A careful assessment has shown that the intensive multi-faceted treatment program offered by the Early Childhood Disorders Psychiatric Day Hospital at the Jewish General Hospital’s renowned Institute for Child and Family Psychiatry is extremely effective at improving the behaviour and academic performance of its young participants.
“We treat children who have really reached the outer limits of what the regular educational system can provide,” said Dr. Ashley Wazana, Co-Director of the Day Hospital. “In order for them to improve and manage their behaviours and integrate into the mainstream academic environment, they need to be accurately diagnosed and receive dedicated treatment for which the schools are just not equipped.”
The assessment, published in The Canadian Journal of Psychiatry, reviewed six years of data (2013-2019) for 261 children between the ages of five and twelve who attended the Day Hospital. Based upon reporting from parents and teachers, the children showed significant improvement in aggression control, emotional outbursts, attention and ability to focus, and became less disruptive in a classroom setting. The children exhibited functional improvement at home and in school, with peers, and in pursuing hobbies. Children with more severe difficulties showed the most improvement. Family functioning did not predict treatment outcomes, meaning that even children with difficult home situations experienced improvements.
The Day Hospital offers classes for kindergarten through grade 6 four days per week, with the patient attending their regular school the fifth day. The program is conducted under the auspices of the English Montreal School Board enabling the children to follow their normal curriculum in addition to their therapy. Each class is limited to seven students so that children receive personal attention. Professionals on staff include psychiatrists, special educators, psychiatric nurses, occupational and speech therapists. Their ranks are supported by trainees who are preparing for careers in associated fields.
“Once we diagnose the underlying causes for the behaviour, we map out a specific treatment plan for each child,” said Dr. Wazana, who leads the Psychosocial Research Axis at the Lady Davis Institute and is Director of Research in the JGH Department of Psychiatry. “We provide, and reinforce, the social skills they will need to solve problems, manage their emotions, and control disruptive impulses in real-world settings. Once they return full-time to the regular school system, they continue to receive between six months and a year of follow-up to ensure a smooth transition.
“Our program gives children the opportunity to improve in an environment where they are understood,” Dr. Wazana goes on, “where they can see that other kids have similar challenges and they don’t feel like they don’t fit in. There are opportunities to learn from their individual therapy, as well as in a group setting and from observing how interventions work with others.”
“Our findings highlight the usefulness of day treatment programs for high-risk elementary-aged children within the mental health network, with evidence that this service works on disorders with costly and lasting consequences,” the study concludes. Going forward, it suggests that more research be dedicated to understanding predictors of outcomes so that clinicians and policymakers can have better insight into which children are most likely to benefit from participation in day treatment programs, as well as those who would be less likely to respond and, thus, require particular attention.
