Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • nil

For clinical advice, please telephone the relevant specialty service.

Northern Adelaide Local Health Network

Southern Adelaide Local Health Network

Women’s and Children’s Hospital Network

  • Women’s and Children’s Hospital Child Development Unit (08) 8161 7287

Inclusions

Comprehensive developmental assessments including for autism spectrum disorder (ASD) are provided for children with complex developmental concerns in three or more of the following:

  • speech and language problems excluding stuttering
  • fine motor problems - handwriting, cutting, manipulation and dexterity
  • gross motor problems - locomotor, ball skills, coordination, climbing, motor planning
  • sensory processing issues - sensitivities or sensory seeking behaviours
  • socialisation problems not relating to peers, poor play skills, poor non-verbal skills, conversation skills, reduced eye contact
  • restrictive and repetitive behaviours - repetition, inflexible, routines, posturing
  • behaviours as listed
    • repetitive behaviours or play, need for routines or rituals, obsessive interests
    • inflexibility, unusual posturing of the body/movement patterns, unusual use of language
    • children > 5 years – inattentive, hyperactive, impulsive behaviours, poor planning and organisation
    • problems with self-care skills - dressing, feeding self, toileting - excluding constipation
    • learning difficulties - reading, spelling, maths or all
  • comprehensive developmental assessments for suspected ASD are provided for children with complex developmental concerns in three or more of the concerns listed above
  • comprehensive developmental assessments for suspected fetal alcohol spectrum disorder (FASD) are provided for children with complex developmental concerns in three or more of the concerns listed above and prenatal alcohol exposure
  • age limits
    • Flinders Medical Centre Child Assessment Team: up to 15 years (if > 15 years, refer to Women’s and Children’s Hospital)
    • Gordon McKay Child Development Unit: up to 8 years at time of referral (if > 8 years, refer to Women’s and Children’s Hospital)
    • Women’s and Children’s Hospital Child Development Unit: up to 18 years

Exclusions

  • age appropriate out of catchment referrals
  • single area of developmental concern
  • learning difficulties alone
  • behavioural issues alone - oppositional defiant Disorder, conduct disorder, aggressive and/or violent behaviour
  • mental health concerns alone - anxiety, depression, paranoia
  • stuttering
  • attention deficit hyperactivity disorder (ADHD) alone
  • auditory processing disorder
  • toileting/constipation
  • failure to thrive
  • ongoing management for complex presentation diagnosis – please refer to the age-appropriate ongoing management for complex presentation diagnosis

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • nil

Category 2 (appointment clinically indicated within 90 days)

  • developmental assessments for priority cohorts
    • children under Guardianship of the Chief Executive (GOCE)
    • children of Aboriginal and Torres Strait Islander status
    • children less than 3 years old

Category 3 (appointment clinically indicated within 365 days)

  • developmental assessments for all other cohorts

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • past medical, surgical, psychosocial, birth, developmental and immunisation history
  • mother's gestational history with child and prenatal alcohol consumption. Prenatal alcohol exposure risk, where relevant
  • family history if known:
    • autism spectrum disorder (ASD)
    • attention deficit disorder (ADD)
    • learning difficulties
    • mental illness
  • medications and allergies
  • height and weight
  • physical examination findings
  • neurological examination findings

Concerning features including

  • developmental regression
  • significant physical illness
  • unintentional weight loss
  • seizure or neurological features
  • functional impairment -  feeding, toileting or sleep issues
  • behaviours of concern including:
    • features of autism spectrum disorder or fetal alcohol spectrum disorder (FASD); if FASD, please provide information regarding prenatal alcohol exposure
    • features of attention deficit disorder
    • features of oppositional defiant disorder
    • potential for aggression
  • psychosocial factors including parental relationship issues, concerning mental illness, substance abuse, parental disability, family in crisis, or child protection involvement
  • previous management trialled and outcomes

Additional information to assist triage categorisation

  • body mass index (BMI) if child is aged 16 years or older
  • growth chart trends
  • blood pressure trends
  • investigations and assessments if appropriate:
    • genetic test screening
    • speech assessment
    • occupational assessment
    • physiotherapy assessment
    • psychology assessment
  • relevant allied health, diagnostic, imaging reports including location of company and accession number
  • age-appropriate visual acuity examination within last 6 months
  • age-appropriate audiometry examination findings

Clinical management advice

Referrals for diagnostic evaluations in children older than 8 years of age within the catchment for the Northern Adelaide Local Health Network, and in children older than 15 years of age within the Southern Adelaide Local Health Network should be directed to the Women’s and Children’s Hospital.

Referrals for developmental assessment can be initiated by GPs, paediatricians, allied health professionals, educators (including early learning and preschool educators) in consultation with leadership and multidisciplinary services with supporting evidence attached at time of referral. Parallel referral to general paediatrics (public or private) for ongoing management following completion of developmental assessment may be beneficial.

Autism diagnostic assessments have a long wait. Please note once a child is referred, the family and referrer will receive correspondence from the child development unit (CDU). If you have not heard from the CDU following a referral (usually contact within 6 weeks from receipt of referral), please contact to make sure referral has been received.

It is important to note that you will not be placed on a waiting list until the questionnaires are completed.

If you decide to pursue a private assessment, please inform us as soon as possible so that we can offer your appointment slot to another family in need. We are here to support you every step of the way.

Our team is available to assist you with any inquiries or concerns you may have.

Clinical resources

Consumer resources

Reason for request

  • to establish a diagnosis
  • for treatment or intervention
  • for advice and management
  • for specialist to take over management
  • for a specified test/investigation the General Practitioner cannot order
  • for other reason (e.g. rapidly accelerating disease progression)
  • transfer of care from another tertiary service
  • clinical judgement indicates a referral for specialist review is necessary.

Patient demographic details

  • 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

Clinical modifiers

  • 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

Other relevant information

  • 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.
  • Relevant social history, including identifying if you feel your patient is from a vulnerable population, under guardianship/out-of-home care arrangements and/or requires a third party to receive correspondence on their behalf.
  • Triage of a specialist outpatient referral is based on clinical decision making to allocate an appropriate urgency categorisation.
  • Where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating or pregnancy) may affect the urgency categorisation and should be communicated as soon as possible.
  • All new referrals will be triaged by a consultant and appointment times scheduled according to clinical urgency.

Adolescents transitioning from paediatric to adult specialist services require a formal handover from paediatric specialist clinician to adult specialist clinician as well as a formal referral from the referring specialist to ensure initial transfer of care is completed.

The General Practitioners role in this process is to provide support to patients as part of holistic care. All ongoing referrals to specialists can subsequently be provided by the General Practitioner once the transfer of care has occurred.