Services Delivered by Specialized Professionals in Childcare Settings in Québec, Canada: Strengths and Limitations of Current Service Delivery Models.
Gabrielle Pratte, Mélanie Couture, Chantal Camden and 2 others
PMID 40484982WHAT IT FOUND
Childcare administrators in Québec identified ten service delivery models for professionals like SLPs and OTs, categorized by funding source and focus.
Childcare-led models offered flexibility and trust, while healthcare-led models provided free access but suffered from long waitlists and rigid mandates. No single model met all needs.
Key findings
01Ten distinct service delivery models were identified and categorized into four quadrants based on two axes: the funding source (internal to childcare or external) and the focus of the service (child-centred or childcare-centred).
02Services funded directly by childcare providers allowed for greater flexibility and responsiveness to specific staff priorities, facilitating stronger trust relationships between educators and specialized professionals.
03Healthcare-funded services were valued for being free of charge but were limited by long waitlists, regional shortages of professionals, and recommendations that often felt disconnected from the realities of childcare environments.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Results reflect only the perceptions of childcare administrators; the views of specialized professionals, parents, or educators were not included in this phase. The study describes the Québec context, where specific funding mechanisms like the Disabled Child Allowance shape service delivery; these findings may not generalize to other jurisdictions with different funding models. Sampling for interviews was intentional to capture diversity, which may not represent the average experience of all childcare settings.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Social Sciences and Humanities Research Council of Canada and the Canadian Institutes of Health Research.
The easy way to misread this
Do not interpret the identified models as evidence that any specific service delivery approach improves child outcomes. This study reports administrator perceptions of strengths and limitations, not clinical efficacy. The 'best' model depends entirely on local funding, staffing, and the specific needs of the childcare setting.