Recommendations for Future Studies
Although this two-year study has provided a wealth of evidence and lessons learned about the P4C service model, like any good research study, it also has resulted in a new set of research questions that now need to be addressed. In the following section, the team has outlined what we believe are some of the key priorities for next steps in the evidence-building process.
Research Priorities related to the P4C model of service as originally developed:
- Determine the most effective approaches for engaging families and building their capacity to support and advocate for their child.
- Track children over time to monitor changes in behaviour at school as they become older; specifically, monitor for mental health problems and peer problems.
- Longer term evaluation to determine whether the P4C service is able to prevent secondary consequences in children with special needs.
Research Priorities related to “how” P4C services are delivered:
- Further develop and refine a fidelity “toolkit” that can reliably evaluate the consistency of the P4C services being offered across schools and regions.
- Evaluate options for modifying the frequency and timing of how P4C services are delivered to determine the optimal “dosage” required to attain positive outcomes for children, families, and schools while ensuring a manageable workload for rehabilitation professionals providing the P4C model of service.
- Evaluate P4C over a longer time period to determine if it is viable to adjust the “dosage” of P4C services over time (e.g. provide more intense services initially when P4C is first introduced into a school with a gradual reduction in services as school capacity is increased).
- Identify factors that influence the workload associated with P4C and evaluate options for how to best optimize workload demands with effective delivery of the P4C service (e.g. size of school, socio-demographic factors, number of children with special needs, distance to rural and remote schools).
Research Priorities related to training and supporting OTs to deliver the P4C model:
- Examine different methods of mentoring and monitoring OTs to support them as they deliver P4C (e.g. meetings, observation, chart audit, satisfaction surveys).
- Develop and evaluate resources and modules to enhance OTs’ ability to work with children with other types of special needs and to provide resources for their families, similar to the ones developed and evaluated for DCD (e.g. children with autism, cerebral palsy, ADHD, developmental disabilities, acquired brain injury).
- Develop online modules for training OTs so they can be available across the province.
- Develop and evaluate presenting the OT training materials as a course.
Research Priorities related to expanding the P4C model:
- Determine if the P4C model is consistent with the activities of other school-based rehabilitation professionals (e.g. speech-language pathologists and physiotherapists), and engage with these groups to investigate how the P4C model could be adapted for their use.
- If the model is consistent with their aims, determine the training needs of these other school-based rehabilitation professionals.
- Study implementation of the P4C service model in middle schools and high schools to identify the types of services needed in these settings with students who are older.
- Examine factors that affect the implementation of P4C in private schools.
Research priorities related to costing:
- Comparative costing (of the P4C model of service with other school-based models of service delivery).
- Comparative costing of different methods of implementing P4C (e.g. transition year; waitlist management; capacity building first).
The Partnering for Change team would be interested in discussing any of these research priorities with Ontario Ministries.