What is P4C?

Principles of the Partnering for Change Model

The principles of Partnering for Change are the four Cs: Building Capacity through Collaboration and Coaching in the school Context.

  • P4C is a needs-based model that emphasizes building the partnership between health professionals, educators, children, families and care coordinators.
  • P4C is responsive to local contexts and the culture of each school.

The Four Cs of P4C

The P4C model aims to build the Capacity of educators and families to support children with special needs in all spaces and places. Therapists do this by Collaborating with educators and families and Coaching in school Contexts that are important to the child — whether that be in the classroom, on the playground, in the gym or at home.


The emphasis in P4C is not on assessment and treatment of an individual child. Instead, the therapist focuses on relationship building, knowledge translation, and development of true partnerships with the educator, student and family. The therapist can provide useful suggestions and strategies but it is the educator and family who spend time with the child each day and who will be there over the long term.

Capacity Building

Educators and parents are supported, through a collaborative approach, in learning to recognize atypical development and special needs. Strategies are introduced right away, without the need for formal assessment or identification, to prevent the development of secondary consequences. The P4C service is focused on building parent and educator capacity.

Knowledge is shared with educators to:

  • facilitate their ability to identify children who have atypical development that suggests a health concern;
  • enable job-embedded learning and best practices in educator professional development;
  • build capacity for educators to deliver or respond to suggestions leading to Universal Design for Learning and Differentiated Instruction. This results in much more inclusive practice for all children, including those with special needs.

Knowledge is shared with families to:

  • facilitate their understanding of their child’s needs;
  • enable learning about their child’s health/developmental concern;
  • support introduction and generalization of strategies that have been found to be successful at school or at home;
  • build families’ capacity to advocate for their child and self-manage their child’s needs in order to prevent the development of secondary consequences.

In our study, we found that occupational therapists also need to build their own capacity to work successfully in this type of service model. This takes time!

Collaboration and Coaching

Health professionals are in school regularly and are available to collaborate with educators; on invitation, OTs coach and support educators directly in the classroom. Coaching builds on the existing skills and knowledge of educators and parents and leads to collaborative determination of solutions.

P4C therapists collaborate with educators and parents to:

  • prevent developmental and motor challenges from becoming greater issues for the student and classroom (e.g. prevention of depression, anxiety, behavioural problems, deterioration in physical fitness, social isolation, school avoidance);
  • promote emotional well-being;
  • enable timely and efficient determination of accommodations that are required to maximize participation;
  • identify individual students’ needs and accommodations to fully demonstrate students’ potential on tests and assessments including EQAO (e.g. provision of technology).

Families are valued partners who can connect with both the educator and P4C therapist when and as needs arise for the student. This enables the family to self-refer without waiting to be referred for service by other parties, eliminating wait times and complex paperwork.

In Context

Children are observed by the therapist in context, in the classroom, gym, playground and throughout the school; dynamic assessment and observation occurs wherever the child is and strategies are trialed at the time to make sure they meet the child’s needs.