Development delay in children < 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
- Definite history of developmental regression
- Significant developmental delay in an infant less than 1 year
Category 2
Appointment within 90 days is desirable
- Severe developmental delays
- Developmental delay with related medical co morbidities
- Child not walking at 18 months
- Marked low tone or high tone
- Differences between right and left sides of body in strength, movement or tone
- Child expected to be in out of home care supervised by the department of child safety for more than 6 months (only those with developmental delay)
Category 3
Appointment within 365 days is desirable
- Moderate developmental delay/ multiple domain concerns
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
- Developmental optometry and auditory processing assessments are not supported by evidence
- Delay across multiple developmental domains is more likely to be associated with significant impairment and require general paediatric review
- The chronological age versus the “developmental age” (which should be available through screening) can be used as a gauge of functional severity. Considering a 4 year old child:
- MILD – 6 months delayed
- MODERATE – 12 months delayed (i.e. a 4 year old who acts more like a three year old re abilities)
- SEVERE – 18-24 months delayed (i.e. a 4 year old who has the abilities of a 2-21/2 year old child)
- Refer to allied health professional for an assessment and/or intervention and review within a pre-determined period of time (e.g. 3-6 months)
- Red flag referral guide link: https://www.childrens.health.qld.gov.au/chq/our-services/community-health-services/child-development-program/
- Mild or unspecified developmental concerns, including isolated speech delay, should be initially referred to community child health nurse or to a community allied health provider rather than to general paediatric outpatients
- Refer for hearing/vision testing as part of differential diagnosis and co- morbidities.
- Parents’ evaluation of developmental status (PEDS) screening tool – is an evidence based screening tool that elicits and addresses parental concerns about children’s development, health and wellbeing. PEDS is a simple, 10-item questionnaire that is completed by the parent. http://www.pedstest.com/default.aspx
PEDS is available in the “red book” (hand held child health record) and can be used informally to ascertain concern across single domain or multiple domains. Child Health Nurses are able to formally administer this. http://www.rch.org.au/ccch/resources_and_publications/Monitoring_Child_Development/ - In the majority of cases it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
Ages and stages questionnaires are available online and can be completed by practice nurse in conversation with parent or formally by Child Health Nurse. Ages and stages questionnaires are not free but may be purchased on line. http://agesandstages.com/products-services/asq3/ - 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/
Referral requirements
A referral may be rejected without the following information.
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.