Friday, November 23, 2012

One question Friday

It's our first day to respond to a BLOOM question (actually, we're doing two today).

Q1. How do healthcare professionals feel when they meet a family that has waited for months to meet them? Do healthcare professionals feel there are adequate resources to appropriately assist all the children they assess?

BLOOM asked Dr. Golda Milo-Manson (photo inset), a developmental pediatrician and vice-president of medical and academic affairs at Holland Bloorview, to respond.

Dr. Golda Milo-Manson: All health professionals wish that they could see children and families as soon as they receive the referral but in order to be fair and meet the demands of all children waiting for service it isn’t always possible.

The great news is that we’ve made a lot of changes at Holland Bloorview to improve our access to services. For example, the wait for assessment of children with complex medical problems or developmental disorders, like autism, is now under three months.

In terms of your second question, it’s difficult for me to speak on behalf of all health professionals. As a developmental pediatrician, I can tell you that we run the largest training program for this specialty in Canada, but our capacity to train is not meeting the demand that is growing. And the demand is not just in Canada – there are vacancies for developmental pediatricians internationally.

Q2. What is the appropriate way to handle a child with special needs who doesn't understand the "rules" of the playroom and throws toys without picking them up? By tagging behind the child constantly telling them not to throw toys, I worry the child is internalizing that everything they do is wrong (always getting in trouble no matter what they do). It is the disability that is preventing the understanding and the sensory issues that are causing the exploratory behaviour. Holland Bloorview is supposed to respect special needs, not reprimand constantly although I understand there are also rules to follow.

BLOOM asked Laura Williams, director of client and family integrated care, to respond.

Laura Williams: Thank you for bringing your concerns forward to us. Your feedback about your experience in the playroom is very important to us, but it's difficult to respond properly to your question without more information. The best way for you to have your ideas and feedback heard and addressed is through our client and family relations process. Kimberley Siu-Chong responds to concerns, compliments and suggestions from our clients and families so that we can continue to improve client care and safety, and enhance your experience at Holland Bloorview. Please contact Kimberley directly at 416-753-6084 to share your thoughts. The playroom team and Kimberley are happy to work together with you to address the issues you’ve raised. Thanks again!


There was no point printing the second question. The response was a non answer. It was simply pointing the family to the person at Holland Bloorview to contact, information that was already provided in the introduction. I think the question could have been answered in a general sense if it could not be answered ore information. Perhaps it would be helpful to suggest that the family speak with a Bloorview language pathologist or occupational therapist to come up with some strategies to try out the next time they visit the playroom. I don't think anyone wants a child to be punished for something he or she doesn't understand due to a disability. One thing I might consider doing is to bring a familiar toy from home the next time. If the child still wants to explore the toys in the room then maybe find a quiet spot in the room to play where the lighting might be dimmed. Or situate yourselves away from the doorway where people are always coming and going. Another thought (depending on the child) is to prepare a social story in advance and bring it along to read upon arrival to teach the rules of the playroom. Maybe having it written out and with nice looking graphics might help. Maybe there is a comfy seat (e.g. beanbag chair) in the room that the child can enjoy to make the experience in the playroom a more relaxing experience. There are many ways to look at the situation. I'm not quite sure how speaking to a manager type person will help. All the best to this family.