Useful Management Information

  • CDS Gold Coast Physiotherapy do not see children referred who are already attending school with delayed motor skills.
  • Orthopaedic concerns not related to development (e.g., Talipes Equinovarus, Developmental Dysplasia of the Hip, growing pains) should be referred to the Orthopaedics .
  • CDS Gold Coast Physiotherapy do not see children referred with musculoskeletal problems, swelling or pain without developmental concerns (e.g., ankle sprains).

Clinician Resources

Patient Resources

Minimum Referral Criteria

Does your patient meet the minimum referral criteria?
Category 1 (appointment within 30 calendar days)

Very Severe Motor Skill Delay - A concurrent referral to Paediatric Medicine at GCUH must also occur

  • Significant developmental delay in an infant < 12 months of age
  • Infant < 12 months with concerns around quality of movement patterns which impact on functional daily activities such as nappy changing, handling by carers
  • Gradual regression or not progressing in motor skills


  • 4 months: Baby who has poor head control and is unable to lift their head up in prone or place and put weight through their forearms
  • 8 months: Baby who is not yet rolling.
  • 12 months:
    • Child who is only able to roll for mobility.
    • Child who is unable to sit.
Category 2 (appointment within 90 calendar days)

Severe Motor Skill Delay

  • Child with developmental delays associated with abnormalities in neurological examination (may be referred to General Paediatrics initially)
    • Marked low tone or high tone
    • Muscle weakness / floppy child
    • Differences between right / left side of body in strength movement or tone
  • Microcephaly or increasing head circumference
  • Children over 18 months of age who are not walking independently
  • Gross motor delays in children under 18 months of age
  • Asymmetrical toe walking or asymmetrical in-toeing
  • Child with pain impacting on development of gross motor skills that has been reviewed by their GP prior to referral (hypermobility)


  • 6 months:
    • Infant not holding head and shoulders up with good control when lying on their tummy
    • Infant unable to hold head in the midline in supine or brings hands together in the midline
    • Infant not holding head with control in supported sitting
    • When supported in standing – persistent weight-bearing on toes
  • 9 months:
    • Infant is not sitting independently, not taking weight on legs when held in standing
  • 12 months:
    • Child sitting independently but cannot move out of sitting
    • Child not pulling to stand or holding on for support
    • Child has no form of independent mobility (e.g. crawling, commando crawling)
  • 18 months:
    • Child not walking
    • Child not standing independently
  • 2-year-old:
    • Child not walking independently
Category 3 (appointment within 365 calendar days)

Moderate Motor Skill Delay (recommended to be seen within 90 to 180 calendar days)

  • Developmental delay with related medical co-morbidities
  • Motor delay: 18 months – 2 years (walking commenced at time of referral)
  • In-toeing causing tripping that is not asymmetrical (less than 3 years of age)


  • 2-year-old:
    • Child walking independently but unable to squat
    • Child with poor balance when walking.

Mild - Moderate Motor Skill Delay (recommended to be seen within 181 – 270 days)

  • Moderate gross motor delays
  • Children that require assessment before school (Prep)
  • In-toeing causing tripping that is not asymmetrical (3 years and older)


  • 3-year-old:
    • Child cannot walk up and down stairs independently
    • Child unable to run and jump
    • Child with poor balance in walking (may have multiple falls)
    • Child unable to balance on one foot momentarily.

Mild Motor Skill Delay (recommended to be seen within 365 days)

  • Mild gross motor delays (3 – 5 years of age)


  • 4-year-old: Not able to climb or use stairs confidently.
  • 5-year-old:
    • Unable to hop
    • Not able to use stairs confidently
    • Poorly coordinated ball skills

If your patient does not meet the minimum referral criteria

  • Assessment and management information may be found on a range of conditions at HealthPathways
  • If the patient does not meet the criteria for referral but the referring practitioner believes the patient requires specialist review, a clinical override may be requested:
    • Please explain why (e.g. warning signs or symptoms, clinical modifiers, uncertain about diagnosis, etc.)
  • Please note that your referral may not be accepted or may be redirected to another service

Essential Referral Information

  • If child is not walking by 2 years of age, a bilateral hip X-ray prior to Child Development Services (CDS) referral is required
  • Confirmation of screening for developmental dysplasia of the hip

Greater detailed information will allow more accurate categorisation - this may be any of the following:

  • A developmental screening tool
  • A Community Child Health Nurse or health worker developmental assessment
  • An allied health assessment
  • Sufficiently detailed developmental milestone history
  • A detailed description of the developmental delays and presenting concerns from referrer and parent
  • See CHQ Red Flag Early intervention Guide and report any developmental red flags child is not meeting
  • Confirm presence or absence of concerning features:
    • Is there a definite history of developmental regression, and if so what specific loss of skills have been noted?
    • Is the child expected to be in out of home care supervised by the CSYW for more than 6 months?
    • Is there a risk of the child’s current placement breaking down?
    • Is there a risk of parents relinquishing care due to child’s behaviour / developmental concerns?
    • Is the child unable to attend childcare/school, at risk of expulsion or been repeatedly suspended due to their behaviour or developmental concern?
    • Is the child engaging in physical aggression or other behaviours that places either themselves or family members (e.g. younger siblings) at risk and /or harming animals or destroying property?
    • Are there any associated abnormalities on neurological or physical examination?

Additional Referral Information

  • Hip X-ray (for children older than 6 months of age), or hip ultrasound (for children less than 6 months of age) if hip concerns noted.
  • Joint Hypermobility/ Beighton’s score (as contributing to motor delays) assessed if relevant

Highly desirable information – may change triage category

  • Pregnancy and birth history
  • Other past medical history, including related medical co-morbidities. Please also specifically state if the developmental / behavioural concern is exacerbating the child’s medical co-morbidities.
  • Observations or specific information pertaining to school or childcare
  • Family history (parental consanguinity, history of neurological disorders, genetic syndromes, learning or developmental problems (i.e., Intellectual Disability, Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder, Specific Learning Disorder], mental illness)
  • Results from visual acuity and audiometry testing. Please note that developmental optometry and auditory processing assessments are not recommended. Be aware that without vision and hearing test results the child’s assessment and therapy services may be delayed.
  • Copies of previous Occupational Therapy, Physiotherapy, Psychology, Speech Pathology or other external assessments and documentation if available.
  • Details of professionals currently involved in care and previous services/therapies accessed (e.g., Paediatrician, Neurologist, mental health services, developmental or allied health therapists etc)
  • Does the child have access to ECEI / NDIS or any other funding bodies?
  • Confirm presence or absence of significant psychosocial risk factors (especially parental mental / physical health or disability, housing and financial stress, family violence, parental substance misuse, previous or current involvement with CSYW e.g. notifications made). The additive effect of such risk factors will be considered and may change categorisation.
  • Desirable information – will assist at consultation
  • Immunisation history
  • Developmental history
  • Other past medical 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
  • Any relevant laboratory tests or medical imaging results
Last updated 7 December 2021

Send Referrals To

Smart Referrals

Preferred Method
About Smart Referrals

Secure Web Transfer

Send to: Gold Coast Child Community Health MO Account: GQ4215000TL HL EDI: qldcomch

Internal Referrals


(07) 5687 4497


Gold Coast University Hospital
1 Hospital Boulevard
Southport QLD 4215


(07) 5687 9141

Related HealthPathways

No directly related pathways found

Service Availability

Dr Francoise Butel
Medical Director Children's Community Health


Gold Coast University Hospital
Southport Health Precinct
Palm Beach Community Health Centre
Helensvale Community Health Centre
Upper Coomera Child Health
Early Years Centre Coomera Springs
Norfolk Village State School Health & Education Hub

If you would like to send a named referral, please address it to the specialist listed above, who will allocate a suitably qualified specialist to see the patient. Alternatively, you can view a full list of our specialists.

Child Safety

If you have a reason to suspect a child in Queensland is experiencing harm, or is at risk of experiencing harm, contact Department of Children, Youth Justice and Multicultural Services . Please consider if mandatory reporting applies.

Gold Coast Health - For Clinicians
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