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January 14, 2026

An innovative program reaches Ontario children who were falling through the gaps

By Patchen Barss

In Ontario, many families with children with physical, intellectual, emotional, or developmental disabilities face barriers to receiving the right support through standard health services.

“These are kids with behavioural challenges who haven’t found the right support yet,” says Mackenzie Health Centre for Behaviour Health Science’s Stefanie Smith. “Maybe for a variety of reasons, talk therapy may not meet their needs at this moment in time. Their behaviour may interfere with their ability to go to school or to access a psychiatric appointment in a safe way. They may not qualify for community mental health services. They may not have the specific diagnosis required to access other services. These kids often face barriers at every turn.”

Smith, an applied behaviour analyst, is the program coordinator of the Mobile Behaviour Treatment Team, an innovative program that brings services to children and youth who otherwise would slip through gaps in the system. This program is a collaboration between Smith’s organization and the non-profit child protection service Simcoe Muskoka Family Connexions.

“Our overarching goal is to keep kids who have behavioural needs in their home, and help kids who are in care stabilize so they can return home — or at the very least, return to their community in a more home-like setting. We want kids to go to their local school. We want kids to have connections to their home communities,” Smith says.

Kids are referred by the child welfare agency, when a case worker specifically identifies behaviours that make their living environment challenging, dangerous, and at risk of breaking down. The mobile team intervenes based on the scientific drawing on a “functional behaviour assessment” to identify underlying causes and factors that affect a child’s behaviour. Interventions include helping kids learn how to manage their own actions, as well as cultivating a supportive living environment that supports their needs and allows them to function at their best. The team supports children from birth to age 18, though they most commonly work with 10 to 16-year-olds.

Over its 14 years of operation, the program has changed the lives of dozens of young people, as well as their families.

John Clarke, the Program Director for Behavioural Sciences at Mackenzie Health, was on the committee that first developed the idea and pitched the mobile team concept to Simcoe Muskoka Family Connexions, which agreed to fund it.

“What I’ve always thought is really special about this project, is that it came from the community for the community,” he said. “For individuals living with intellectual disabilities and mental health challenges there was a huge service gap. There were not enough supports available.”

The groundbreaking concept grew naturally out of the existing ethos of Mackenzie Health.

“Our agency is based on meeting people where they are,” Clarke said. “If we design a super elaborate program in a treatment home, and then I try to apply it to a child’s house, where there are four other kids and a mom and dad trying to make dinner, and the TV is on and people are running off to hockey and scouts and so on, then it won’t work. Getting in there and understanding the real-life environment has proven to be a better approach.”

The mobile team better serves kids and families, but the program is also cost conscious — it’s significantly more efficient to help people in their home environments than it would be to move them to a care facility.

In fact, more than a decade of independent assessment data demonstrates that the program both reliably saves money, and improves kids’ quality of life, reduces stress and behavioural challenges, and increases stability

Now, other regions are working to replicate that success. Last year, Surrey Place began a similar program serving kids with neurodevelopmental disabilities or cognitive impairments in downtown Toronto.

Terri Hewitt, Surrey Place’s CEO, has already seen the impact of reaching kids where they live.

“There was a child around nine or ten years old. They were neurodivergent and had a lot of sensory challenges. They couldn’t tolerate a seatbelt, or putting on clothes. The parents couldn't take the kid to school,” Hewitt says. “Child Welfare was informed because the child wasn't attending school or really going out at all.”

With a referral from Child Welfare, Surrey Place’s mobile team worked with the family at their home — the only place this child was reachable. In that setting, they were able to work with the child and the family to overcome sensory challenges to a point where the child could return to school. Through the intervention, Child Welfare was able to close the case without further intervention.

“Our partnership with Children’s Aid Society of Toronto gets those clinical services needs identified and in place so that we can resolve those gaps,” Hewitt says. “In this case, this little child could go to school or to the park. It greatly altered their family's life.” 

While province-wide data on the demand for mobile behavioural services is not available, Stefanie Smith says there has been growing interest in York Region, (including from Dnaagadwenmag Binnoojjiiyag Child and Family Services) as well as inquiries from groups in other Ontario cities about how to replicate the program regionally. She says success depends on developing productive partnerships with local child welfare agencies and on keeping services flexible enough to meet the unique needs of each family.

“I know the relationship and that partnership I have with the current agencies is so vital. How do I do that as well, from a distance with someone else? As we grow, we have to have the right people in the right places, and that's what we're working on,” Smith says.

Positive relationships, both with child welfare agencies and with high-needs children and their families, can be delicate and difficult to cultivate. Hewitt and Smith, though, both agree that the lives they change make it highly worthwhile.

“It's why practitioners are in this work,” Hewitt says. “Nobody gets paid the most working in developmental services. They do it because they see the need. It feels great when you're able to help families. It makes such a huge difference in people's lives. That's incredibly satisfying.”