Skip links and keyboard navigation

Behavioural problem in a child ≥ 6 years


Minimum Referral Criteria

  • Category 1
    (appointment within 30 calendar days)
    • Child in out of home care supervised by the Department of Children, Youth Justice and Multicultural Affairs where there is imminent threat of breakdown of current foster placement due to behaviour
  • Category 2
    (appointment within 90 calendar days)
    • 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, or is unable to attend due to their behavioural challenges
    • Child presenting with moderate-severe behavioural concerns i.e. putting themselves or others at risk of harm, that have associated moderate-severe developmental / learning concerns.
    • 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
    • Sudden change in behaviour in a child who has previously been diagnosed with a developmental condition i.e. FASD, ASD, Intellectual Impairment) Children with significant anxiety or other behavioural concerns who have been seen by mental health or psychology services and have ongoing significant difficulty requiring medical (health) assessment
    • A child currently in out of home care (OOHC) or at risk of entering or leaving OOHC, where they have previously been on a waiting list for this problem and were removed without receiving a service
    • Children with significant behavioural concerns, that have been seen by mental health or psychology services, that are requesting specialist paediatrician review for diagnostic purposes
  • Category 3
    (appointment within 365 calendar days)
    • Most other referrals for behavioural problems in children > 6 years. Child must be concurrently supported / referred to external behavioural services.

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

  • Description of the behaviours of concern
  • If educational setting concerns are present, then a letter from the educational setting must be included in a GP referral. In the absence of a letter from the educational institution provided with the referral, the referral will be categorised Cat 3 unless they meet other non-educational criteria.
  • Report presence or abscence of Concerning features
    • 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 Children, Youth Justice and Multicultural Affairs 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?
  • Confirmation of OOHC (where appropriate)

3. Additional referral information Useful for processing the referral

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 Children, Youth Justice and Multicultural Affairs 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

4. Request

Last updated: 13 June 2023