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-2215896645176May 20th, 2016.2476501866900Dr. Ronit MestermanChair of PONDA NetworkAssociate Professor of PediatricsDivision of Pediatric NeurologyDivision Head of Developmental PediatricsMcMaster UniversityMedical Director of Developmental Pediatric Rehabilitation and Autism Spectrum Disorder McMaster Children’s Hospitalmester@mcmaster.caDr. Pamela FridFounder in Developmental PediatricsAssociate Professor of PediatricsThe University of Western OntarioMedical Director, Thames Valley Children’s Centrepamela.frid@tvcc.on.caDr. Gillian HoganDevelopmental PediatricianClinical Assistant Professorhogang@mcmaster.caDr. Nicola Jones-StokreefDevelopmental PediatricianChildren's Treatment Network of Simcoe YorkOrillia Soldiers Memorial Hospitalnjonesstokreef@osmh.on.caDr. Benjamin KleinDevelopmental PediatricianMedical Director of Lansdowne Children’s Centrebenjamin.klein@medportal.caDr. Olaf Kraus de CamargoAssociate Professor of PediatricsDivision of Developmental PediatricsMcMaster Universitykrausdc@mcmaster.caDr. Alvin LohAssistant Professor of PediatricsDivision of Developmental PediatricsUniversity of TorontoMedical Chief of Staff, Surrey Place Centrealvin.loh@surreyplace.on.caDr. Mohammad S. ZubairiDevelopmental PediatricianHolland Bloorview Kids Rehabilitation Hospitalmzubairi@hollandbloorview.ca Website: ponda.ca0Dr. Ronit MestermanChair of PONDA NetworkAssociate Professor of PediatricsDivision of Pediatric NeurologyDivision Head of Developmental PediatricsMcMaster UniversityMedical Director of Developmental Pediatric Rehabilitation and Autism Spectrum Disorder McMaster Children’s Hospitalmester@mcmaster.caDr. Pamela FridFounder in Developmental PediatricsAssociate Professor of PediatricsThe University of Western OntarioMedical Director, Thames Valley Children’s Centrepamela.frid@tvcc.on.caDr. Gillian HoganDevelopmental PediatricianClinical Assistant Professorhogang@mcmaster.caDr. Nicola Jones-StokreefDevelopmental PediatricianChildren's Treatment Network of Simcoe YorkOrillia Soldiers Memorial Hospitalnjonesstokreef@osmh.on.caDr. Benjamin KleinDevelopmental PediatricianMedical Director of Lansdowne Children’s Centrebenjamin.klein@medportal.caDr. Olaf Kraus de CamargoAssociate Professor of PediatricsDivision of Developmental PediatricsMcMaster Universitykrausdc@mcmaster.caDr. Alvin LohAssistant Professor of PediatricsDivision of Developmental PediatricsUniversity of TorontoMedical Chief of Staff, Surrey Place Centrealvin.loh@surreyplace.on.caDr. Mohammad S. ZubairiDevelopmental PediatricianHolland Bloorview Kids Rehabilitation Hospitalmzubairi@hollandbloorview.ca Website: ponda.caBackgrounder: Evidence-based intervention for learning disabilities in Ontario schoolsThis is a proposal for Ontario to implement evidence based literacy interventions in all school boards in the province. Learning disabilities affect approximately 5% of Ontario children age 6 to 15 years old, and 85% of these children have significant problems learning to read and write. These problems are not outgrown, and better outcomes result when intervention occurs in the early years of schooling. Unwanted outcomes are more common in people with LD: 25 % drop out of high school (more than twice the average rate), and only 8% go on to post secondary education. Adults with LD are 2 to 3 times more likely to report fair-to-poor physical, mental and general health.Reading and writing are not singular skills. Learning to read requires the acquisition of multiple layers of skill, including phonemic awareness (awareness of the individual speech sounds in spoken words), learning of letter-sound and letter cluster-sound correspondences, learning of the structure of words (e,g, prefixes, suffixes), and learning that a word may have multiple meanings and functions within a sentence. Skilled reading, fluency, and text comprehension are built upon these foundational reading skills. Starting in Grade 4, we know the performance gap between proficient and disabled readers starts to increase, making it more challenging and less effective to intervene in later grades. Not only is there a gap in skills, but children with LD are less likely to see themselves as capable, and become disengaged with learning. Anxiety symptoms, low self esteem, and/or behaviour problems often ensue. There are a few programs currently available to address literacy based LD in the province. An example already in place in over 600 Ontario schools are the EmpowerTM Reading Programs, a set of evidence-based interventions for children and teens with reading disabilities.For more than three decades, researchers at the Hospital for Sick Children in Toronto have documented clear evidence of the beneficial effects of early systematic reading intervention in children with severe learning challenges. A team led by Dr. Maureen Lovett has studied over 6500 severely reading disabled students, evaluating in controlled research a set of programs they developed called EmpowerTM Reading. Studies show that use of Empower in the primary grades allows children with learning challenges to make significant gains in reading skills and to maintain and add to those gains after the program ends, regardless of SES disadvantage, lower IQ, or if English is not their primary language. If children are not identified as having learning challenges -22158966451762476501866900Dr. Ronit MestermanChair of PONDA NetworkAssociate Professor of PediatricsDivision of Pediatric NeurologyDivision Head of Developmental PediatricsMcMaster UniversityMedical Director of Developmental Pediatric Rehabilitation and Autism Spectrum Disorder McMaster Children’s Hospitalmester@mcmaster.caDr. Pamela FridFounder in Developmental PediatricsAssociate Professor of PediatricsThe University of Western OntarioMedical Director, Thames Valley Children’s Centrepamela.frid@tvcc.on.caDr. Gillian HoganDevelopmental PediatricianClinical Assistant Professorhogang@mcmaster.caDr. Nicola Jones-StokreefDevelopmental PediatricianChildren's Treatment Network of Simcoe YorkOrillia Soldiers Memorial Hospitalnjonesstokreef@osmh.on.caDr. Benjamin KleinDevelopmental PediatricianMedical Director of Lansdowne Children’s Centrebenjamin.klein@medportal.caDr. Olaf Kraus de CamargoAssociate Professor of PediatricsDivision of Developmental PediatricsMcMaster Universitykrausdc@mcmaster.caDr. Alvin LohAssistant Professor of PediatricsDivision of Developmental PediatricsUniversity of TorontoMedical Chief of Staff, Surrey Place Centrealvin.loh@surreyplace.on.caDr. Mohammad S. ZubairiDevelopmental PediatricianHolland Bloorview Kids Rehabilitation Hospitalmzubairi@hollandbloorview.ca Website: ponda.ca0Dr. Ronit MestermanChair of PONDA NetworkAssociate Professor of PediatricsDivision of Pediatric NeurologyDivision Head of Developmental PediatricsMcMaster UniversityMedical Director of Developmental Pediatric Rehabilitation and Autism Spectrum Disorder McMaster Children’s Hospitalmester@mcmaster.caDr. Pamela FridFounder in Developmental PediatricsAssociate Professor of PediatricsThe University of Western OntarioMedical Director, Thames Valley Children’s Centrepamela.frid@tvcc.on.caDr. Gillian HoganDevelopmental PediatricianClinical Assistant Professorhogang@mcmaster.caDr. Nicola Jones-StokreefDevelopmental PediatricianChildren's Treatment Network of Simcoe YorkOrillia Soldiers Memorial Hospitalnjonesstokreef@osmh.on.caDr. Benjamin KleinDevelopmental PediatricianMedical Director of Lansdowne Children’s Centrebenjamin.klein@medportal.caDr. Olaf Kraus de CamargoAssociate Professor of PediatricsDivision of Developmental PediatricsMcMaster Universitykrausdc@mcmaster.caDr. Alvin LohAssistant Professor of PediatricsDivision of Developmental PediatricsUniversity of TorontoMedical Chief of Staff, Surrey Place Centrealvin.loh@surreyplace.on.caDr. Mohammad S. ZubairiDevelopmental PediatricianHolland Bloorview Kids Rehabilitation Hospitalmzubairi@hollandbloorview.ca Website: ponda.cauntil later in their school career, they still make significant gains in their reading using the EmpowerTM Reading program. Identification of students at risk is simple, and can be done in minutes by a regular classroom teacher. Testing by a psychologist is not necessary. This program is currently being used in approximately 600 Ontario schools, as well as schools in Manitoba, Alberta, Quebec, and BC. In the near future, training will begin in India to bring the benefits of EmpowerTM to that country’s children with reading challenges. In Ontario, decisions regarding programming for students are made at the local board level, but must meet curriculum standards set by the Ministry of Education. As a result, there are a variety of reading interventions that are offered, depending on the particular school board. Teachers providing reading interventions need ongoing training and support to implement effective evidence based practices. As a result, thousands of students in Ontario schools go without the most effective interventions to improve their reading and writing difficulties. Many of them present to physicians offices, looking for help with mental health or behavioural problems, and to find an answer to why they are struggling academically. Over 50% of the referrals seen in a general paediatrician’s office are for school related problems, and a significant number of these children and youth have a learning disability of some variety. Many of these children are later seen by a school board or private psychologist to identify a learning disability. There are long waiting lists for these services, and they are costly, but they do not solve the problem because so often there isn't effective, evidence based instruction in the child's school.PONDA is an advocacy group of concerned physicians and psychologists who insist that students in all school boards with reading and writing LDs deserve the interventions that have been proven through research to be effective. We want to see the Ministry of Education insist on Evidence Based interventions for use in all school boards to address learning difficulties in reading and writing. We want to see school boards implement programs such as EmpowerTM in all their schools to meet the very high demand (5% of students) for this intervention. It has already worked in over 600 schools in Ontario. Implementation of EmpowerTM in all schools would result in an improvement in achievement, mental health and best of all, equity for all students. ................
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