Rehabilitation of Children With Multiple Disabilities

The Comparative Effect and Expense of More and Less Integration of Services That Provide Treatment and Rehabilitation for Children With Multiple Disabilities: A Randomized Controlled Trial

The objective of the study is to compare the usual care and treatment of children and youth (0-19 years) with multiple developmental delays and disabilities and their families in Simcoe York with a co-ordinated, navigated approach to care using the Children's Treatment Network (CTN) services.

Study Overview

• Status: Completed
• Conditions: Cerebral Palsy; Brain Injury; Autism; Down's Syndrome
• Intervention / Treatment: Other: CTN model of care for children and their families

Detailed Description

The Children's Treatment Network (CTN)links existing children's services rather than creating a new Centre. The purpose of the evaluation is to compare the effectiveness and efficiency of this service with the usual care that people receive. 500 Children will be randomized to receive either usual care (250) or the co-ordinated, navigated care from CTN (250). The primary question to be addressed is whether the more integrated CTN model of service improves family-centered services, parent mental health, parenting, family function and the quality of the child's life and the families resource needs as well as reduce expenditures for the families' use of all other health and social services compared to the outcomes of usual care alone. What children and families with what characteristics and circumstances most benefit from which approach to the treatment of childhood disability in Simcoe-York? At what cost?

Agencies providing services to children will be evaluated as to how effective their integration of teams are functioning, their partnership with each other and capacity building in the community.

• Study Type: Interventional
• Enrollment (Actual): 445
• Phase: Phase 1

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Hamilton, Ontario, Canada, L8N 3Z5
      • McMaster University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 1 minute to 19 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Children and youth up to 19 years of age
• living in Simcoe-York.
• English speaking
• multi-need family
• children on agency service wait lists
• children under the care of Children's Aid Societies
• Families with more than 1 disabled child

Exclusion Criteria:

-youth over 19 years.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Parental reports of their children; Parental report of family-centered processes of care (MPOC) Parent mental health Parent perceived social support	Other: CTN model of care for children and their families; Parental reports on the quality of life of their children and service needs
No Intervention: Integration of service provider teams; Network co-alition teams were measured using the Integration of Human Services Measure, the Partnership Synergy Measure and a Network Capacity Measure were employed at the CEO level.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Parental reports in the Quality of Life of Children and Youth	Parent report of family centred processes of care (MPOC) Parent mental health Parent perceived social support	12 and 24 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Integration of teams amongst service providers. Integration was measured at two levels using the Integration of Human Services Measure.	The measure evaluates observed and expected depth of integration among service providers. CEO or senior manager participation in the Network was measured.	12 months and 24 months

Collaborators and Investigators

• Sponsor: Children's Treatment Network
• Collaborators: McMaster University
• Investigators: Principal Investigator: Sandy Thurston, Children's Treatment Network

Study record dates

Study Major Dates

• Study Start: April 1, 2007
• Primary Completion (Actual): December 1, 2009
• Study Completion (Actual): December 1, 2009

Study Registration Dates

• First Submitted: June 14, 2011
• First Submitted That Met QC Criteria: June 22, 2011
• First Posted (Estimate): June 23, 2011

Study Record Updates

• Last Update Posted (Estimate): June 23, 2011
• Last Update Submitted That Met QC Criteria: June 22, 2011
• Last Verified: June 1, 2011

More Information

Terms related to this study

• Keywords: Rehabilitation; Mental Health; Children; Costs; Integration; Family Functioning
• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurologic Manifestations; Wounds and Injuries; Neurobehavioral Manifestations; Congenital Abnormalities; Brain Damage, Chronic; Genetic Diseases, Inborn; Craniocerebral Trauma; Trauma, Nervous System; Intellectual Disability; Abnormalities, Multiple; Chromosome Disorders; Cerebral Palsy; Brain Injuries; Down Syndrome
• Other Study ID Numbers: 2008H00766