Referral to Community-Based Child Development Services

 

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Many infants admitted to NICU are at risk of developmental problems in childhood. For many infants, developmental problems do not surface until after discharge. However, some infants require referral for developmental follow-up prior to discharge.

Note: National Women’s Newborn Services have a Child Development Unit (CDU) which is distinct from the community-based Child Development Services (CDS).  Please do not confuse the two when making a referral.

In addition, NICU has a developmental therapist service that performs inpatient developmental assessments and intervention.  A referral should be made for infants who are going to require community developmental follow-up and who will be in-patients in NICU for more than a few days.

Generally, there are two situations where developmental follow-up should be arranged prior to discharge.

Infants expected to have developmental problems

  • This includes infants with severe birth asphyxia with persisting neurological abnormalities, infants with significant brain lesions (e.g. major intracranial haemorrhage, periventricular leukomalacia), and infants with syndromes known to involve developmental delay (e.g. Down Syndrome).
  • Early referral to the appropriate Developmental Paediatrician within the family’s catchment area.
  • The referring doctor needs to provide sufficient information about the baby’s condition, what clinical course is expected, and what information the parents have been given.
    • It may be most appropriate for this to be done at a specialist-to-specialist level.
  • It is important to specify if a referral has already been made to the appropriate CDS.
  • Early referral (2-3 week prior to discharge) to the appropriate Child Developmental Service within the family’s catchment area.
  • It is important to specify which paediatricians are involved or to whom referrals have been sent.
  • Need to provide sufficient information (including social circumstances, if appropriate) for the CDS to be able to prioritise the needs of the baby and family.
  • Provide a name and contact number so further information can be provided if necessary.

Infants at risk of developmental problems

  • This may include preterm or term infants where developmental concerns are raised prior to discharge, but referral to a Developmental Paediatrician is not indicated at this point
  • An early referral (2-3 weeks prior to discharge) to the appropriate Child Development Service is preferred but is not always possible.
  • Staff need to specify what follow-up arrangements have been made (for example, NWH Paediatrician vs. Starship Paediatrician vs. other paediatrician).
  • Sufficient information needs to be provided for the CDS to be able to prioritise the needs of the baby and family.
  • Provide a name and contact number so further information can be provided if necessary