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Autism controversy, confusion and what lies ahead for Ontario families

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Lisa MacLeod, minister of children, community and social services, said sweeping changes are necessary to clear the therapy wait list of 23,000 kids within 18 months and make the program fiscally sustainable.

“Today, almost three out of every four children who require autism supports continue to be stranded on wait lists,” she told reporters at a Feb. 6 news conference in Toronto. “We are introducing reforms to provide them with the fairness and equality they deserve.”

The Star consulted experts, advocates and government officials and websites to answer some questions about autism and what lies ahead for Ontario families.

Five regional centres across Ontario, including Holland Bloorview Kids Rehabilitation Hospital in Toronto, have behaviour analysts who are specially trained to diagnose children from about age 2.

Evidence shows that when children start behavioural intervention between ages 2 and 5, they gain improvements in cognitive and language development, are better prepared for school and have better long-term outcomes in adulthood, the ministry notes.

There are currently 2,400 children waiting — many for up to two years — for a publicly funded diagnosis from one of the five diagnostic hubs. Families unwilling to wait can pay for a diagnosis from a trained professional.

What is the government doing about the wait list for diagnosis?

The government has doubled funding for diagnostic hubs to $5.5 million over two years to ensure children are being diagnosed in a timely way.

How many children in Ontario have autism?

The latest research shows roughly 1 in 66 Ontario children have autism, or about 40,000 kids under age 18.

How many children are being treated now?

About 8,400 children are receiving needs-based treatment funded by the Ontario Autism Program, set up in 2017 by the previous Liberal government.

What is the bill for taxpayers?

The annual budget is $321 million. The government added an additional $100 million this year. But MacLeod has said it is one-time funding and changes are needed to make the program fair for families and sustainable for taxpayers.

What is Applied Behavioural Analysis, or ABA therapy?

ABA is the most effective evidence-based treatment for children with autism and is used with varying intensity, depending on a child’s needs.

The therapy uses repetition and positive reinforcement to help children master life and social skills, such as dressing and having a conversation. In intense intervention, therapists work one-on-one with children to break down skills into small teachable steps. Once a skill has been mastered, the therapist works on helping the child use the skill in a natural setting.

For example, a child may be taught to request a favourite toy during a therapy session and then be encouraged to repeat the skill during a play date.

How much does it cost?

Children diagnosed with moderate to severe autism may require between 20 and 40 hours a week of ABA therapy, which can cost between $50,000 and $80,000 a year.

What is a Board Certified Behaviour Analyst (BCBA)?

A BCBA holds a master’s degree in a related field such as psychology, behaviour analysis or education. To become “board certified,” — an American certification — individuals must complete about two years of formal training in behaviour analysis, 1,500 hours of supervised practice and pass board exams.

For some children, ABA therapy is overseen by a clinical supervisor with a PhD in behaviour analysis or related field.

How is the government planning to clear the therapy wait list?

Instead of needs-based funding for a few children, managed by regional service agencies, the government will give money directly to all families so they can choose the services they want.

Funding will be capped based on age and targeted to lower- and middle-income families.

How can the money be used?

Unlike the previous program that limited public funds to evidence-based ABA therapy and parent training only, families will be able to use the money on “behavioural services such as assessments and consultations, family/caregiver capacity building and training, respite services, technology aids, and travel,” the government’s website says.

Does the government regulate behavioural therapists like nurses and doctors?

No. By April 1, the government will create an online list of “verified qualified service providers” that will be available to help families access behavioural services, according to the website. Before April 2021, families can work with clinical supervisors who are not on the list, as long as they are working towards their qualifications. After that time, all clinical supervisors will have to meet program qualifications.

How will families get their money?

Currently, parents apply to one of nine regional autism service agencies for either publicly funded behaviour therapy, or for funding they can use to buy services from private clinics. The amount of therapy or direct funding a family receives is based on the severity of the child’s diagnosis and the behaviour plan drawn up by a recognized professional. Families are served in order of their application date.

Under the new model, families will receive autism program funding through an independent intake agency which the ministry says will be set up within the next year. The new agency will help families register for the program, assess their funding eligibility, approve their “childhood budgets” and help them choose which services to purchase.

Families will no longer need a behaviour plan because funding will be based solely on their child’s age and household income.

Starting April 1, kids under age 6 will receive up to $20,000 a year. Those over 6 will get $5,000 a year. Childhood budgets up to age 18 will be capped at $140,000 for kids entering the program under age 6 while lifetime funding for those entering at older ages will be limited to $55,000.

Funding will be income-tested with more money going to lower-income families. Although the ministry has not yet said what family income would receive the full amount, households above $250,000 will no longer qualify for funding.

Eligibility and the amount of funding a family receives will be reviewed annually, according to the ministry website.

Details on how families will receive their funding, eligible expenses and the reconciliation process will be available by April, 1, according to ministry officials.

How will the program be managed until the new intake agency is set up?

Starting April 1, government officials will help families register for the new childhood budgets, although it is not yet clear how they will get access to the wait lists, which are currently held by the nine regional service agencies. Nor is it clear how newly diagnosed children will be registered.

“All these details are still being worked out and will be available before April 1,” a government official said.

What happens to the 8,400 families already receiving publicly funded services?

New behaviour plans will continue to be developed until March 31, according to the government. If existing behaviour plans end after that date, government officials will help families apply for a childhood budget.

Ministry officials say there are no plans to put children currently receiving support back onto a wait list. All children who have a behaviour plan will continue to receive the services outlined in that plan until the plan’s end date.

Any money families have already received through the Ontario autism program will not be deducted from the new childhood budgets.

Families with questions can call the province’s toll-free autism services line at 1-888-284-8340 or consult ontario.ca/autism

Laurie Monsebraaten is a Toronto-based reporter covering social justice. Follow her on Twitter: @lmonseb

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Anglais

‘Business as usual’ for Dorel Industries after terminating go-private deal

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MONTREAL — Dorel Industries Inc. says it will continue to pursue its business strategy going forward after terminating an agreement to go private after discussions with shareholders.

« Moving ahead. Business as usual, » a spokesman for the company said in an email on Monday.

A group led by Cerberus Capital Management had previously agreed to buy outstanding shares of Dorel for $16 apiece, except for shares owned by the family that controls the company’s multiple-voting shares.

But Dorel chief executive Martin Schwartz said the Montreal-based maker of car seats, strollers, bicycles and home furniture pulled the plug on a deal on the eve of Tuesday’s special meeting after reviewing votes from shareholders.

“Independent shareholders have clearly expressed their confidence in Dorel’s future and the greater potential for Dorel as a public entity, » he said in a news release.

Dorel’s board of directors, with Martin Schwartz, Alan Schwartz, Jeffrey Schwartz and Jeff Segel recused, unanimously approved the deal’s termination upon the recommendation of a special committee.

The transaction required approval by two-thirds of the votes cast, and more than 50 per cent of the votes cast by non-family shareholders.

Schwartz said enhancing shareholder value remains a top priority while it stays focused on growing its brands, which include Schwinn and Mongoose bikes, Safety 1st-brand car seats and DHP Furniture.

Dorel said the move to end the go-private deal was mutual, despite the funds’ increased purchase price offer earlier this year.

It said there is no break fee applicable in this case.

Montreal-based investment firm Letko, Brosseau & Associates Inc. and San Diego’s Brandes Investment Partners LP, which together control more than 19 per cent of Dorel’s outstanding class B subordinate shares voiced their opposition to the amended offer, which was increased from the initial Nov. 2 offer of $14.50 per share.

« We believe that several minority shareholders shared our opinion, » said Letko vice-president Stephane Lebrun, during a phone interview.

« We are confident of the long-term potential of the company and we have confidence in the managers in place.”

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Anglais

Pandemic funds helping Montreal businesses build for a better tomorrow

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Many entrepreneurs have had to tap into government loans during the pandemic, at first just to survive, but now some are using the money to better prepare their businesses for the post-COVID future.

One of those businesses is Del Friscos, a popular family restaurant in Dollard-des-Ormeaux that, like many Montreal-area restaurants, has had to adapt from a sit-down establishment to one that takes orders online for takeout or delivery.

“It was hard going from totally in-house seating,” said Del Friscos co-owner Terry Konstas. “We didn’t have an in-house delivery system, which we quickly added. There were so many of our employees that were laid off that wanted to work so we adapted to a delivery system and added platforms like Uber and DoorDash.”

Helping them through the transition were emergency grants and low-interest loans from the federal and provincial governments, some of which are directly administered by PME MTL, a non-profit business-development organization established to assist the island’s small and medium-sized businesses.

Konstas said he had never even heard of PME MTL until a customer told him about them and when he got in touch, he discovered there were many government programs available to help his business get through the downturn and build for the future. “They’ve been very helpful right from day one,” said Konstas.

“We used some of the funds to catch up on our suppliers and our rents, the part that wasn’t covered from the federal side, and we used some of it for our new virtual concepts,” he said, referring to a virtual kitchen model which the restaurant has since adopted.

The virtual kitchen lets them create completely different menu items from the casual American Italian dishes that Del Friscos is known for and market them under different restaurant brand names. Under the Prasinó Soup & Salad banner, they sell healthy Greek options and their Stallone’s Sub Shop brand offers hearty sandwiches, yet the food from both is created in the same Del Friscos kitchen.

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Anglais

Downtown Montreal office, retail vacancies continue to rise

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Some of downtown Montreal’s key economic indicators are heading in the wrong direction.

Office and retail vacancies in the city’s central core continued to climb in the fourth quarter of 2020, according to a quarterly report released Thursday by the Urban Development Institute of Quebec and the Montréal Centre-Ville merchants association. The report, whose first edition was published in October, aims to paint a socio-economic picture of the downtown area.

The survey also found office space available for sublet had increased during the fourth quarter, which may foreshadow even more vacancies when leases expire. On the residential front, condo sales fell as new listings soared — a sign that the downtown area may be losing some of its appeal to homeowners.

“It’s impossible not to be preoccupied by the rapid increase in office vacancies,” Jean-Marc Fournier, the former Quebec politician who now heads the UDI, said Thursday in an interview.

Still, with COVID-19 vaccinations set to accelerate in the coming months, “the economic picture is bound to improve,” he said. “People will start returning downtown. It’s much too early to say the office market is going to disappear.”

Public health measures implemented since the start of the pandemic almost a year ago — such as caps on office capacity — have deprived downtown Montreal of more than 500,000 workers and students. A mere 4,163 university and CEGEP students attended in-person classes in the second quarter, the most recent period for which figures are available. Border closures and travel restrictions have also brought tourism to a standstill, hurting hotels and thousands of local businesses.

Seventy per cent of downtown workers carried out their professional activities at home more than three days a week during the fourth quarter, the report said, citing an online survey of 1,000 Montreal-area residents conducted last month.

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