BY NORM TOLLINSKY

Eight organizations serving the developmentally disabled in Northern Ontario are no longer limited to the specialized resources within their own communities. Local organizations such as Community Living Algoma in Sault Ste. Marie and Options Northwest in Thunder Bay are now able to arrange consultations with psychologists, psychiatrists, speech pathologists and a variety of other professionals across the region and beyond through videoconferencing.

Established in March 2006, the North Community Network for Specialized Care is one of four umbrella organizations funded by the Ministry of Community and Social Services to augment local care teams across Ontario.

“There has been a whole movement towards bringing people out of institutional settings and into communities and part of the transformation was to create the Community Networks for Specialized Care to ensure there was co-ordination of specialized services,” said Pam Einboden, manager of the North Network.

With 23 North Network videoconferencing sites across the region, Northerners requiring specialized services no longer have to travel four to six hours or get on a plane to Toronto. Based in Bracebridge and operated by Hands, the FamilyHelpNetwork.ca, formerly Algonquin Child and Family Services, North Network has compiled a roster of professional expertise across its eight partner organizations to facilitate referrals through the Ontario Telemedicine Network’s videoconferencing service.

“For example, we had a person in Bracebridge who was grieving for the death of her husband,” said Frank Wager, clinical videoconferencing co-ordinator. “We looked through our roster and found a social worker in Thunder Bay with the required expertise, so we contacted her and arranged for support through videoconferencing.”

Roaster of professionals
The roster includes a speech pathologist in the Sudbury area, for example, who speaks Oji-Cree, and others across Northern Ontario with specialized expertise, “so if a referral comes in, say for Kabuki Syndrome, to use an example, and there’s no one in that area, the clinical team can make a referral to us and we’ll find someone who has the expertise,” said Wager.

Clinical service team
The North Network is unique among the province’s four regional community networks for specialized care in that it also has a clinical service team to augment the resources available in its partner organizations. It employs a full-time psychological associate and a senior behavioural consultant, and purchases services as required for psychiatrists, speech pathologists and occupational therapists.

“The local clinical teams may just need an outside opinion, or they may be stuck because they tried something that didn’t work and, now, with this service available, they can ask someone else for support,” explained Wager. “Sometimes, it’s just for confirmation of what they’re doing.”

Consultations using videoconferencing also help to keep the local clinical team in the loop because everyone is connected simultaneously. Prior to the establishment of the North Network, individuals would have been sent away for a consultation and the local clinical team could wait up to a month to receive a report. Using videoconferencing technology, “we are able to maintain a multidisciplinary model supporting these individuals, which is really the most effective way of supporting them,” said Wager.

The North Network also co-ordinates professional training for clinical teams and families of the developmentally disabled. As an example, North Network senior behavioural consultant Angie Nethercott, an expert in sexual deviance and sexual offending behaviour, recently shared her expertise through a videoconference link-up with hundreds of people at 63 sites across the province.

Clinical teams in Geraldton, for example, rarely participated in training prior to the establishment of North Network because they would have to travel three and a half hours to Thunder Bay and be absent from work for three days. Travel to Toronto for training was out of the question because of the expense, said Rosanne Stein, videoconference training co-ordinator.

“Training through videoconference may be the only training that staff are able to access. It’s saving agencies a lot of money, saving them time and providing training that would not have been available to them at all.”

In addition to participating in real time, clinical teams from across the North are able to view presentations through live web streaming on their computers or by accessing archived presentations on the Ontario Telemedicine Network web site. DVDs are also produced and distributed to partner agencies across the region.

Stein canvasses staff across the North to determine training needs, identifies professionals with the relevant expertise and puts together a training calendar that is distributed across the region and beyond.

“Hundreds of people across the province can benefit from this education and it’s free,” said Stein. “They just have to register as a participant.”

Family physicians
Family physicians caring for the developmentally disabled can also participate in training opportunities to learn about medical problems associated with intellectual disabilities.

“Down Syndrome, for example is commonly associated with hypothyroid difficulties and presenile dementia, and some specific cardiac problems are associated with genetic syndromes,” said Stephen White, psychological associate. “From my understanding, these conditions are not a large part of the focus in medical schools.”

Videoconferencing is also used for monthly rounds that bring together approximately 30 behavioural therapists across the North to discuss cases and share ideas for professional development. Psychiatrists, psychologists and psychometrists also meet quarterly.

“It’s wonderful that people in the North want to connect with each other,” said Einboden. “They have really welcomed our invitation to partner and have worked very, very hard at coming together. Northern Ontario is unique in that there is a strong sense of identity that comes from years of relying on each other and overcoming challenges posed by geography and weather.”

The North Community Network for Specialized Care and its partner agencies serve clients with an intellectual impairment and challenging behaviour, as well as dual diagnosis clients with developmental disabilities and psychiatric difficulties.

A decades-long process of closing long-term care facilities for the developmentally disabled and relocating them in community settings is scheduled to conclude in March 2009.

Historically, the developmentally disabled were often given up at birth to be raised in institutions located hundreds of kilometres from their homes and families. Today, they are living in group homes, with host families and, in some cases, in their own apartments with support from local agencies.