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Primary Care Liaison

Developmental problems

  • This pre-referral guideline provides information for referring children aged 0–18 years with developmental problems.

    When to refer

    • If there are no closer public hospital or community health services available
    • The child has complex medical issues currently managed at The Royal Children's Hospital (RCH)
    • Community management has not adequately addressed the child/ family goals
    • After the referrer has completed/ coordinated the initial workup (see below)

    Exclusion criteria

    Referrals will not be accepted at the RCH for developmental issues if public paediatric clinics or community health services are available to make initial assessments closer to home, or where there is not enough information in the referral to make an informed triage decision.

    Initial workup


    • Onset and course of symptoms; relevant family history
    • Developmental status, including information such as the PEDS or Brigance results child health nurse (MCHN)
    • Diagnoses/ concerns that are under consideration (e.g. autism spectrum disorder, behaviour problems)
    • Information regarding NDIS and/or Early Intervention


    • Developmental and neurological examination


    • Audiology assessment especially if speech delay
    • Optometry or ophthalmology assessment if visual screening by MCHN or GP abnormal

    Alternatives for referrals

    Early Childhood Early Intervention (ECEI) 0–6yo

    When a child’s development is delayed in two or more domains (speech and language, swallowing, fine motor skills, gross motor skills, social development, play or adaptive skills) they should be referred to Early Childhood intervention Services in your region – see

    National Disability Insurance Scheme (NDIS) >7yo

    When there is a concern about a ‘permanent and significant disability and, where the concern is likely to be a chronic condition.

    Community Health

    Depending on location, can offer a range of allied health services (speech pathology, occupational therapy, physiotherapy, psychology, dietetics). Many community health centres restrict eligibility to children who have concerns in a single developmental domain.


    For concerns about learning progress, parents should engage their child’s school. While services vary across Government, Independent and Catholic schools, students may be able to access psychologists, speech pathologists, social workers, and mental health practitioners. School based student support services are best placed to review academic progress, and cognitive and language concerns, as well as to provide advice and guidance on teaching approaches.

    Parents and carers can talk to their child’s teacher about:

    • Concerns about learning progress
    • Concerns about behaviour
    • Concerns about attendance

    Private Health

    Families may choose to access alternative or concurrent health services privately, for example a speech pathologist or psychologist.

    • Fina a Speech Pathologist
    • Find an Occupational Therapist
    • Find a Psychologist

    Information to be included in referral to the RCH

    • Demographic data
    • Birth, developmental and medical history
    • Family and social history
    • Copies of previous of mental health, language, cognitive, audiology assessments
    • Referral form (Word file)
    • Parent handout (PDF)

    Support for referrers

    The RCH Developmental Intake Team triage all referrals with a developmental concern. If you have a question about referring a child with a developmental concern to the RCH, please contact the team:


    • Raising Children Network
    • Parent fact sheets (condition specific)
    • Education department child development information
    • Clinical resources
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