Identifying risk, increasing success

By: Cory Habermehl
Friday, November 20, 2015

Shannon photo for story.jpg

Associate Professor Shannon Stewart is working with a team of international experts to help improve the lives of young children.


A single lesson in a Grade 11 sociology class changed the course of Shannon Stewart’s life.

“I remember the teacher spent one session on the subject of children’s psychology and mental health, and I said ‘wow, that’s exactly what I want to do’,” said Stewart, associate professor at Western’s Faculty of Education. “From that day onward, I knew I was going to help children.”

She was right.

Stewart went on to become a registered child psychologist, and, prior to joining Western, was the head of research at Ontario’s Child and Parent Resource Institute. In addition to her current role at Western, she’s also an associate scientist at the Children’s Health Research Institute (CHRI) as well as an interRAI research fellow.

interRAI is a not-for-profit consortium of international researchers and clinicians from more than 30 countries that develop assessment tools to support the evaluation and treatment of vulnerable populations. It’s there that Stewart led an international team of experts to bring her latest research – an assessment “instrument” for at-risk children from zero to three years of age – to fruition.

Called interRAI 0-3, the instrument helps identify babies, toddlers and preschool children at risk for negative developmental and social outcomes based on a series of questions answered by parents, caregivers and the children themselves, as well as additional information available to clinicians.

“We’re looking to assess many things, at a very early age,” said Stewart. “Everything from fine and gross motor skills, medical diagnoses and emotional development to environment, developmental milestones and toxin exposure.”

Answers and information are entered into a database and the instrument produces an assessment score based on specific algorithms. The instrument then provides evidence-informed treatment plans that were developed in collaboration with experts on three different continents.

Recently, Stewart’s work received funding of $167,000 from the London Community Foundation’s Community Vitality Grant, and more than $470,000 from the Ontario Government’s Poverty Reduction Strategy.

“I think this tool has the potential to bring a very unified approach to assessing these children and to the system of children’s services itself,” said Martha Powell, president and CEO of London Community Foundation. “I’d like to see this as a shared resource and tool for evaluative services across all community agencies.”

Research indicates every dollar spent on early intervention saves the system between $10 - $13 on deep-end services like residential treatment and inpatient care in the future, said Stewart.

The recent funding will help implement interRAI 0-3 in some local community agencies, including the Merrymount Family Support and Crisis Centre, as part of their standard of care for at-risk youth. The instrument will also be used in the newly formed Mary J. Wright Research and Education Centre at Merrymount.

“I’m so grateful for the support we’ve received,” said Stewart. “Without this type of funding, these projects would simply be sitting on the shelf as ideas.”

 Early intervention, she said, is the key to avoiding a host of negative outcomes in the future.

 “We’re trying to give high-risk babies the best start possible, and getting involved early can lead to things like improved educational success, which often diverts children from a trajectory leading to a life of poverty or crime,” she said. “This work can literally help circumvent long-term suffering for children and families.”

 Stewart has already developed similar instruments for other age groups, including children from age 4 to18 with mental health issues, individuals within youth justice facilities, and children with developmental disabilities. Several of these have been implemented internationally. She hopes interRai 0-3 will follow a similar path .

 “This work is transferable to any community in any country around the world,” she said. “I would love to see it utilized internationally to round out the suite of existing instruments, and to help make as big an impact as possible on the lives of the world’s children.”