When to refer?

Know the signs.
Use the First Words tools and/or your pediatric tools to determine if a child needs to be referred:

• First Words online screening tool.
• First Words Speech and Language Development Physician’s Checklist - download or order free copies.
• The updated Rourke Baby Record is now available to primary care practitioners.
• Nipissing District Development Screen is being updated – look for the updated version in 2010.

Refer when:

• a child does NOT meet developmental milestones or presents high risk indicators.
• a family history of speech and/or language delays is known.
• a parent is concerned.

Act Early!
A SINGLE “NO” response on the First Words tools and/or in the pediatric tools (RBR, NDDS) can trigger a referral to First Words or other community agencies as these milestones are set AFTER the time of normal milestone acquisition. Absence of any items is considered a high-risk indicator indicating further assessment is required.  These norms directly address the “wait and see approach”.