Extensive Needs Service Program
Transforming Support for Families in Niagara

In 2024, Niagara Children’s Centre co-led the local design and implementation of Niagara’s Extensive Needs Service (ENS) program alongside Contact Niagara. With leadership from McMaster Children’s Hospital and funding from the Ministries of Health and Children, Community and Social Services, Niagara’s ENS model was uniquely built to leverage the strengths, roles, and deep expertise of six local partner organizations: Niagara Children’s Centre, Contact Niagara, Bethesda, Pathstone Mental Health, Niagara Training and Employment Agency and De dwa da dehs nye>s Aboriginal Health Centre.

Together, we’ve created inter-agency teams to support children and youth (ages 0–18) who live with a combination of neurodevelopmental, physical, and mental health conditions, often resulting in interfering behaviours that limit their participation in home, school, and community life.

What makes Niagara’s model distinctive is its commitment to continuity and family choice. Many of the children supported by ENS have been involved with more than one of the partner organizations—often receiving services in a siloed manner. This new model allows families to continue working with trusted professionals, when possible, and have a say in who supports their child’s care. Teams are intentionally built to draw from clinicians already known to the family or who may continue supporting the child after ENS involvement ends.

Niagara Children’s Centre’s contributions are foundational to this integrated approach. We offer a range of disciplines—speech-language pathology, occupational therapy, social work, communication assistants, and service planning—and bring the added benefit of strong relationships with school boards through our School-Based Rehabilitation Services (SBRS), Specialized Seating & Mobility Clinic (SSH), and Expanded Level Assisted Devices Program Clinic.

Other partners bring equally valuable contributions. Contact Niagara, as the region’s single point of access for many developmental and autism services, provides critical leadership through its Coordinated Service Planners. Bethesda offers expertise as an Ontario Autism Program (OAP) provider. Pathstone’s MITT team supports children with co-occurring mental health and developmental diagnoses. Niagara Training and Employment Agency provides regional respite and autism programming, while De dwa da dehs nye>s brings essential cultural and health navigation services for Indigenous families.

This model goes beyond coordination—it’s true collaboration. Professionals don’t just bring their unique expertise to the table; they work together to integrate goals, strategies, and delivery models that are sustainable across all environments. Together, we identify and address the root causes of behavioural challenges and support goals that extend beyond skill development. These include strengthening family relationships, creating inclusive environments, and promoting quality of life through a “6 F’s” lens: Function, Family, Fitness, Fun, Friends, and Future.

The result is wrap-around care that is flexible, trauma-informed, and deeply personalized. It’s not just about services—it’s about belonging, resilience, and giving families confidence that their child is supported at every step.

Through the ENS program, Niagara Children’s Centre continues to lead in innovative care, working alongside our community to help children with extensive needs thrive—in every space they live, learn, and play. 

Participant Profile:

Jimeeka, 10, lives with Autism Spectrum Disorder, Intellectual Disability, and frequent health complications. When ENS began, Jimeeka was experiencing severe dysregulation, self-injurous behavior despite in-patient treatment/hospitalizations, 24/7 behavioural supports, and frequent use of community services. One year ago, the unique service delivery model of ENS allowed a collaborative, interdisciplinary/inter-agency team the time and flexibility to provide the holistic supports desperately needed. As a result of the ENS program, Jimeeka is happier, healthier, and more interactive. She is spending more quality time with her family, enjoying time in the community, and her contagious smile and belly laugh have returned!