Behavioural problem in a child ≥ 6 years
PAEDIATRIC
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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.
- Suicidal or immediate danger of self-harm
- Aggressive behaviour with immediate threatening risk to vulnerable family members
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| Category 1 (appointment within 30 calendar days) |
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| Category 2 (appointment within 90 calendar days) |
where they have previously been on a waiting list for this problem and were removed without receiving a service |
| Category 3 (appointment within 365 calendar days) |
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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
- 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 absence 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 Child Safety, Seniors and Disability Services 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 Child Safety, Seniors and Disability Services 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
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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.)
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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
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