Exclude Hearing Loss Paediatric

PAEDIATRIC

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

    Adult

    • Hearing loss
      • Sudden loss or sudden deterioration of hearing (sudden = within 72 hours) (British Academy of Audiology, 2016)
    • Otitis media
      • Any suspicions of the complications of ASOM i.e. Mastoiditis (proptosis of pinna), meningitis etc
    • Vertigo/Vestibular
      • Recent sudden onset with neurological symptoms
    • Facial Nerve Palsy
      • Sudden onset facial weakness

    Paediatric

    • Paediatric Hearing loss
      • Sudden loss or deterioration
    • Paediatric Otitis media
      • Any suspicions Mastoiditis (proptosis of pinna), meningitis or other complication of ASOM
      • Trauma
      • New onset facial nerve palsy
    • Other referrals to emergency not covered within these conditions (Paediatric)
      • Foreign body
      • ENT conditions with associated neurological signs e.g. facial nerve palsy, profound vertigo and/or sudden deterioration in sensorineural hearing
      • Acute and/or complicated mastoiditis
      • Auricular haematoma
      • Significant head injury
      • Congenital abnormality of the head/neck
      • Meningitis/encephalitis
    • Refer to Health pathways or local guidelines
    • These referrals may meet criteria for hearing screening. Consider local hearing screening services if available before referring to hospital clinics
    • Consider referral to speech pathology or child health clinician for developmental speech and language screening in children
    • Consider referral to General paediatrician if there are significant developmental delays
    • Consider protective factors such as referral to local Early Years services and playgroups
    • Manage any middle ear pathology initially
    • Hearing impairment may be permanent or temporary
    • Passing newborn hearing screening does not exclude mild hearing loss or preclude late onset or progressive hearing loss
    • Speech discrimination testing
    • Any other health care professionals are currently involved (e.g. other Allied Health Professionals, Health Clinicians).
    • The person's hearing and communication needs at home, or in education, and in social situations
    • Psychosocial difficulties related to hearing
    • Details of any otologic symptoms or pre-existing hearing loss if applicable

    Clinician resources

    Patient resources

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • No Cat 1 criteria
Category 2
(appointment within 90 calendar days)
  • Diagnosed by a speech pathologist as having a severe speech or language impairment
  • Unscreened children (who have not been screened under a universal hearing screen at birth)
  • Refugee screen
  • Suspected Autism Spectrum Disorder
  • Diagnosed with a significant additional disability, syndrome or disorder
Category 3
(appointment within 365 calendar days)
  • Speech and language milestones are delayed
  • Making slow progress with regular speech pathology support
  • Developmental delays
  • Learning or behavioural difficulties
  • School recommendation
  • Parental concern

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • 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

2. Essential referral information Referral will be returned without this

  • Provide information of nature of the speech and language concern
  • Additional behavioural issues including social-emotional issues and impacts on participation e.g. attention at school
  • Social modifiers i.e. effect on home schooling, out of home residence
  • Otological history

3. Additional referral information Useful for processing the referral

  • Clinical observation of hearing
  • Previous audiology results or hearing screening
  • Family history of hearing loss/ASD
  • Any other health care professionals are currently involved (e.g. other Allied Health Professionals, Health Clinicians)

4. Request

  • Patient's 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

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • 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

    Reason for request

    • 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

    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.)

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

    • Please note that 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 becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.

    • 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.

Last updated: 21 September 2022

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