What is P4C?

Evidence for the Partnering for Change Model of Service Delivery

Dr. Cheryl Missiuna, Cathy Hecimovich, and a multi-disciplinary team of researchers at CanChild conducted several previous studies of the Partnering for Change model.

  • P4C is based on participatory action research studies dating from 2008.
  • The P4C model is evidence-based and aligns with the 2010 Deloitte recommendations and the Ontario Special Needs Strategy.

Addressing Needs

The Partnering for Change model was first developed by CanChild researchers, leaders from the Central West CCAC, and many other stakeholders to address the inequity and escalating needs of children with Developmental Coordination Disorder (DCD) who represented a majority of the students waiting for services from occupational therapists.

What is Developmental Coordination Disorder?

Developmental Coordination Disorder (DCD) is a specific motor disability that affects about 5% of all children — that is, about one student in every classroom. DCD significantly impacts a child’s ability to complete everyday motor-based academic and self-care tasks such as printing, using scissors, lacing up shoes, opening a knapsack, managing lunch containers or putting on outdoor clothing. DCD is a chronic health condition that occurs in children with a normal range of intellectual abilities: it persists throughout adolescence and may eventually affect social interactions, school completion rates and vocational choices (American Psychiatric Association, 2013). While DCD is present from very early in life, children’s difficulties become most apparent when they enter full day kindergarten and encounter new motor challenges and increased requirements for independence. Without appropriate support at school, children with DCD, their families, and their educators struggle and become frustrated. Secondary academic, mental health, and physical health issues develop, which make children’s needs more complex and difficult to cope with as they progress into intermediate grades. More information about DCD can be found on the CanChild website.

Partnering for Change is Evidence Based


Pilot project funded by Ontario Neurotrauma Foundation


Demonstration project funded by Canadian Institutes of Health Research


Knowledge translation project funded by Canadian Institutes of Health Research


Implementation and formative evaluation study funded by Ontario Ministry of Health and Long-term Care


Summative evaluation study funded by Ontario Ministry of Education


The evidence describing the Partnering for Change model served to guide the current study and is well documented in peer-reviewed publications.

Campbell, W.N., Missiuna, C., Rivard, L., & Pollock, N. (2012). “Support for Everyone”: Experiences of occupational therapists delivering a new model of school-based service. Canadian Journal of Occupational Therapy, 79, 51–59.

Missiuna, C., Pollock, N., Campbell, W.N., Bennett, S., Hecimovich, C., Gaines, R., DeCola, C., Cairney, J., Russell, D., & Molinaro, E. (2012). Use of the Medical Research Council Framework to develop a complex intervention in pediatric occupational therapy: Assessing feasibility. Research in Developmental Disabilities, 33(5), 1443–1452.

Missiuna, C., Pollock, N., Levac, D., Campbell, W., Whalen, S.S., Bennett, S., et al. (2012). Partnering for Change: An innovative school-based occupational therapy service delivery model for children with developmental coordination disorder. Canadian Journal of Occupational Therapy, 79, 41–50.


  • American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.) Washington, DC: Author.