SECTION 1: Introduction


The following guidelines provide direction regarding the Independent Clinical Review (ICR) process in the Ontario Autism Program (OAP). The ICR allows families to request a review of their child or youth’s OAP Behaviour Plan, developed by an OAP Behaviour Clinician.1 It is a peer-review process with decisions being rendered by a team of independent clinicians based on the clinical review of a child’s OAP case file materials. The ICR is administered by a third party agency, the ICR Coordinator.

Active engagement of families, as set out in the OAP Guidelines and the OAP Clinical Framework, is a key element of the ICR. It requires a clear understanding of the family’s perspective.

The Ministry of Children and Youth Services will continue to work with stakeholders on the design of the OAP. Consequently, as new elements of the OAP are introduced throughout this process, the ICR Guidelines will continue to evolve.

Guiding Principles

The following principles will guide the operation of the ICR:

  1. Clarity and Transparency: The review process is clear and transparent. The family has the opportunity to contribute additional materials to the case file that will be used in the review process, and to present their perspective to the ICR Clinical Reviewers. OAP providers and the ICR Coordinator communicate in a clear and transparent manner with families about decisions related to their child, and the opportunity to have their child’s OAP Behaviour Plan reviewed.
  2. Family Engagement: The review process engages the family through built-in mechanisms to help provide a clear understanding of the family perspective, and an opportunity for families to present their perspectives to the Clinical Reviewers.2
  3. Quality Decision-Making: Decision-making in the ICR is the responsibility of the two Clinical Reviewers. Decisions are guided by the reviewers’ clinical expertise, existing research on evidence-based behavioural intervention for children with Autism Spectrum Disorder (ASD) and a thorough review of the OAP case file materials.
  4. Confidentiality: All ICR staff sign confidentiality agreements, and all documents and information from and about the family and child requesting the review are de-identified by the ICR Coordinator. The ICR Coordinator also acts as an intermediary between all parties to maintain confidentiality in the review process. Any time that the family does have direct contact with members of the ICR Review Committee, it is done on a first-name basis only. In some instances, there is a need to balance the wishes of the family to present their perspective directly to the ICR Clinical Reviewers, and the need to protect confidentiality. In these cases, the family must sign and submit a waiver to the ICR Coordinator confirming that they understand that this may result in a loss of anonymity to the reviewers.
  5. Effective and Efficient Service Delivery: The ICR is administered in a manner that helps to provide timely reviews for children and their families.
  6. Independence: Potential conflicts of interest are avoided by administering the ICR through a third party agency that is independent from the Ministry, the OAP provider and the family, and by having independent clinicians review Behaviour Plans.

Purpose and Application

The ICR Guidelines provide operational guidance for:

The guidelines set out the Ministry’s expectations for the delivery of the ICR across the province.

back to top