the
ministries involved with the child.

. The referral should be sent to the
designated ministry representative on
the I.M.A.P.T. team of the ministry
responsible for the agency. (See form,
Appendix C). In cases of joint
referrals, each ministry responsible for
an agency making the referral Should
receive the referral.

. A school board will be expected to refer
all children who have been designated
unable to profit, for information only.

(d) Referral documentation

 

Conflict resolution referral:

. Assessment data that supports the need
for the assessment that is in conflict.

. Statement with supporting documentation
from the non-providing agency that
outlines the rationale for not providing

the assessment requested.

277

. Chronological listing of all of the
attempts made to resolve the situation
locally.

Service gap referral:

. Summary of all assessment activities by
involved agencies that support the need
for the specialized assessment that is
unavailable locally.

. Identification of attempts made to
secure the assessment and reasons why
they were not successful.

. If possible, the identification of
potential source of specialized
assessment and costs involved.

Unable to profit referral:

. All assessment documentation from the
board of education and other community
agencies which were used in the process
of arriving at the designation Unable to
Profit.

(e) Outcomes

. Designation of a responsible agency for

the provision of the assessment in

question.

278

. Direction to agencies to make further
attempts to resolve the issues locally.

. Determine that the assessment in
question is not necessary.

. Support the Unable to Profit Hard to
Serve decision and assist the board in
determining an appropriate placement to
meet the child's needs.

Follow-up

 

All cases that are referred to I.M.A.P.T. will
have a case manager assigned by I.M.A.P.T. generally on
the basis of the agency with the most involvement with
the child. Regular reviews of these cases will be done
by I.M.A.P.T. to ensure that their recommendations are
carried through and that a plan of action for service

delivery is developed.

279

INTERHINISTERIAL

MONTHLY ASSESSMENT REFERRAL ACTIVITY

actucv' scum:

   
   
 
   
    
   
 
   
   
   

   

 
 
 
   

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Counse)!

   
 

To

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Stimulat(on

 

Chi dren s
Educat(on
Assessment.

 

   
 

C

 

1 Uni

 
 

its)

 
 

y
1 Health

S
Centre

    

T tmznt Centre

I
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De).

  

Stiau11t$on
Education

Other

Inter-agency

Referring Agency

 

Name

 

Address

 

 

 

Child Information

 

Name

 

Sex

 

Address

280

Referral Form

Date of referral

 

Telephone

 

Contact person

 

 

Telephone

 

DOOOB.

 

 

 

Parent's/Guardian's Names:

Father

 

Mother

 

Present School Placement:

Name

 

Address

 

 

 

Service Request

 

Telephone

 

Contact person

 

 

Please state the assessment activity you would like us

to carry out and why.

Attach copies of relevant

assessment information which supports this request.

 

281

 

 

 

 

 

 

 

 

 

Signature Position

282

I.M.A.P.T. Referral Form

Agency Name

 

Address

 

Telephone

 

Is this a joint referral? Yes No
If yes complete section below.

Agency Name

 

Address

 

Contact Person

 

If not a joint referral, please identify agency(ies) of

another Ministry(ies) which is/are involved in this

 

 

 

 

 

 

 

 

case.

Name Name

Address Address
Telephone Telephone
Contact Person Contact Person

 

 

 

 

Is this case being referred to I.M.A.P.T. because of

A. a need for conflict resolution
B. a service gap situation
C. Unable to Profit (Education) (information

only)

283

Please complete the section below which is most
appropriate for this referral.

Conflict resolution referral

 

 

 

 

l. a) What assessment has been requested that is in
dispute?
b) Name of agency that you are requesting

assessment from.

 

 

c) Outline your rationale for the assessment
requested. (Please attach assessment

reports).

 

 

 

 

 

 

 

 

 

284

d) Please attach written response from provider
agency that outlines their reason for not

providing assessment requested.

 

Signature

 

Position

285

Service Gap Referral

 

This must be a joint-agency submission.
1. a) Identify assessment needed that is

unavailable at the local level.

 

 

 

b) If you have identified a potential provider
for the above assessment, please identify

below. Indicate costs if known.

 

 

 

 

2. Outline your rationale for why you feel this
assessment is necessary. Please attach supporting

documentation.

 

 

 

 

 

 

 

 

286

 

 

Signature Signature

 

 

Agency Agency

287

Unable to Profit (Education)

 

1. List outside agencies which have been involved in

assessing this child.

 

 

 

2. Outline rationale for why you consider this child
to be Hard to Serve. Attach formal assessment

reports.

 

 

 

 

 

 

 

 

 

Signature

 

Board

288

APPENDIX D

 

TRAINING SESSION

 

EVALUATION FORM

 

289

Training Session
Evaluation Form

General Overview

 

1. Was the overall purpose of this project clearly
explained to you?

Yes No

 

 

2. Was the model for co-ordinating the delivery of
assessment services fully clarified?

Yes No

 

 

If you answered no to either question 1 or 2,
please comment on what further clarity you feel is

needed.

 

 

 

 

 

Specific Components

 

A. Do you feel each of the following components of
the process were clearly explained?
1. Points where cross-Ministry inter-agency
referrals would occur.

Yes No

290

If no, specify where clarity is needed.

 

 

2. Definitions of general assessment responsibilities
for each Ministry.

Yes No

 

 

If no, specify where clarity is needed.

 

 

3. Specific areas of assessment responsibility:
A) Psychosocial Yes ___ No ___
B) Learning disabilities Yes ___. No ___
C) Speech & Language Yes ___ No ___
D) Developmental Yes No

If no to any of the above, please Specify

where clarity is needed.

 

 

 

 

4. Documentation needed for local level cross-ministry
referral.

Yes NO

291

If no, specify where clarity

is needed.

 

 

Responsibilities of all parties in a cross-ministry

local level assessment.
Yes No

If no, specify where clarity

is needed.

 

 

Responsibilities of agencies
assessment services.
Yes NO

If no, specify where clarity

purchasing

is needed.

 

 

Responsibilities of agencies
purchased service.
Yes NO

If no, Specify where clarity

providing a

is needed.

 

 

Documentation required for purchase of

service agreements.

Yes NO

10.

11.

12.

292

If no, specify where clarity is needed.

 

 

Criteria and documentation for a charge-back
situation.

Yes NO

 

 

If no, specify where clarity is needed.

 

 

Criteria for I.M.A.P.T. referral.

Yes No

 

 

If no, specify where clarity is needed.

 

 

Procedures for I.M.A.P.T. referral.

Yes No

 

 

If no, Specify where clarity is needed.

 

 

Function of I.M.A.P.T. committee.

Yes No

 

 

If no, specify where clarity is needed.

 

 

 

 

293

B. Please identify other topic areas that you feel

should have been discussed during the training

session.

 

 

 

C. What other areas of assessment responsibility do

you feel need to be defined?

 

 

 

D. Please provide your comments on the following:

i)

ii)

iii)

iv)

V)

Length of training session

 

Method of presentation

 

Group size/composition

 

Resource materials

 

Other

 

294

E. Any further comments you may wish to make regarding

the training session are most welcome.

 

 

 

 

 

 

 

Thank you.

295

APPENDIX E

 

EVALUATION FORM

 

IMPLEMENTATION - PILOT PROJECT

 

296

Evaluation Form
Implementation — Pilot Project
Co-ordination of the Delivery of Assessment Services

Agency Name

 

Person completing form

 

Telephone Number

 

1. Do you feel the points identified where cross-ministry
inter-agency referrals should take place are

valid?

 

 

 

2. Are there other situations which Should be included

for cross-ministry referrals?

 

 

 

3. Specific Ministry responsibilities were determined
for each of the following areas of assessment.
Were they useful to your agency and did they
assist in local level co-ordination efforts?

A. Psychosocial

 

 

 

297

B. Speech & Language

 

 

 

C. Learning Disabilities

 

 

 

D. Developmental

 

 

 

Are there other areas of assessment responsibility

that you feel need to be defined?

 

 

 

Impact on Manpower

 

What impact have these procedures had on the
workload of your assessment staff i.e.

A. Time for assessments

 

 

B. Co-ordination tasks

 

 

C. Case conferences

 

 

298

D. Inter-agency contacts

 

Generally do you feel there has been a positive or
negative effect on staff as a result of

implementing these procedures?

 

 

 

 

 

 

 

Administrative Procedures

Is material requested on inter-agency referral

form adequate?

 

 

 

Do the procedures for Purchase of Service meet

your needs?

 

 

 

10.

11.

12.

299

Do you feel the criteria for charge-backs is

adequate?

 

 

 

Do you feel that costs other than just for the
assessment should be charged back?

Yes No

 

 

If yes, please elaborate

 

 

 

Have you had experience with an agency unwilling
to accept a charge-back?

Yes No

 

 

If yes, please elaborate

 

 

 

Do you feel criteria for I.M.A.P.T. referral is
adequate?

Yes No

 

 

Please elaborate

 

 

 

300

13. Do you feel that the I.M.A.P.T. procedures are
adequate?

Yes No

 

 

Please elaborate

 

14. Do you feel that I.M.A.P.T. has been successful
resolving service difficulties?

Yes NO

 

 

Please elaborate

 

 

 

15. Please feel free to make any further comments
about this project that you wish. Since this is a
pilot activity, all feedback can be used to help
improve our procedures before we implement across

the entire Region.

 

 

 

 

 

 

 

 

 

 

Thank you.

301

BIBLIOGRAPHY

An Experiment in Progress and Process: An

 

Evaluation of the Coordinated Planning Model of

 

The Children's Services Committeel North York

 

Inter-agency Council (1977, August). Community

 

Concern Associates Ltd., Environics Research Group
Limited, Social Policy Research Associates.

Annual Review and Amendment of the Plans for the

 

Development of Comprehensive Programs and Services

In Special Education 1983-84 (1984). Individual

 

program planning for developmentally handicapped
people: PrOposed standards and guidelines. The
Sudbury Board of Education. Sudbury.

Barr, W., & DelFava, C. (1980). Public
School and Community Mental Health Interagency

Cooperation for Treatment of the Child with

 

Special Educational Needs. Tacoma, Washington:

 

Pierce County Health Department.
Bozeman, B., & Massey, J. (1982). Investing in
policy evaluation: Some guidelines for

skeptical public managers. Public Administration

 

Review. 42 (2).

302

Brinkerhoff, R. O. (1979). Evaluating full service

special education programs. Instructional

 

Planning for Exceptional Children: Essays from
Focus on Exceptional Children. Denver: Love
Publishing Company.

Brolin, D. B., et a1 (1982). Lifelong Career
Development Handbook: Linking Community Services

for Disabled Adults. College of Education:

 

Missouri University, Columbia.

Cash, J. (1978). School doctors and Warnock.
Special Education (Forward Trends). British
Journal of Special Education. S (3).

Co-ordination of Services to Children, Youth and

their Families (1977, August). A report by a

 

sub-committee of the Interministerial Council for
Troubled Children and Youth.

Cranley, F. (1981, April). Indicators of
cooperative planning —- Imperial County,
California. A paper presented at the Annual
Meeting of the American Educational Research
Association, Los Angeles, California.

Croan, G. M., & Lees, J. F. (1979). Building

303

Effective Coalitions: Some Planning
Considerations. Arlington, Virginia:
Westinghouse National Issues Center.

Cross, A. (1977). Diagnosis. Identifying

Handicapped Children: A guide to Casefinding,

Screening, Diagnosis, Assessment, and Evaluation.

New York: Walker and Company.
Cross, L. (1977). An introduction. Identifying
Handicapped Children: A guide to Casefinding,

Screening, Diagnosis, Assessment, and Evaluation.

New York: Walker and Company.

Davidson, Iain (1981). Learning abilities:

Identification and intervention practices.

Ministry of Education.
L'Education de l'enfance en difficulté d'adaptation

et apprentissage au Quebec (1976). Rapport du

Comité provincial de l'enfance inadaptée (COPEX).

Ministere de l'Education. Quebec.

Epstein, M. H., & Cullinan, D., & Sabating, D. A.

(1977). State definitions of behaviour disorders.

The Journal of Special Education. 11 (4).

Fossey, G. A. (1973, May). Project Equity.

Carleton Board of Education.

Gallagher, J. J. (1978). Organizational needs for

304

quality special education. Futures of Education

 

for Exceptional Students: Emerging Structures. A
publication of The National Support Systems
Project. Minneapolis.

Gearheart, B. R. (1980). Special Education for the
.LEQLE- St-Louis: Mosby Company.

Goguen, L., & Leslie, P. (1980). Special
education administrative policy develOpment,
toward comprehensive education for all children.

Special Education in

 

Canada. S4 (3).
Hagebak, B. R. (1982). The foregiveness factor:
Taking the risk out of efforts to integrate human
services. Public Administration Review. 42_(1).
Harbin, G. (1977). Educational assessment.
Identifying Handicapped Children. A Guide to
Casefinding, Screening, Diagnosis, Assessment, and

Evaluation. New York: Walker and Company.

 

Heron, T. B., & Heward, W. L. (1982).
Ecological assessment: Implications for teachers
of learning disabled students. Learning

Disability Quarterly. 5 (2).

 

Hobbs, N. (1975). The Futures of Children. Report

 

305

on The Project on Classification of Exceptional
Children. Washington: Jossey-Bass Publishers.
Hood, E., & Anglin, J. (1979, April). Clinical

Assessment in Children's Services. Ministry of

 

Community and Social Services. Children's
Services Division.

Illerbrun, D., & Greenough, P. (1983).
Classroom/clinical diagnosis of young language
learning disabled children: An integrated

approach. Special Educational in Canada. S1 (2).

 

Johnson, H. L., & Nutter, C., & Callan, L., &
Ramsey, R. (1976). Program evaluation in
residential treatment: Some practical issues.

Child Welfare. 5 (4).

 

Karagianis, L., & Nesbit, W. (1980). The Warnock
Report: Implications for special education in

Canada - Part I. Special Education in Canada. S4

 

(2).
Karagianis, L. D., & Nesbit, W. C. (1980, Summer).
Special education: Public policy in Canada.

Education Canada.

 

Kelsey, G. J. (1978). Structure and restructuring:
Becoming uncomfortable in a comfortable world.

Education Canada. 18 (2).

 

306

Korteweg, L. L. (1983). Reacting or responding to

the special needs of students. Special Education

 

in Canada. 7 (2).

 

LaCour, J. A. (1982). Interagency agreement: A
rational response to an irrational system.

Exceptional Children.

 

Lazure, D., & Roberts, C.A. (Eds.) (1970). The

Celdic Report: One Million Children. Toronto:

 

Leonard Crainford.

MacIntyre, R. B. (1980). Identification of learning
disabilities in Ontario: A validity study.
Ministry of Education.

Maher, C. A., & Barbrack, C. R. (1979).

Perspective and principles for the evaluation of

special-service programs. The Journal of Special

 

Education. 3 (4).

 

Marrs, L. W., & Helge, D. I. (1978). The role of
needs assessment in program planning and

evaluation. The Journal of Special Education. 12

 

(2).
Mayer, M. Fritz (1975). Program evaluation as a
part of clinical practice: An administrator's

position. Child Welfare. 4 (6).

 

McKinnon, D. (1976). Needs of and resources for

 

307

children of two Northern Ontario boards: A
resource study. Ministry of Education.

Miller, D. A. (1981). Service delivery models for
Social work practice: Organizing the content of
human behaviour and social environment courses.
Journal of Education for Social Work. 11 (l).

Mittler, P. (1978). The needs of the under fives.
Special Education (Forward Trends): British
Journal of Special Education. S (3).

Morin, C. (1979). The Schools onuebec: Policy
Statement and Plan of Action: Children with
Difficulties in Learning and Adaptation. Quebec
Ministry of Education.

Mulford, C. L., et al (1979). Assessment of the

 

Nature and Impact of Coordination Between
Organizations: Summary of a Research Network's
Findings. Ames, Iowa: North Central Regional
Center for Rural Development.

Nesbit, W., & Karagianis, L. (1980). The Warnock
Report: Implications for special education in
Canada - Part II. Special Education in Canada.
25 (3).

O'Bryan, K. G. (1976). The Windsor Early

 

308

Identification Project. (Ministry of Education

Research Project).
(1979). Problems and issues in

12 (3).

Perkins, S. A.

special education. Education Canada.

Perkins, S. (1975). Shortcomings in the delivery of

Education Canada. 1; (l).
A

special education.

Poleschuk, F., & Sullivan, J., et al (1979).

Proposal For The Provision of Assessment and

Psychosocial Services in Northern Ontario: A

Proposal. Ministry of Education.

Posno, R. (1981). Who's afraid of individual

education plans (IEP'S)? Special Education in
Canada. SS (1).

Rawlyk, S. A. (1977). Some fundamental issues in

funding special education. Education Canada. 11
(1).

Reed, A. J. S. (1977). Collaboration: A Review,

Synthesis, and Analysis of the Literature and

Research. Tallahassee, Florida: Florida State

Department of Education.

Roberts, J. (1980). Highlights: Selected

Statements from the Literature on Collaboration

and Coordination. Philadelphia, Pennsylvania:

Research for Better Schools, Incorporated.

309

Roberts, J. (1981, April). Collaborative planning
between an R & D Agency and a state education
Agency: A case history. (Paper presented at the
Annual Meeting of the American Educational
Research Association, Los Angeles, California).

Scarlett, C., & O'Kelly, S. (1978). Warnock

and social workers. Special Education (Forward

 

Trends) British Journal of Special Education. S

 

(3).
Schermerhorn, J. R., & Hunt, J. G. Jr., & Osborn, R.

N. (1982). ManagingfiOrganizational Behavior.

 

Toronto: John Wiley and Sons.
Tindall, L. W., et al (1981, January). Status

Report of Inter-agency Linkages at the State

 

Level. Vocational Education Models for Linking

 

Agencies Serving the Handicapped. Wisconsin

 

University, Madison Wisconsin. Vocational Studies
Center.

Walkenshaw, M., & Fine, M. (1979).
Psychoeducational assessment: An integrated

viewpoint. Instructional Planning for Exceptional

 

Children: Essays From Focus on Exceptional

 

Children. Denver: Love Publishing Company.

Wanczycki, W. (1983). The kindergarten early

 

310

identification component of Bill 82. Special

Education in Canada. 7 (l).

 

Warnock. H. M. (1978, May). Special Education

 

Needs. Report of the Committee of Enquiry Into

 

The Education of Handicapped Children and Young

 

People. (Presented to Parliament by the Secretary
of State for Education and Science, The Secretary
of State for Scotland and The Secretary of State
for Wales by Command of Her Majesty. London: Her
Majesty's Stationary Office.)

Whelan, R. J. (1979). Evaluation. Instructional

 

Planning for Exceptional Children: Essays from

Focus on Exceptional Children. Denver: Love

 

Publishing Company.
Williston, W. B. (1971). Present Arrangements for

The Care and Supervision of Mentally Retarded

 

Persons in Ontario. (A Report to the Honorable

 

A.B.R. Lawrence, Minister of Health.)
Woodil, G. (1981). Children With Special Needs. A

Manual of Canadian Resources. Second Edition:

 

Ptarmigan Publishing.

311

Yin, R. K., & Gwaltney, M. K. (1981).

Organizations Collaborating to Improve Educational

 

Practice. Cambridge, Massachusetts: Aby

 

Associates.
Ysseldyke, J. E. (1983). Current practices in
making psychoeducational decisions about learning

disabled students. Journal of Learning

 

Disabilities. SS (4).

 

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