Editor’s note: While both authors contributed to the writing of this article, the mother referred to is Ghina.
Twins. Two babies, born within a minute of each other. Double the trouble and double the fun – isn’t that what they always say? Navigating parenthood is undoubtedly a blessing, but it often comes with challenges.
As a parent of twins, a bright boy and a beautiful girl, I learned to double everything, from clothes and dentist appointments to my daily espresso. The thing that threatened to tip the balance was the congenital heart disorder that my son was diagnosed with. This brought many challenges, but it also opened doors that would otherwise be closed.
During Grade 2, my son began to struggle at school. After discussing the issue with the school and his pediatrician, it was recommended that he undergo a psychoeducational assessment (PEA) to support his learning plan (also known as an individualized educational plan or IEP). As per the Handbook of psychoeducational assessment: Ability, achievement, and behaviour in children, a PEA is used to help diagnose learning disabilities such as dyslexia, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder and emotional/behavioural disorders. It opens doors to much-needed school resources, including accommodation and specialized programs.
The pediatrician suggested his twin sister also undergo the evaluation process despite her strong academic performance. Research by Quinn and Fuller-Thomson et al found that girls often tend to be highly functional or mask their symptoms to meet their parents and teachers’ expectations.
Trying to schedule assessments through the school board proved harder than competing at the Olympics. I was informed that waitlists for a publicly funded PEA were extremely long, potentially taking years.
However, due to my son’s pre-existing heart condition, we secured a Neuropsychological Evaluation (NPE) at our local children’s hospital. The NPE is more comprehensive than a PEA, assessing various cognitive functions like memory and attention to identify strengths and areas for improvement. As per The importance of neuropsychological assessment for the evaluation of childhood learning disorders: NAN Policy and Planning Committee, it also considers emotional and behavioural factors that can affect learning. We completed the evaluation in just one month, and it was fully covered by OHIP.
Then came the time to have my daughter assessed. Since she did not have any pre-existing medical conditions, there was no way for her to be seen through the children’s hospital’s program. I was therefore presented with two options: to wait for our turn on the school’s waitlist, which could take up to three years, or to go through private practice, which would cost between $2,000-$4,000.
The situation we found ourselves in was anything but fair. It felt as though the universe was playing one of its cruel tricks on us; in my son’s case, the cardiac anomaly that once seemed like a heavy burden has become a blessing. With just a few simple adjustments and accommodations, he is now thriving happily at school. Meanwhile, because my daughter is physically healthy, she has had to wait years for an assessment. In hopes of being proactive, I took the decision to take the financial hit and try to get an assessment via private practice, where the waitlist was approximately one to two months.
According to the 2024 People for Education’s Annual Report on Ontario’s Publicly Funded Schools, the average wait time for a publicly funded PEA through Ontario schools is approximately three years. Many families are on waitlists and are unable to receive timely assessments and interventions. Those who can afford it often turn to costly private assessments and tutoring as a bridge to interventions.
This financial burden, combined with limited access to professional evaluations, particularly affects marginalized children or those coming from lower-income backgrounds. Research by Gander & Campbell indicates that these children are more frequently referred for behavioural issues but are less likely to undergo PEAs, hindering their ability to receive the necessary support.
Accessing proper assessments and interventions should be a right for all children.
The absence of early intervention and learning support not only impacts children and their families but also has important social and economic repercussions. The Pediatricians Alliance of Ontario and the Physicians of Ontario Neurodevelopmental Advocacy (PONDA) emphasize the crucial role of literacy in influencing health outcomes. Additionally, the Canadian Association of Chiefs of Police reports that investing in early childhood literacy and learning benefits individuals and reduces societal costs associated with low literacy, such as high unemployment and crime rates.
Accessing proper assessments and interventions should be a right for all children. Instead, kids are stuck between the struggling policies of the health-care and educational systems. It is time to address this overlooked issue. Policy changes must be implemented to ensure that all students, regardless of their background or parent’s income, receive the support they need to succeed.
This is why the Ontario Human Rights Commission recommends implementing early and ongoing screenings, starting as early as kindergarten if necessary, to help identify at-risk students promptly. This proactive approach would reduce the chances of children suffering in silence for extended periods. It also suggests advocating for policies to standardize these interventions across the province to ensure that all students, regardless of their socioeconomic background, receive the necessary support for both academic and emotional success.
People for Education reports that improved coordination between health-care and educational systems could significantly enhance the referral and assessment process. Psychiatrists and psychologists should create clear guidelines for referrals to better support schools that lack resources and funding, and to provide proper interventions to those needing them. This collaboration could potentially accelerate the process and expand the range of available support options.
As for the parents feeling powerless in their search for resources and funding, subsidies or sliding-scale payment options should be offered to families who cannot afford private NPEs or PEAs. EdCommodate’s report, Understanding Psychoeducational Assessments in Ontario: Why the Waitlists?, suggests that programs that partner with private psychologists could help to make these assessments more accessible, reducing the financial strain on low-income families and allowing more children to get the necessary interventions.
Parenting twins is a balancing act, especially when the stakes are high and their futures are at play. My son’s NPE provided us with a clear path forward, one that offers specialized support and new opportunities for him to flourish. However, his sister’s journey brought to light the shortcomings in the system, where waiting years for an assessment can lead to missed opportunities to address the underlying issues.
As parents, we are the first and most important advocates for our children. There is nothing more important than health and education and we are stranded in between two systems that work in silos. And while these systems might not be perfect, continued advocacy is needed to ensure that all children have access to the assessments and resources they deserve.
My journey is a reminder that these evaluations aren’t just routine paperwork; they’re essential tools for unlocking potential and building a brighter future, not just for our kids, but for all children who need a fair chance to succeed.
