There are a number of resources to help you implement the enhanced 18-month visit in your practice. This web page contains a selected short-list of some of the key tools, service information, patient education, and reference resources associated with the visit. Our comprehensive resource database has additional documents and links as well. A directory of early child development and parenting system resources with contact numbers by region is also under development.
The Rourke Baby Record (RBR) is an evidence-based health supervision guide for primary healthcare practitioners of children in the first five years of life. This is the July 2011 Ontario version of the RBR, and Guide IV of the RBR contains the column dedicated to the 18-month visit.
The Nipissing District Developmental Screen® (NDDS) was compiled by a multi-disciplinary team, and is an easy-to-use tool that explores a child's skills in the following areas: vision, hearing, speech, language, communication, gross motor, fine motor, cognitive, social/emotional and self-help. Age appropriate activities which are designed to promote overall development accompany the Screens.
Video examples showing a child successfully demonstrate each item and activity on the NDDS® checklist.
This collection of resources on core topics related to the 18-month visit includes a variety of tools and references that have been indexed. You can perform a keyword search for resources, or browse by categories (e.g. search for resources related to nutrition or behaviour, or patient education handouts).
A downloadable version of the Toronto specific Early Childhood Resource Pathway.
A list of Toronto area resources by specialization including a brief description and phone number.
As part of the Rourke Baby Record, the growth of all full term infants and preschoolers should be evaluated using growth charts from the 2006 World Health Organization Child Growth Standards with measurement of recumbent length, weight, and head circumference.
A reference guide for Ontario physicians including information about factors that influence child development, signs of atypical development, links to local services, and much more.
A searchable database providing easy access to community, social, health and related government services in Ontario. Users can search by topic or location making finding local services easy.
Designed to provide info regarding services available in communities, this chart illustrates the organization of local early child development and parenting resources across a community, region or district so that young children are offered the opportunity for healthy development and the best start in life.
Fill in this outline of screening and treatment/intervention resources with your local contact numbers as a handy job aid.
A great resource to promote communication between parents and professionals, improve developmental outcomes for children, and encourage families to use local community resources such as Ontario Early Years Centres.
The MCYS of Ontario website with info on programs and services for both the public and health care providers. Including - in the section on Early Childhood - information on the Best Start program, Ontario Early Years Centres, Healthy Babies Healthy Children program, Hearing, Blindness and Low Vision, and Speech and Language.
The OCFP is the Ontario chapter of the College of Family Physicians of Canada(CFPC) and a voluntary, not-for-profit organization that represents more than 8,400 family physicians who provide patient care for remote, rural, suburban, urban and inner city communities throughout Ontario. The OCFP has been a leading organization in advocacy, research and education about healthy child development for many years, and helped to lead the establishment of the enhanced 18-month well-baby visit.
OntarioMD works with and on behalf of physicians to leverage information technology (IT) to meet the growing needs of patients and physicians. Established by the Ontario Medical Association and the Ministry of Health and Long-Term Care, OntarioMD manages the EMR Adoption Program, which funds and assists physicians to acquire, implement and adopt IT. OntarioMD is working to help implement electronic tools to help with the 18-month visit.
The Ministry's vision is to enable Ontarians to lead healthy, active lives and make the province a healthy, prosperous place to live, work, play, learn and visit.
The Ministry of Health and Long-Term Care is working to establish a patient-focused, results-driven, integrated and sustainable publicly funded health system.
The Canadian Paediatric Society is the national association of paediatricians, committed to working together to advance the health of children and youth by nurturing excellence in health care, advocacy, education, research and support of its membership.
The mission of the Centre of Excellence for Early Childhood Development (CEECD) is to improve our knowledge of the social and emotional development of young children.
Screening and intervention resources with contact info for Hamilton, Ontario.
Information for both the public and health care professionals on a variety of health initiatives.
This document provides the background, rationale, instructions, and planning guide for developing a Quality Improvement Plan for the enhanced 18-month well-baby visit.
Evolving neuroscience reveals an ever-strong relationship between children’s earliest development/environment and later life experience, including physical and mental health, school performance and behaviour. Paediatricians, family physicians and other primary care providers need to make the most of well-baby visits—here a focus on an enhanced 18-month visit—to address a widening 'opportunity gap' in Canada. An enhanced visit entails promoting healthier choices and positive parenting to families, using anticipatory guidance and physician-prompt tools, and connecting children and families with local community resources. This statement demonstrates the need for measuring/monitoring key indicators of early childhood health and well-being. It offers specific recommendations to physicians, governments and organizations for a universally established and supported assessment of every Canadian child’s developmental health at 18 months.
A child’s early experiences and environments have a significant, measurable effect on later life trajectories of health and well-being. Each child’s own world, especially parents and other caregivers, literally sculpts the brain and impacts stress pathways. Effective early childhood interventions exist that can improve adult and societal outcomes. In this statement, the Canadian Paediatric Society calls on federal and provincial/territorial governments to measure and monitor the developmental progress of children in Canada, which can vary widely among communities and demographic groups. The statement explores the objectives for collecting quality information about early child development, its determinants and long-term outcomes. It also examines four approaches to collecting population based, person-specific and longitudinal data, both in young children and later in life. A key outcome of monitoring development is timely intervention. Linking individual data to the home and community levels is a critical step, so that communities and governments can monitor and take actions that support early child development.
Families raising young children need all the support they can get. In Canada we are making progress. Mothers are supported with universal pre- and postnatal care. All babies are screened at birth. Newborn home visiting is widespread and family centres are found in most neighbourhoods. It is between the end of parental leave and the beginning of schooling that supports break down and public policy is confused about what to do. Ensuring that all young children enjoy the best preschool that we can devise is Canada’s unfinished business. This report is intended to show where we are, what we know and what we can do to finish the job.
The following article entitled "Ontario's Enhanced 18-Month Well-Baby Visit: program overview, implications for physicians," by authors Robin C Williams, Jean Clinton, David J Price, and Nancy E Novak first appeared in the February 2010 issue of the Ontario Medical Review and is reproduced with the permission of the Ontario Medical Association.
Report of the expert panel on the 18-Month Well-Baby Visit from September 2005.
Ontario College of Family Physicians and Guidelines Advisory Committee final report and executive summary of the evidence-based clinical practice recommendations underpinning the enhanced 18-month well-baby visit.
The following article entitled "Improving early childhood development–part I: proposed enhancements to the 18-month well baby visit, and the critical role of the primary care physician in child development," by authors Robin C Williams, A Biscaro, and J Van Lankveld first appeared in the November 2006 issue of the Ontario Medical Review and is reproduced with the permission of the Ontario Medical Association.
The following article entitled "Improving early childhood development–part II: literacy, the primary care physician, and the enhanced 18-month well baby visit," by authors Robin C Williams, W Watson, J Van Lankveld, and A Biscaro first appeared in the November 2006 issue of the Ontario Medical Review and is reproduced with the permission of the Ontario Medical Association.
Publication available from the Council for Early Child Development website describing the critical importance of children's early interactions in shaping their development.
Publication available on the Council for Early Child Development website building on the findings of the Early Years Study to more closely examine the processes involved in healthy brain development.
A helpful brochure about the new enhanced 18-month well-baby visit and what to expect. This brochure also contains a list of useful websites for parents and guardians.
Information for physicians & other health professionals about the enhanced 18-month well-baby visit.
The Data Dashboard is intended to be a "snapshot" of how the early childhood system of services and supports is helping young children develop and thrive.
Robin Williams, Jean Clinton, and Anne Biscaro. Paediatr Child Health. 2008 December, 13(10): 850-856.