Red Flags School-aged Guide

Supporting conversations and service engagement for children with neurodevelopmental concerns

Developmental concerns Behavioural concerns Emotional concerns

Poor school performance Distracted Socially withdrawn
 ifficulties with talking/
D Overactive Frequent meltdowns
Your concerns

listening/playing/co-ordination Disruptive Frequently worried/sad

Loss of skills Aggressive

Child/young person’s history What else? Trauma

Medical history Information from school/ Current trauma/s
We will ask about

Family and social history other settings Historical trauma/s

Developmental history Options tried Family trauma/s
Parental mental health Family functioning
External factors (e.g. illicit
substance, cyber bullying)

Difficulties with Difficulties with Difficulties with

Learning new things Sleep Calming after being upset
Understanding another’s view Toileting/Dressing Making and keeping friends
Together we will explore

Understanding jokes Changes in routines Recognising emotions

Giving relevant information Diet and mealtimes Separating from parent
Taking turns in conversation Organising self and belongings Sharing/cooperating
Following directions Achieving everyday tasks Playing with others
Finishing tasks (would rather be alone)
severity scale
Frequency/

One task Some tasks Most tasks All tasks

One environment Some environments Most environments All environments
 © Queensland Government (Children’s Health Queensland Hospital and Health Service) 2019.

Call 13HEALTH (13 432 584) 24 hours, 7 days to speak to a Child Health Nurse.
1300 366 039 (prompts 2, 2) for more information regarding referrals.
Please contact Child Development Program Access Service on

present with developmental concerns.

with mental health concerns are more likely to
complexity; a history of trauma and/or a parent
shows that children who have a history of medical
with identified vulnerabilities occurs. Research
MONITORING of development of children
function and participation.
strengths that can support a young person’s
challenges. It can also help identify developmental
considered to determine impact of developmental
ACROSS CONTEXT presentations are
it is important to ask about their development.
person is having behavioural or emotional concerns,
by behavioural or emotional concerns. If a young
health, medical complexity). They may be hidden
often occur with other conditions (e.g. mental
other conditions. Developmental difficulties
EXPLORATION and identification of
First edition
developmental concerns may require extra support.
school-aged children with neurodevelopmental concerns are some key transitions where young people with
Supporting conversations and service engagement for leaving primary or high school, age 9, grade 9
Red Flags School-aged Guide TRANSITIONS are supported. Starting/
communities and specialist services can work together to ensure:
Child and Youth Community Health Service School aged children need a TEAM approach. Families, schools,
Children’s Health Queensland Hospital and Health Service

What is the Red Flags School-aged guide? Referring

The Red Flags School-aged Guide is a health resource for Every family is different, before referring consider:
• Family readiness for assessment. If not ready, consider GP case
professionals (including general practitioners, child health nurses,
management and school liaison
allied health professionals and educators) to support conversations
• Family identification of which services will be most helpful now
with families about developmental concerns in school aged
• Service eligibility (e.g. age, geography)
children and enable timely and targeted referrals. This guide will:
• If there is a risk to family, self or others – consider services to
• Assist with identification of the impact of developmental
support child’s mental health and safety (e.g. Child and Youth
concerns on a young person’s day-to-day functioning.
Mental Health Service, psychiatrist, Child Safety).
• Assist with decision making for the most appropriate service to
engage, based on the young person’s presenting concerns. A referral to a developmental service and/or general paediatrician
may be indicated if:
The Red Flags Early Identification Guide is also available for • History of developmental concerns over time.
children under six. • Presentation of developmental concerns over contexts
(e.g. school and home).
Tips for using this guide • Severity scale is most/all tasks, most/all environments.
• It is recommended that this resource be used to support a
Most tasks All tasks
conversation between parents/carers and a professional who Most environments All environments

understands typical development of a school-aged child.

A referral to a behavioural based service may be recommended
• Red flag icons indicate an area of concern.
if behavioural or emotional concerns are noted (e.g. aggressive,
• Question mark icons are used to prompt further conversations.
frequent meltdowns) but minimal/no developmental concerns.
• A single red flag is not always an indication for concern or referral.
• An orange/red indicator on the severity scale supports a If a young person is experiencing difficulties with one/some
specialist referral. tasks in one/some environments services including private
allied health, university clinics or child health may be indicated.
Definitions One task Some tasks
One environment Some environments
• Trauma: an event or series of events that have long lasting
impacts (e.g. abuse, neglect, witness to violence). If a young person is experiencing current trauma (e.g. using illicit
• Tasks: activities that you would expect a child of similar age to substances or being affected by cyber bullying) ensure the young
do as part of a family, school or community (e.g. playing with person is safe and supported before a referral to an appropriate
friends, participating in physical activities, enjoying a meal). service is made.