Families and clinicians shape mental health support for neurodiverse children

Children with neurodevelopmental conditions can often face daily emotional and behavioural challenges that can be difficult for parents to manage. Interact-North, a virtual, evidence-based program at The Hospital for Sick Children (SickKids), addresses the need for effective, accessible support for parents of neurodevelopmentally complex children. 

A study published in Implementation Research and Practice and led by Dr. Tricia Williams, Clinical Neuropsychologist in the Division of Neurology and Associate Scientist in the Neurosciences & Mental Health program, examined the program’s implementation into clinical settings through family and clinician focus groups. The study identified key facilitators, barriers, and equity, diversity and inclusion considerations, with consistent themes emerging around the program’s flexibility, adaptability and personalized approach as core strengths.  

“In the clinic, I see parents who are striving, and sometimes struggling, to provide the best support for their child. Interact-North gives them evidence-based parenting resources when they need it most, helping families reduce early behavioural problems and foster lifelong mental health,” says Williams, Director of Interact-North and Garry Hurvitz Innovator in Brain Health. 

Personalized support grounded in family needs   

Adapted from the American I-InTERACT program, Interact-North (formerly known as I-InTERACT-North) is a stepped-care parenting resource for families of neurodiverse children with brain injuries, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and related neurodevelopmental conditions.  

The program uses a transdiagnostic model to address a range of related conditions rather than focusing on a single diagnosis. It offers a spectrum of support, from self-guided educational modules to coaching with trained therapists, tailored to meet each family’s unique needs. 

“Interact-North was developed in response to a previous parent needs assessment. Working closely with our patients in clinic, our goal is to reduce stress and help parents navigate the emotional and developmental impacts of these conditions,” says Dr. Rivky Green, a senior therapist with Interact-North.  

Families begin with an introductory consultation with a therapist to understand the family’s background, goals, culture and values. With both online and in-person options, the therapist can then provide parenting guidance that aligns with the family’s needs and dynamics, aiming to support family wellness and stronger parent-child relationships at a pace that suits each family.  

This flexible delivery model has helped families like Leonda and her son Cameryn connect meaningfully with the program. 

A mother of four, Leonda was referred to Interact-North after Cameryn began experiencing challenges at school and was diagnosed with ADHD at age eight.  

In play therapy, she spent structured one-on-one time playing with Cameryn, an activity he eagerly anticipated each week, while actively building skills that helped him to improve his focus. Meanwhile, Leonda participated in a variety of learning modules on topics such as setting children up for success, which equipped her to better prepare for family outings like going to church and to experience fewer conflicts. 

“Sometimes as a parent, the right thing to do might seem obvious, but in the moment, when you’re overwhelmed, it’s easy to forget techniques that will support you and your child,” says Leonda. “The program helped me prepare Cameryn for success. On the surface, it seems like playing games, but it helps build a connection with your child, parenting them from a place of love and understanding.” 

Leonda has since completed the program and continues to contribute as a member of its Family Advisory Committee, a cornerstone of Interact-North's family-centric approach.  

Co-designing support with families  

Interact-North actively involves families in co-design, regularly seeking input from its Family Advisory Committee to improve the program content and delivery. Findings in the recent study from family and clinician groups emphasized the need for greater geographic accessibility and representation.  

“One big finding from the study was the need for more cultural, linguistic and age diversity,” explains Marin Taylor, Clinical Research Project Manager of the NeuroOutcomes lab. “Many of our video modules were not representative enough of Canadian diversity. Families also wanted fewer ‘perfect’ examples to better reflect real-life parenting challenges.”  

The research team has incorporated much of this feedback over the last two years: today, approximately 50 per cent of the content has been updated to better reflect the realities of families, with all new content reviewed by the Family Advisory Committee.  

Shaping accessible, inclusive behavioural care support nationwide 

Aligned with Precision Child Health, a movement to individualize care for patients and families at SickKids, Interact-North supports both medical and family needs through a stepped-care model. This approach gives flexibility for parents in commitment, intensity and therapist involvement, along with access to a broad range of content.  

To date, the program has supported over 600 SickKids families, with 92 per cent of parents reporting an improvement in their child’s behaviour, and continues to evolve to meet the needs of the diverse communities it supports. Plans are underway to expand the program’s age range to include content for parents of children as young as 18 months.  

Using implementation guidelines developed by Dr. Melanie Barwick, Scientific Director of the Knowledge Translation Program in the Learning Institute and Senior Scientist in the Child Evaluative Sciences program, the team hopes to move toward long-term integration within SickKids and is working to share the program’s core model with hospitals across Canada. Expansion is already in progress, with SickKids leading new collaborations with psychologists and care teams at Alberta Children’s Hospital, BC Children’s Hospital and CHU Sainte-Justine.  

“Interact-North is paving the way for accessible mental health care, not only for SickKids families but for families everywhere,” says Williams.  

This study was funded by the Canadian Institutes of Health Research (CIHR), the Garry Hurvitz-Centre for Brain and Mental Health and the Edwin S.H. Leong Centre for Healthy Children.