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Exclude Hearing Loss (Paediatric)

Does your patient wish to be referred?

Minimum referral criteria

Does your patient meet the minimum referral criteria?

Category 1

Appointment within 30 days is desirable

  • No category 1 criteria

Category 2

Appointment within 90 days is desirable

  • Diagnosed by a speech pathologist as having a severe speech or language impairment
  • Unscreened children (who have not been screened under a universal hearing screen at birth)
  • Refugee screen
  • Suspected Autism Spectrum Disorder
  • Diagnosed with a significant additional disability, syndrome or disorder.

Category 3

Appointment within 365 days is desirable

  • Speech and language milestones are delayed
  • Making slow progress with regular speech pathology support
  • developmental delays
  • learning or behavioural difficulties
  • School recommendation
  • Parental concern

If your patient does not meet the minimum referral criteria

Consider other treatment pathways or an alternative diagnosis.

If you still need to refer your patient:

  • 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

Other important information for referring practitioners

Not an exhaustive list

  • Refer to Health pathways or local guidelines
  • These referrals may meet criteria for hearing screening. Consider local hearing screening services if available before referring to hospital clinics
  • Consider referral to speech pathology or child health clinician for developmental speech and language screening in children
  • Consider referral to General paediatrician if there are significant developmental delays
  • Consider protective factors such as referral to local Early Years services and playgroups
  • Manage any middle ear pathology initially
  • Hearing impairment may be permanent or temporary
  • Passing newborn hearing screening does not exclude mild hearing loss or preclude late onset or progressive hearing loss
  • Speech discrimination testing
  • Any other health care professionals are currently involved (e.g. other Allied Health Professionals, Health Clinicians).
  • The person’s hearing and communication needs at home, or in education, and in social situations
  • Psychosocial difficulties related to hearing
  • Details of any otologic symptoms or pre-existing hearing loss if applicable

Referral requirements

A referral may be rejected without the following information.

Essential referral information

  • Provide information of nature of the speech and language concern
  • Additional behavioural issues including social-emotional issues and impacts on participation e.g. attention at school
  • Social modifiers i.e. effect on home schooling, out of home residence
  • Otological history

Additional Referral Information (Useful for processing the referral)

  • Clinical observation of hearing
  • Previous audiology results or hearing screening
  • Family history of hearing loss/ASD
  • Any other health care professionals are currently involved (e.g.  other Allied Health Professionals, Health Clinicians)

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use

  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander

  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature

  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)
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