Autism spectrum disorder (diagnosed or suspected)

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.

    • No emergency indicators identified; routine prioritisation applies
    • Refer to local HealthPathways or local guidelines
    • Developmental optometry and auditory processing assessments are not supported by evidence
    • If a concern about possible autism has been raised but there are no obvious symptoms or other reasons to suspect autism, explore further why the parent is concerned. If the school has suggested this diagnosis, ask that they provide a letter outlining the reasons for the concern.
    • Children with confirmed autism who are medically stable do not require routine assessment.
    • In the majority of cases, it is thought inappropriate for children to wait more than 6 months for an outpatient initial appointment
    • Next of kin or person(s) who is legally responsible for patient consent, with the exception of children under guardianship orders with the Department of Child Safety, Seniors and Disability Services, should be present at the first outpatient appointment.
    • 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
    • Statement of intent – the prioritisation of health services for children and young people in the child protection system

    Clinician resources

    Patient resources

Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Definite history of significant developmental regression such that a progressive neurological disorder is suspected
Category 2
(appointment within 90 calendar days)
  • Children < 6 years who have developmental screening / or allied health assessments indicating difference across communication, social and behavioural domains suggestive of ASD
  • A child:
    • at risk of entering the child protection system (0 – 18 years of age)
    • currently in out of home care (OOHC) (0 – 18 years of age), or
    • Adolescents transitioning to adult healthcare following an out of home care experience (15 – 25 years of age)

    • where they have previously been on a waiting list for this problem and were removed without receiving a service

  • Child whose behaviour is putting self or others at high risk of significant harm (details must be provided)
  • Child who is at risk of being placed into out of home care
  • Child excluded from childcare or school due to developmental concerns
Category 3
(appointment within 365 calendar days)
  • All other referrals

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

  • Detail the parent or carer's concern about behaviour that leads to the concern about communication and, social skills and behaviour
  • 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 absence of concerning features:
    • Clear documentation of any suggestive features for Autism observed by the GP or Clinician
    • Is there definite history of developmental regression, and if so what specific loss of skills has been noted?
    • Is the child expected to be in out of home care supervised by the Department of Child Safety, Seniors and Disability Services for more than 6 months? (ONLY those with developmental delay). If so, do you consider that the child's foster placement is at risk of breaking down due to the child's behaviour?
  • Previous attempts to engage NDIS must be provided
  • Confirmation of OOHC (where appropriate)

3. Additional referral information Useful for processing the referral

Highly desirable information – may change triage category

  • Is physical aggression placing family members (e.g. younger siblings) at risk? If so, provide specific details
  • 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
  • Significant psychosocial risk factors (especially parents mental health, family violence, housing and financial stress, Department of Child Safety, Seniors and Disability Services involvement)
  • School history –exclusions or suspensions

Desirable information- Will assist at consultation

  • Please comment on the duration, severity and intervention to date.
  • For children below school age an assessment report from a developmental therapist such as a psychologist or speech pathologist or both. An assessment from a multidisciplinary child development service is preferred.
  • For children attending school a school guidance officer or education department speech pathology report
  • Family history, including family members affected with ASD, ADHD, learning difficulty or mental illness
  • Either GP assessment of current developmental status (age appropriate, some delay, significant delay) or brief comment on current school educational attainments (good, average, poor, very poor (>2 years behind))
  • Has the child previously been diagnosed with ASD? If so, does the child have access to Commonwealth Government Early Childhood Early Intervention (ECEI-NDIS funding)?
  • 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

  • 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: 4 December 2024

© State of Queensland (Queensland Health) 2023

Except as permitted under the Copyright Act 1968, no part of this work may be reproduced, communicated or adapted without permission from Queensland Health. To request permission email ip_officer@health.qld.gov.au1.