• Children who are experiencing symptoms associated with a history of trauma may also be appropriate for parallel treatment and engagement with other services such as Child and Youth Mental Health Service (CYMHS ) or Evolve Therapeutic Services
• If there has been a recent change in placement for children in out of home care; consideration will be made regarding the timing of specialised FASD assessment, as deferring to allow for adjustment period may be appropriate before formal assessment.
• GP to consider whether a referral for a medical speciality (e.g. Paediatrician, Neurologist) would be a more appropriate initial action
• GP to consider if the child has seen a Child Health Nurse for assessment and general development strategies
• Delay across multiple developmental domains is more likely to be associated with significant impairment and require Paediatric review
• To support classification of the severity of the child’s behaviour or cognition:
  • Moderate-Severe concerns suggestive of Category 2 may include:
    • Standard scores in the clinically elevated range on standardised questionnaires assessing behavioural, emotional or social concerns
    • Standard scores on formal cognitive / intellectual assessment measures being ranked as clinically impaired (i.e., < 10th percentile) for the developmental area/s being tested
  • Mild concerns suggestive of Category 3 may include:
    • Standard scores in the borderline range on standardised questionnaires assessing behavioural, emotional or social concerns
    • Standard scores on formal assessment measures being ranked in the borderline range (i.e., 10th – 16th percentile) for the developmental area/s being tested

Clinician Resources

• Australian Guide to the diagnosis of FASD
• FASD Hub Australia
• Red Flags Early Identification Guide

Patient Resources

• FASD Hub Australia
• NOFASD Australia
• Russell Family Fetal Alcohol Disorders Association
• Raising Children - The Australian Parenting Website
  
  

• As specified in key criteria, evidence of prenatal alcohol exposure is required (i.e., directly reported, witnessed or documented in formal records), including details regarding frequency, duration and quantity of consumption. Where possible the AUDIT-C should be completed to characterise alcohol exposure during the target pregnancy.
• Sufficient screening of symptoms or behaviours of concern. This may include developmental status, mental health status, behaviour and/or social wellbeing
• If school-based behaviours are the primary reason for the referral, provide a letter from the school outlining behaviours of concern.
• Specify what medical investigations, if any, have been requested or completed (e.g., laboratory tests, medical imaging). Please attach copies of results where available. Please provide a reason when investigations are clinically indicated, but not yet completed.
• Medical history including:
  • Information regarding adverse events during pregnancy or birth
  • Details regarding relevant medical events
  • Provide evidence and source of current diagnoses (e.g., Intellectual Disability, Attention Deficit Hyperactivity Disorder, Autism Spectrum Disorder, Anxiety, Post-traumatic Stress Disorder, Reactive Attachment Disorder etc.)
• Specify what assessments, if any, have been completed by external service providers (i.e., Allied Health Practitioners, Department of Education). Please provide a summary of findings or attach copies of reports where available.
• Sufficient information of screening of developmental concern.

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 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

Highly desirable information – may change triage category

• Copies of reports from the school which include information and comments pertaining to:
  • Academic achievement and engagement with schoolwork (e.g., Age/Grade equivalents)
  • Behavioural and emotional wellbeing, and social engagement with peers
  • Details regarding suspensions or expulsions
  • Details regarding school attendance (i.e., days missed, school refusal)
• Details regarding care history for children in out of home care
• Details of exposure to early childhood adverse events (i.e., type of trauma, length of exposure, mode – directly experienced or witnessed) and referrals made to address this concern
• 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

• Please provide copies of the following documents:
  • Any correspondence from support services involved (e.g., Child Safety Services case manager, Family and Child Connect service, Intensive Family Support service, After-Care service)
  • Current Child Protection Order
  • 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