Referral
to Community-Based Child Development Services
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Reviewed by Carl Kuschel
and Rosemary Marks |
April
2002 |
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.
- All infants <1500g are automatically referred to NWH
CDU to have their developmental progress assessed at the age of 18 months
and 4 years (infants <1000g are also seen at 9 months). See also
the
CDU guideline.
- Infants referred to the community-based Child
Developmental Services (CDS) generally require ongoing surveillance and/or
intervention for developmental concerns (e.g. motor delay, feeding
problems). Click here to open a
referral
form.
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).
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- 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.
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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
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- 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
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