This pre-referral guideline covers learning difficulties and school problems in children from 5-18 years of age.

Initial work-up

History

• Standard history and physical exam. Include history from parents/ caregivers regarding onset and course of symptoms and family history of similar patterns.
• Hearing and vision assessment.
• School history.
• Consider contributing causes eg anxiety, family dysfunction, auditory processing problems.
• Consider co-morbidities e.g.ADHD, other  behaviour disorders, language disorders, developmental disorders, intellectual disability.
• Consider administration of PEDS Screening Tool (Parents' evaluation of developmental status)

When to refer

• Significant parental concern PEDS Screening Tool
• Child not functioning as expected in school.
• Cause of learning problems not clear.
• Routine school supports e.g. reading recovery, not effective or not sustained.
• Previous assessments not well understood, or integrated into school or homework programs.
• Child developing anxiety, low self esteem.

Information needed

• Demographic data.
• Birth, developmental and medical history.
• Family and social history.
• School history.
• Copies of previous of mental health, language, cognitive, audiology assessments.
• Treatments: recommended and delivered.
• Response to treatment.
• Information regarding previous medication interventions.

Resources

Kids Connect (RCH Primary Care Liaison)

Kids Health Info (Parent factsheets online)

Contact information