There is a wide range in what is considered 'normal development'. See our approach Child development and trauma.
There are a number of accepted 'milestones' for every child as they grow and develop. For example, children learn to walk unassisted somewhere between 11 and 18 months, by 18 months they will know eight or more words and can identify objects. By 3 to 4 years children should be able to use complex sentences, feed themselves, climb a ladder and catch a ball with both hands. By 5 to 6 years children will be able to write some numbers and letters.
When a child fails to reach these milestones, they may have or be at risk of a developmental delay. Developmental delay may include abuse and neglect including a lack of exposure to learning opportunities or may be related to conditions such as cerebral palsy, hearing or sight deficits, chromosomal abnormalities, or illness.
As a child protection practitioner, if you suspect a child may have a developmental delay, addressing this issue early maybe the key to producing the most positive impact on developmental outcomes. A referral for a developmental assessment should be considered in conjunction with the parents at the earliest possible time. Seek a consultation with relevant professionals if you are unsure about what developmental tasks a child should be obtaining at a particular age. For example, a maternal and child health nurse, paediatrician, or practice leader.
A developmental assessment may cover all aspects of the child's development and behaviour including:
- medical history including immunisations and exploration of any specific medical issues
- nutrition and growth
- gross motor skills e.g. walking, hopping, throwing a ball
- fine motor skills e.g. using a pincer grip, cutting, drawing, wrist control
- receptive and expressive language
- general and cognitive development (standardised tests may be used to establish the child's cognitvie abilities)
- emotional development
- sleeping patterns
- relationships including issues of attachment
The range of services referred to for developmental assessments include:
Paediatric developmental assessment
A referral may be made to a public hospital or private paediatrician.
The paediatrician will take a comprehensive medical history and will consider the child's height, weight, past illnesses and prematurity (if relevant). Paediatricians will undertake a physical examination and a developmental assessment. A paediatrician may refer the child for further relevant investigations, for example blood tests or vision and hearing tests, if indicated.
A paediatrician may arrange a referral as part of their assessment. This may involve the child and family being seen by other medical and allied health professionals within the hospital or externally, including all or some of the following: speech pathologist; psychologist; occupational therapist; or audiologist.
Early Childhood Early Intervention
Where a developmental assessment shows a child is experiencing a developmental delay, contact should be made with the National Disability Insurance Scheme (NDIS) to access early intervention services. The NDIS provides an ‘Early Childhood Early Intervention’ (ECEI) approach which is available to all children nationally who are aged under 7 with a developmental delay or disability.
The NDIS has engaged Early Childhood Partners around Australia to deliver the ECEI approach. Early Childhood Partners are experienced in providing early childhood intervention. The Early Childhood Partner will be the first contact point for families or case managers working with children with a developmental delay. Early Childhood Partners will help identify the most appropriate supports that would benefit the child. This may include:
- connecting the child with supports in the local area, such as community health centers, educational supports and playgroup
- provision of short-term early intervention where it has been identified as the most appropriate support
- support to request NDIS access if the child requires longer-term early childhood intervention supports.
To locate a local Early Childhood Partner, visit the NDIS website and search for Early Childhood Partners. Families and case managers can also contact the NDIA directly or your Local Area Coordinator for further information about accessing ECEI in your area.
Community health centres
Local community health centres may offer some of the services relevant to early childhood development. Contact your local community health centre for details of the services they provide.
Hospitals (public and private)
All hospitals will have some services regarding assessment and treatment of a range of developmental issues for children and their families.
Contact your local hospital for details of paediatric services offered.
With private hospitals there may be an associated cost. Confirm that you have approval to pay for this service before proceeding.
Maternal and child health service
The maternal and child health (MCH) service is a free universal service, available to all families with children from birth to school entry. It provides services that offer families with young children support, information, health promotion, early identification and intervention for health concerns. See service description Enhanced maternal and child health service.
There will be a number of private providers in your area that may be referred to, for example, developmental psychologists or speech pathologists.
With private providers there may be an associated cost. Confirm that you have approval to pay for this service before proceeding.
Consider arraning referals for any child who presents with apparent developmental, cognitive, learning, behavioural, language or emotional difficulties. Some services will have a narrow focus, such as speech pathology; others will have a wide focus such as early intervention.
Contact the relevant professional directly to obtain details of eligibility and the referral process as this will vary.
NDIS Early Childhood Partners will work with children who have a developmental delay or disability from 0 to under 7 years of age.
Health and Education Assessments for children and young people in residential care
The health and education assessments are separate assessments that aim to ensure that the health and education needs of children and young people in residential care are met. The target group for these assessments is all children and young people in residential care and entering residential care aged 0-18 years.
Health assessments aim to improve the health outcomes of all children and young people in or entering residential care by ensuring they have each had a preliminary health check, and where necessary, they have been referred by their General Practitioner (GP) to a paediatrician for a comprehensive health assessment. A dental health and optical assessment is also required for this cohort of children and young people as a part of this initiative.
The case manager (CSO case manager or child protection practitioner, as the case may be) is responsible for arranging the preliminary health check by a GP for each child or young person in residential care and coordinating access to any ongoing treatment that may be necessary. The responsibility for coordinating the medical appointments for each child and young person may be discussed with the care team at the care and placement plan meeting. See service description Looking After Children.
Authority to provide consent for a child or young person to undergo a health assessment or treatment varies depending on the type of Children’s Court order to which the child or young person is subject. The child protection practitioner has responsibility for obtaining consent from the appropriate person to enable health assessment or treatment to occur and for liaising with the GP or specialist medical practitioners to obtain feedback, on behalf of the care team.
All children and young people of school age and placed in residential care longer than three months will be eligible for an education needs assessment that will identify the actions needed to improve and sustain their participation and achievement in education or training.
For those children or young people attending a government, Catholic or independent school, the child or young person’s Student Support Group should complete the relevant assessment referral form and will also be responsible for receiving and acting upon the assessment report. For children or young people not in an education program, child protection and the child’s care team are responsible for assessment, referrals and follow up action. Education support packages will be provided to those children and young people with high educational needs as determined through the education assessment process.
Brokerage funding to meet health and education needs
Brokerage funding is available to meet the health and education needs of children and young people in residential care. Not all children and young people in out-of-home care will require access to brokerage funds to meet their health and education needs. The majority of children and young people are supported to access services and interventions that are free or low cost.
Allocation of brokerage funding is managed by the Health and Education Assessment Coordinators (HEACs) HEACs are located within operational divisions in the Placement Coordination Units and work closely with partners in Community Service Organisations, Child Protection, and the Department of Education and Training.
For health needs, funding of approximately $1,500 per child or young person in their first year and $1,000 each year thereafter that the child or young person continues to reside in a residential care placement, is available.
For education needs, funding of approximately $1,200 per child or young person is available.