Accelerating stepped-care mental health with and for at-risk neurodiverse children and families using co-design

The COVID-19 pandemic defied all estimates in length and mental health impact. Children with pre-existing mental health issues have been particularly affected. I-InTERACT-North is a virtual positive parenting support program designed for neurodiverse children (i.e., Brain Injury, Attention Deficit Hyperactivity Disorder, Autism). It helps improve family relationships, child behaviour and parent stress. Our team rapidly integrated a COVID-specific research element to our existing program and adapted to a stepped-care approach to enhance feasibility and better meet families' needs during the pandemic. Stepped-care offers effective treatment tailored in intensity and level of therapist involvement to family needs. The proposed study is a vital expansion of COVID-19 research already underway and ongoing given the protracted course of the global pandemic. It leverages an existing multi-phase project assessing the impact of I-InTERACT-North and informs next steps in larger-scale implementation. In the proposed study, we will extend and expand the existing COVID-19 response project in 3 ways; 1) continue to offer intervention to families already engaged as well as new prospective families given ongoing COVID-19 impact, 2) evaluate how program knowledge helped families in the context of the pandemic, and 3) partner with parent and community stakeholders to co-design future studies and scale wider I-InTERACT-North access, essential to extend and improve family mental health support. Our study is partnered with the Province of Ontario Neurodevelopmental Disorders (POND) Network, a large cohort of neurodiverse children. We will recruit parents of children ages 3-9 years across 4 major centers: Holland Bloorview, SickKids, University of Western Ontario, Queen's University. The purpose of the entire project is to evaluate stepped-care intervention for neurodiverse children and their families to mitigate mental health risk and family dysfunction and inform program scalability.