Behavioural problem in a child ≥ 6 years
Emergency referrals
If any of the following are present or suspected, phone 000 to arrange immediate transfer to the emergency department or seek emergent medical advice if in a remote region.
It is proposed that the following conditions should be sent directly to emergency. This is not a list of all conditions that should be sent to the emergency department, it is intended as guidance for presentations that may otherwise have been directed to general paediatric outpatients:
Does your patient wish to be referred?
Minimum referral criteria
Does your patient meet the minimum referral criteria?
Category 1
Appointment within 30 days is desirable
- Primary school child needing a medical assessment due to a recent change in behaviour that has resulted in being expelled or repeatedly suspended from school for more than 50%of the last 3 months
- Sudden change in behaviour with a suspected medical comorbidity as a possible cause
- Children with significant anxiety who have been seen by mental health or psychology services and have ongoing significant difficulty requiring medical assessment
Category 2
Appointment within 90 days is desirable
- Primary school child needing a medical assessment due to a recent change in behaviour that has resulted in being expelled or repeatedly suspended from school for more than 50%of the last 3 months
- Sudden change in behaviour with a suspected medical comorbidity as a possible cause
- Children with significant anxiety who have been seen by mental health or psychology services and have ongoing significant difficulty requiring medical assessment
Category 3
Appointment within 365 days is desirable
- Most other referrals for behavioural problems in children > 6 years
If your patient does not meet the minimum referral criteria
Consider other treatment pathways or an alternative diagnosis.
If you still need to refer your patient:
- Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
- Please note that your referral may not be accepted or may be redirected to another service
Other important information for referring practitioners
Not an exhaustive list
- Refer to local care pathway
- The following children should be directed to Child and Youth Mental Health Services
- children who may be at risk of self-harm
- aggressive behaviour with high risk of significant injury to vulnerable family members
- primary school child with significant school refusal due to anxiety
- Raising children network www.raisingchildren.net.au
- If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, you need to contact Child Safety Services: https://www.communities.qld.gov.au/
- In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
Referral requirements
A referral may be rejected without the following information.
- General referral information
- Description of the behaviours of concern
- A letter from the school outlining behaviours of concern is required if school based behaviours are the primary reason for the referral.
- Report presence or abscence of red flags
Presence or abscence of red flags
- Is physical aggression placing family members (e.g. much younger siblings) at risk of injury? If so, provide details outlining which family members and why they may be at risk of injury. Consider referral to Child Youth Mental Health service as per other useful information
- Is the child expected to be in out of home care supervised by the department of child safety for more than 6 months?. If so, do you consider that the child’s foster placement is at risk of breaking down due to the child’s behaviour?
Highly desirable information – may change triage category
- Brief comment on current school educational attainments (good, average, poor, very poor (>2 years behind))
- Guidance officer assessment or other information from the school.
- Information about school attendance, expulsion or suspension.
- estimate number of days suspended in the previous 3 months.
- estimate number of days missed because of school refusal.
- Previous medications or therapies used.
- Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, department of child safety involvement)
- Previous services accessed (other paediatricians, mental health services, allied health services, etc.)
- Family history, including family members affected with ASD, ADHD, learning difficulty or mental illness.
- Copies of previous of speech, occupational therapy, physiotherapy or cognitive assessments if available.
- Audiometry
- If the child is in foster care please provide the name and regional office for the Child Safety Officer who is the responsible case manager.
Desirable information — will assist at consultation
- Pregnancy and birth history
- Other past medical history
- Immunisation history
- Developmental history
- Medication history
- Height/weight/head circumference and growth charts with prior measurements if available.
- Other physical examination findings inclusive of CNS, birth marks or dysmorphology
Out of catchment
Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.
- Impact on employment
- Impact on education
- Impact on home
- Impact on activities of daily living
- Impact on ability to care for others
- Impact on personal frailty or safety
- Identifies as Aboriginal and/or Torres Strait Islander
- To establish a diagnosis
- For treatment or intervention
- For advice and management
- For specialist to take over management
- Reassurance for GP/second opinion
- For a specified test/investigation the GP can’t order, or the patient can’t afford or access
- Reassurance for the patient/family
- For other reason (e.g. rapidly accelerating disease progression)
- Clinical judgement indicates a referral for specialist review is necessary
- Presenting symptoms (evolution and duration)
- Physical findings
- Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
- Body mass index (BMI)
- Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
- Current medications and dosages
- Drug allergies
- Alcohol, tobacco and other drugs use
- Full name (including aliases)
- Date of birth
- Residential and postal address
- Telephone contact number/s – home, mobile and alternative
- Medicare number (where eligible)
- Name of the parent or caregiver (if appropriate)
- Preferred language and interpreter requirements
- Identifies as Aboriginal and/or Torres Strait Islander
- Full name
- Full address
- Contact details – telephone, fax, email
- Provider number
- Date of referral
- Signature
- Willingness to have surgery (where surgery is a likely intervention)
- Choice to be treated as a public or private patient
- Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
Send referral
Hotline: 1300 364 938
Fax: 1300 364 952
Electronic: eReferral system
Mail: Metro North Central Patient Intake
Aspley Community Centre
776 Zillmere Road
ASPLEY QLD 4034
Health pathways
Access to Health Pathways is free for clinicians in Metro North Brisbane.
For login details email:
healthpathways
Login to Brisbane North Health Pathways:
brisbanenorth.