Frequently Asked Questions

Within the continuum of early years services and supports for children in Ontario, Infant and Child Development Services provide a range of prevention, early identification, and early intervention services and supports for families of infants and young children who have a developmental delay or who are at risk for delayed development. The delays in development typically arise because of established or biological risk factors, but may be compounded by co-existing psychosocial risks, such as an impoverished home environment, parenting problems, attachment issues or familial mental health disorders, which exacerbate the likelihood these children will not be ready to learn when they reach school-age.

The first Infant Development Programs in Ontario were established in 1974 by the Ministry of Community and Social Services (now Children and Youth Services). There are currently 49 programs in Ontario, one in every county, district and regional municipality.

Programs serve children from birth to five years of age and are sponsored by a variety of community agencies. Although all infant and child development programs have the same purpose and goals for the families they serve, the manner in which these services are delivered has evolved in different directions across the 49 programs to meet the specific needs of each community and to complement the mix of other services available within that community.

Infant and Child Development Services are designed to serve families with infants and young children with developmental disability or who are at risk for developmental delay. An infant’s or child’s development may be in jeopardy from one or more of these risk categories:

• Established risk -These are risks associated with lifelong difficulty in function and are related to diagnosed medical disorders, such as:
• genetic and chromosomal syndromes(e.g., Down Syndrome)
• neurological disorders (e.g., seizures, cerebral palsy)
• congenital malformations of the nervous system (e.g., microcephaly, hydrocephaly)
• sequelae of infections of the nervous system (e.g., meningitis, encephalitis, HIV, CMV, herpes)
• metabolic disorders (e.g., untreated hypothyroidism, PKU)
• Biological risk -These are risks related to a history of prenatal, perinatal, neonatal, early developmental events, or medical conditions which may affect the central nervous system and increase the probability of life-long developmental problems, such as:
• pre- or perinatal complications (e.g., small for gestational age, anoxia, stroke in utero or during/after birth)
• prematurity and associated complications (e.g., chronic lung disease, cerebral haemorrhage, jaundice)
• sensory impairments such as blindness and deafness
• parent(s) with a developmental disability, neurosensory problem or sibling having a developmental disability of unknown origin
• early global developmental delays
• parent(s) with chronic, established mental illness
• prenatal substance abuse
• Psychosocial risk -These are risks related to the child’s environment. Infants and young children in this category appear to be biologically sound but are at risk of delayed development because of individual susceptibilities or vulnerabilities magnified by environments which cannot respond adequately to their physical, developmental, and/or social-emotional needs. Psychosocial risk may be associated with:
• child characteristics, e.g., “difficult” temperament or behavioural characteristics (not including infant mental health disorder or autism)
• caregiver characteristics, e.g., inexperience or mental health problems
• attachment difficulties
• non-organic failure to thrive
• child neglect or abuse

A diagnosis is not required for families to access infant and child development services. Referrals are made by parents, physicians and community agencies.

Check with the local program listed on our web site for more information on the types of services provided.

We provide an integrated approach to infant and young child development in family-centred intervention that is responsive to parent strengths, competencies and priorities, and is based on up-to-date research data regarding evidence-based practices. Infant and child development consultants provide the expertise needed to assist the family to make informed decisions regarding goals and objectives for their child that will support optimal development and functional outcomes.

The family is the major decision‑maker in a child's life, and its active involvement throughout intervention is essential to a satisfactory and meaningful outcome (Dunst, Trivette, & Deal, (1988, 1994); Meissels & Shonkoff, (1990, 2000); Turnbull, A.P., Beach Center on Disability, University of Kansas).

Through a transdisciplinary approach, and in collaboration with other service providers in the community, we provide for the optimal development of the child and family. Support is provided within the child's natural environment where the infant and young child development consultant serves many functions.

Some services are*:

• informal and formal child and family assessments, using a variety of screening and diagnostic assessment measures
• direct early intervention in all developmental domains (gross and fine motor, social and emotional, language and cognitive)
• development of and support in providing interventions to promote secure infant attachment
• assistance to families wishing to access specialized funding and information about additional community resources and supports
• service co-ordination in a family-centred process of planning, locating, co-coordinating and monitoring the services and supports to meet the child’s and family’s needs
• assistance to parents in obtaining information about their child's condition or diagnosis
• supportive counselling where a diagnosis of developmental delay or medical condition exists
• advocacy for and with families in their relationship with health, social and community services
• provision of information related to typical and atypical child development
• play-based therapeutic intervention
• support to enhance parenting skills and parental competence
• interventions that focus on promoting infant mental health and positive parent-child interactions, providing support to the parent-infant relationship
• supported transition into child care and school
• community-wide planning, for the child with the family, with other service providers in a cross-sectoral approach
• pre-emptive public education to help decrease the effects of preventable delays

The infant and child development consultant assists families in the identification of their needs, resources and service requirements. The family's involvement and participation is a recognized key factor in the achievement of successful outcomes(Bromwich, 1997).

We serve more than 15,000 children per year throughout the province of Ontario. A range of intervention strategies and approaches are used, including visits to the child’s home environment at a frequency negotiated with the family. Frequency and type of service is established according to family and child needs, and is crucially dependent on the resources available to each program. In many cases we serve families in a consultation framework with Healthy Babies Healthy Children or other community service providers.

Infant and Child Development Services participate on community planning committees for a more comprehensive and rational service delivery system through Best Start, Developmental Services, Children's Mental Health, Child Welfare, and Local Health Integration Networks. (Making Services Work for People, Implementation Planning Guidelines for Best Start Networks)

Our teams of highly qualified infant and child development consultants are skilled in providing an effective home-based intervention service. They benefit from continuous staff development opportunities, both locally and provincially, through the support of OAICD and through base funding by MCYS, when that is provided. Each staff member has training in one or more of the following disciplines: child development; developmental services; early childhood education; education; infant mental health; nursing; occupational therapy; physiotherapy; psychology; social work; or other related disciplines.

The breadth of training backgrounds underscores the degree to which our infant and child development consultants bring a unique set of skills and abilities to work with high-risk infants and children and their families. Their expertise covers in-depth knowledge of typical and atypical child development, acute observation skills, the ability to assess developmental and environmental strengths and needs, an awareness of issues related to family dynamics and child-rearing. Their expertise also includes training with respect to supporting those who experience grief and loss following the diagnosis/identification of a child as having life-long special needs, or in some cases, coping with the needs of a child with a terminal illness or shortened life expectancy.

Family-centred service encourages positive parent-child interactions and promotes the infant’s or child’s optimal developmental progress. The relationship of secure attachment to developmental accomplishment is promoted by the active engagement of parents in recognizing their child’s cues and their response in ways that foster a sense of security that allows for appropriate developmentally based learning through play (Bromwich, 1997).

What happens to children in the first years of life will play a large role in the path they will follow as adults. Recent research in the neurosciences provides powerful evidence for the influence of the early years on children's later competence and coping skills. These influences will affect learning, behaviour, and health throughout their life span

Infant and Child Development Services are effective in promoting positive outcomes for the children and families who access these services during the children's early years. These outcomes have both short- and long-term effects. Research from Finland has shown that preterm children receiving early intervention similar to that offered through the Ontario infant and child development services have significantly higher intelligence scores at 4 years of age, fewer behavioral issues and better sleep patterns than preterm children who did not receive these services (Sajaniemi et al, 2001). In Ontario, research from two Regional Neonatal Follow-up programs has shown that 70% of children identified in the first year of life with early motor delays demonstrate normal motor patterns by the time they are 2 years of age following intervention through Infant and Child Development Services.

By the very nature of their home-based intervention, Infant and Child Development Services are able to reach “hard-to-serve” families who are unable to access more traditional intervention services in the community, such as occupational therapy, physiotherapy or speech-language services offered in treatment centers, hospitals or centrally-based preschool speech language programs, either because the families cannot afford to take time off work for therapy appointments, or they do not have access to transportation to reach these services. The added benefit of the home-based intervention model is that it allows the parent to capitalize on learning opportunities for the child throughout the day: developmentally appropriate activities are integrated seamlessly into the child’s daily life experiences.

Not only do Infant and Child Development Services provide developmentally appropriate interventions and support the families in their application of developmentally beneficial activities, they also play a pivotal role in identifying the strengths and weaknesses of these children as they transition into school through the provision of timely, in-depth screening and/or diagnostic assessments. These assessments provide diagnoses and alert, as well as educate families and school personnel regarding the adverse effects of specific weaknesses on the child’s subsequent learning. They also provide recommendations regarding activities parents can implement and services parents can access to minimize adverse outcomes, as well as advocate for appropriate supports within the school system itself.