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Primary Care Liaison

Communication Problems - Unusual Socialization

  • This pre-referral guideline covers communication problems - unusual socialization (potential Autism spectrum disorders - Aspergers disorder) in children from 2-15 years of age.

    Initial work-up

    • Standard history and physical exam. Include history from parents/caregivers regarding onset and course of symptoms, family history of similar problems.
    • Developmental progression e.g.
      • single words = 12-15 m
      • 2 word sentences = 2 yr
      • conversations = 3-4 yr
      • shared attention e.g. pointing = 12 m
      • imaginative pretend play = 18 m
      • eye contact, warm interaction
    • Differential diagnosis e.g. consider language disorder, intellectual disability, hearing loss.
    • Consider administration of  PEDS Screening Tool
    • If child has been previously diagnosed, in addition toRCH referral, consider referral to community based services e.g  Early Intervention Disability Intake and Response Service 

    Recommended pre-referral treatment

    • Demographic data
    • Birth, developmental and medical history
    • Family and social history
    • Copies of previous mental health, language, cognitive, audiology assessments
    • Early Intervention / Treatments: recommended and delivered
    • Response to treatment
    • Audiology results

    When to refer

    • Significant parent concern PEDS Screening Tool 
    • Significant language delay.
    • Unusual repetitive behaviors.
    • Poor social responsiveness.
    • Concern from other agencies (MCH Nurses, childcare, preschool).


    References and more reading

    Guideline developed by specialists at RCH. First published Jan 2008. Reviewed August 2009. Please read  Copyright and Disclaimer