The community social pediatrics approach as developed by Dr. Gilles Julien has been the subject of several evaluations. The results of these evaluations are included below.
In order to reach the objective of helping 20,000 vulnerable children and their families by 2021, the Fondation Dr. Julien promote initiative in the field of social pediatrics and provide support to new centers.
This research aims at identifying communities most at risk for social and economic poverty indicators so that it can target its initiatives to Québec’s most vulnerable children and families. To do so, datasets from different agencies (famille, éducation, santé et service sociaux, travail) will be cross-referred to create different indicators for social and economic poverty.
More precisely, objectives of the research are to:
- Operationalize two concepts central to social pediatrics: “vulnerability” and “community”.
- Conduct a province-wide analysis to identify communities most at risk based on the concentration of pre-determined vulnerability indicators. This analysis will be carried out on the smallest territorial unit available (CLSC or FSA).
- Draw up a portrait of the communities in which social pediatrics clinics have already been implanted and are operational based on the indicators and indices used to identify at-risk communities.
Final report will be submitted early in the year 2017 and will outline all analysis performed for the project as well as recommendations for the targeted communities. It will also include visual representation – a map – of communities based on their level of vulnerability.
Tonino Esposito, PhD, Adjunct Professor and Canada Research Chair, School of Social Work, Université de Montréal
Catherine Roy, PhD, Researcher, Centre for Research on Children and Families, McGill University
Nico Trocmé, PhD, Director and Philip Fisher Chair in Social Work School of Social Work, McGill University
La musicothérapie est une pratique appliquée dans de nombreux milieux de prévention et d’intervention. Elle utilise les qualités expressives et motivationnelles de la musique afin d’influencer positivement le bien-être, la santé mentale, physique et spirituelle. La musicothérapie est intégrée à l’approche de pédiatrie sociale au Québec depuis 2011, mais aucune recherche reliant ces deux approches n’a été écrite.
Dans son mémoire de maîtrise, Sandrine Zuyderhoff dresse un cadre théorique de l’application de la musicothérapie dans un milieu de pédiatrie sociale en communauté. Elle s’appuie sur son expérience personnelle de musicothérapeute à la Fondation du Dr Julien, ainsi que celle de collègues œuvrant dans différents centres. Cette recherche prend la forme d’une réflexion ouverte sur les questionnements et les bénéfices d’une telle pratique dans le milieu précis de la pédiatrie sociale. Elle aide à comprendre non seulement les différents principes qui sont appliqués, mais aussi les enjeux rencontrés par les musicothérapeutes. Cette démarche originale est la première à examiner la combinaison des deux approches, elle représente donc un outil important pour le développement et le rayonnement d’une telle thérapie au sein du réseau de la pédiatrie sociale en communauté.
Regard mixte sur certaines particularités et retombées de l’approche de la pédiatrie sociale telle qu’implantée au Québec et sur son intégration dans le système actuel des services sociaux et de santé. Rapport de recherche [A Look at Certain Features and Benefits of the Social Pediatrics Approach as Practised in Québec and at its Integration into the Current Health and Social Services System. Research Report] - Evaluation, overall approach
This study looked at the approach used in community social pediatrics centres (CSPCs) in five regions in Québec (Montreal, Gatineau, Lévis, Saint-Jean-sur-Richelieu and Trois-Rivières) from 2011 to 2014.
It highlighted two features that distinguished these centres from other organizations in the health and social services system: 1. Access to diagnoses and comprehensive health services for children at risk; and 2. Provision of medical, specialized, psychosocial and, in some cases, legal services all in the same place, in order to meet the range of children’s and families’ needs.
Results also suggested that the CSPCs had ties with a number of different sectors involved with the children and families (education, health, social and legal services, recreation) and that these ties were closer with the public health and social services network than with community organizations.
As to how children and families benefited from CSP practice, the study’s results suggested that, after one year, CSP interventions contributed to improving the children’s socio-emotional development, relationships between parents and children, and the parents’ sense of being supported by a formal and informal social support network.
For more information
- Marie-Ève Clément, Lead Researcher, Psychoeducation and Psychology Department, Université du Québec en Outaouais
- Jacques Moreau, Lead Co-Researcher, Université de Montréal
- Sophie Léveillé, Project Coordinator, Université de Montréal
- Sylvie Gendron, Université de Montréal
- Chantal Lavergne, Centre jeunesse de Montréal-Institut universitaire
- Geneviève Turcotte, Centre jeunesse de Montréal-Institut universitaire
- Anne-Marie Piché, Université du Québec à Montréal
- Annie Bérubé, Université du Québec en Outaouais
- Marie-Hélène Gagné, Université Laval
- Marc Alain, Université du Québec à Trois-Rivières
- Ghayda Hassan, Université du Québec à Montréal
- Geneviève Pagé, Université du Québec en Outaouais
- Francine de Montigny, Université du Québec en Outaouais
- Annick St-Amand, Université du Québec à Trois-Rivières
2011 to 2014
Report commissioned by
Ministère de la Santé et des Services sociaux (MSSS)
The primary objective of the Knowledge Acquisition and Transfer Project in Community Social Pediatrics was to document community social pediatrics practice (knowledge, skills and abilities) as it was developed by the Fondation du Dr Julien’s expert centres. Two documents came out of this process: a document outlining community social pediatrics (CSP) practice and a certification tool. These are primarily meant to support community social pediatrics centres (CSPCs) and provide them with guidelines for their operations and the roles of professionals working there.
The evaluation team’s task was to review the knowledge building process (both explicit and tacit), to determine whether it addressed the needs of intended users in CSPCs supported by the FDJ and to make recommendations to improve knowledge transfer to the user communities.
The study’s results show that:
- The document outlining CSP practice and the certification tool were consulted by the vast majority of respondents.
- Participants in the study felt that the document outlining CSP practice was comprehensive and useful, and that it helped them fully understand the model and shape their practice.
- These same participants thought that the certification tool established clear criteria that became reference points for the CSPCs to gauge where they stood relative to each objective (this was more difficult when it came to assessing an overall level). It also provided guidelines, which helped them improve their practice and the services offered.
- They also found the collaborative approach to preparing documents both relevant and useful.
- Using all the information found in the document outlining CSP practice was a major challenge, given the large amount of data.
For more information
Research report (in French only)
Christian Dagenais, Ph. D., Researcher, RENARD team, Université de Montréal
Didier Dupont, M.Sc, Social Sciences Research Specialist, Université de Montréal
Frédéric N. Brière, Ph. D., Boscoville 2000 / Research Group on School Environments (GRES)/RENARD team, Université de Montréal
The Accès à l’école program was started in 2005 by Dr. Gilles Julien and the principal of St-Pascal Baylon school in the Côte-des-Neiges district of Montreal. Its aim was to increase pre-kindergarten enrolment (4 year olds) in order to prevent major problems that occurred when children started school, including a poor grasp of French and the difficulty some children had in leaving their parents. Schools and the Côte-des-Neiges community social pediatrics centre designed the Accès à l’école program together and it quickly attracted interest from several other schools.
In 2008, the Ministère de l’Éducation, du Loisir et du Sport [Québec Education Ministry] granted funding to the Côte-des-Neiges community social pediatrics centre (CSPC) to set up the program in several other schools in Côte-des-Neiges and Hochelaga-Maisonneuve. The program was implemented in thirteen schools in 2009.
A portion of the Ministry’s funding also went to evaluating the program. The evaluation looked at the program’s implementation and its impact on parents, children and schools.
The evaluation showed at the outset that the program was implemented in line with the conceptual model and in the same way throughout the schools involved.
The immediate effects were felt primarily by teachers and included: increased involvement in the school, better preparation for the children’s arrival at the beginning of the school year, a feeling of being better equipped to step in, a more positive attitude towards children attending pre-kindergarten and a smoother start to the school year.
The program also gave parents the information they needed to prepare their children for school and gave them a clearer sense of what would happen when the school year began.
Finally, the tools used to measure the children’s development did not show that the program had an effect on the children’s socio-emotional development, nor that it contributed to children being better prepared cognitively for school, despite the fact that comments by teachers suggested some beneficial results.
Reviewers noted that the evaluation provided food for thought on setting up transition-to-school programs.
For more information
Result of implementation (in French only)
Results of outcomes (in French only)
- Gilles Cantin, Professor, Department of Education and Pedagogy, Université du Québec à Montréal
- Caroline Bouchard, Professor, Department of Teaching and Learning Studies, Université Laval
- Annie Charron, Professor, Department of Education and Pedagogy, Université du Québec à Montréal
- Julie Lemire, Research Specialist, Université du Québec à Montréal
2008 to 2011
Ministère de l’Éducation, du Loisir et du Sport
The Assistance d’enfants en difficulté (AED) centre, now known as the Hochelaga-Maisonneuve Community Social Pediatrics Centre, set up a Preventing Parental Neglect program (PPN) in a bid to address problems caused by parental neglect in the short, medium and long term.
The goal was to follow up systematically with families where one (or both) parents had previously been identified as being at risk of neglecting their child(ren). The program was intended to provide resources and tools to the parents and to support them in their parenting role. At the same time, it fostered attachment between the child and parent(s) so that the child’s needs could be met within the natural family setting.
The program underwent an evaluation that could be qualified as “exploratory”, given the innovative nature of the initiative and the evaluation methodology’s limitations.
Its objectives included:
- Document users’ perception of the care and services provided within the context of the program.
- Identify the benefits that users considered to be most important.
- Identify the main benefits for users based on the PPN individual case plans.
- Review whether the services provided and the users’ perceived benefits were consistent with program objectives.
Results showed that:
- The PPN led to a significant number of children staying in their family settings.
- Parents who participated in the program noticed positive changes in their parenting skills and self-confidence, and felt the quality of the relationship with their children improved.
- Parents who participated stated that AED was a positive presence in their family environments, and that it reassured them and contributed to their support needs.
The evaluation submitted two hypotheses for further exploration, namely that AED could be 1) involved in resilience tutoring for families and 2) a protective factor for children.
For more information
Summary of research results (in French only)
Sophie Marcoux, M.Sc. Ph.D.
2009 to 2010
Ministère de la Santé et des Services sociaux
The Child’s Protective Circle is a mediation process developed and set up by Hélène (Sioui) Trudel that is part of community social pediatrics practice. It grew out of a desire to share the decision-making power traditionally held by various professionals and practitioners with the child and members of the family network. The first step toward sharing power is to engage the child, key people in his or her life and the main practitioners and professionals already involved with the family. The next step relies on participants’ willingness to build trusting relationships with each other. The objective of the Child’s Protective Circle is to get participants to work together to meet children’s needs more effectively with a focus on implementing the 1989 Convention on the Rights of the Child.
McGill University’s Centre for Research on Children and Families conducted a study to explore and describe this intervention model. Ten circles were observed during the summer of 2008 and the fall of 2009. Descriptive data were collected, including: 1) the families’ and networks’ participation; 2) their impressions of the Protective Circle; 3) access and use of shared resources; and 4) information sharing among partners.
The evaluation’s goals were to:
- Identify challenges around rallying program partners.
- Determine how the Protective Circle was perceived within the community.
- Study which factors fostered or hindered mobilization of family networks.
The authors offered several observations and drew a number of conclusions, most notably:
- The model met a need expressed by the families and the network’s practitioners.
- It was suitable and useful for building partnerships.
- It pushed people in the child’s informal networks to be more aware of what he or she was experiencing and got them involved in countering the child’s social isolation.
- It was feasible and desirable but extremely complex. Aligning visions and finding the most effective ways of working together posed particular challenges to family, community and institutional partners who were being asked to collaborate with each other.
- The meeting was not sufficient in and of itself to resolve all problems. In conflict situations, it was only the first step toward establishing a working relationship. Adding follow-up Protective Circles and maintaining open communication between the main partners were key to ensuring that the safety net created by the Protective Circle would survive over time.
- Adding follow-up Protective Circles has become an integral and very important part of the process, and contributed to its changing nature. More time can be taken to come to decisions, which can better reflect the changing realities of many children. The process has to include new practitioners along the way who are not used to the model. This rapid transformation is a testament to the model’s flexibility and its potential to adapt and change.
For more information
Summary of research results (in French only)
- Nico Trocmé, Ph. D. in Social Work, Director and Professor, School of Social Work, McGill University
- Anne-Marie Piché, Centre for Research on Children and Families, McGill University
- Elizabeth Fast, Centre for Research on Children and Families, McGill University
- Angela Campbell, Centre for Research on Children and Families, McGill University
2008 to 2011
- J.W. McConnell Family Foundation
- Power Corporation of Canada
- Fondation des Gouverneurs de l’espoir
The Assistance d’Enfants en Difficulté (AED) Program, now known as the Hochelaga-Maisonneuve Community Social Pediatrics Centre (CSPC), grew significantly during the 2000s. Founder Dr. Gilles Julien requested an evaluation of AED activities and their impact on the centre’s users and the community, with an eye to maintaining the program’s standards and improving the quality of services offered.
The objective was two-fold.
- Corroborate AED’s relevance with respect to users’ needs.
- Support AED’s development by identifying its key features and priorities for improvements to the program.
The evaluation showed that AED:
- Appeared to meet the needs of troubled children.
- Addressed an important problem which had repercussions throughout a child’s entire life and for which an integrated approach had been largely absent.
- Offered innovative programming that was completely in keeping with the principles of social pediatrics on which it was based.
- Targeted risk factors identified in the scientific literature.
In order to facilitate expansion of the program, the evaluation suggested:
- Explaining in detail and describing AED’s client selection process to set guidelines for providing care and services to 6- to-12-year-old children, including the process’s limitations.
- Further clarifying how working with parents to support their parenting skills fits in conceptually with the services offered by AED.
- Outlining the criteria used to decide which and how often activities would be provided.
Finally, the evaluation noted that two of the program’s objectives, i.e., “Encourage various levels of government to take a more active role in improving services for disadvantaged children and high-risk families” and “Protect the rights of children and families in their home environments” appeared to be peripheral to AED’s mission, given its limited means and resources.
For more information
Research report unavailable in digital format
François Chagnon, Researcher, Institut de recherche pour le développement social des jeunes, Chaire d’étude sur l’application des connaissances dans le domaine des jeunes et familles en difficulté, Université du Québec à Montréal
Louise Pouliot, Research Specialist, Université du Québec à Montréal
Two studies of the Assistance d’Enfants en Difficulté (AED) and the Centre de services préventifs à l’enfance (CSPE) programs – now known as the Hochelaga-Maisonneuve and Côte-des-Neiges Community Social Pediatrics Centres (CSPC) – were undertaken during the 2000s by a team of researchers at the Centre de recherche et de formation du CLSC Côte-des-Neiges (CIUSSS du Centre-Ouest-de-l’Île-de-Montréal).
These studies took a critical look at the development of the two centres, which were still in the early development stages at that time, and which used an approach focused on empowerment, collaboration across a range of sectors and disciplines, and bringing a variety of community and social actors together.
Two reports emerged from these studies. They described the way the CSPE was set up, AED’s operating model in its early years, both centres’ activity sectors and their networks of partners. Several points of view were presented, including those of practitioners, partners and parents using the centres’ services.
For more information
Report on AED: Action communautaire, empowerment et construction identitaire : ethnicité et pauvreté. Unavailable in digital format.
Report on CSPE: Recherche évaluative du Centre de services préventifs à l’enfance de Côte-des-Neiges. Unavailable in digital format.
Jacques Rhéaume, Researcher, Centre de recherche et de formation du CLSC Côte-des-Neiges, Université du Québec à Montréal
Denise Roy, Research Specialist, Centre de recherche et de formation du CLSC Côte-des-Neiges, Université du Québec à Montréal
2001 to 2003 (AED)
2003 to 2006 (CSPE)