Child Health referrals

On my current prac we receive many referrals from child health and school nurses, often for minor things that turn out to be not a problem. However, being on this prac has made me aware of the immense importance of these nurses in the development of many children in the area. Last week we received a referral regarding a little boy who walked on his toes and his feet slightly turned in. At the start of the assessment, it seemed that the boy was simply toe walking, and there turned out to be a family history of this. However, as the time with the child went on, it became obvious that something was not quite right. He didn't make eye contact, was easily distracted, and his movement patterns were not what we would have expected. Rather than starting to form words, he made very primitive noises to get what he wanted, and the more the mother told us, the more we worried. He also had some minor abnormal tone findings. As a result of our assessment, he has been further referred to see the paediatrician, with a possible diagnosis of CP or autism.

This expereince has made me realise that although many referrals come through from child health nurses, and some are just precautionary, some of the precautionary ones tend to be lifechanging for the child involved. A thorough assessment is paramount, and if possible, 2 sets of eyes are better than one. Child health nurses are an invaluable part of our healthcare system, and we should never underestimate the power of a referral. The mother in this scenario simply thought her first child was restless and was reaching all his milestones, when in reality he was not. Hopefully the intervention of the nurse, physiotherapy department and finally paediatrician will allow the child to lead as normal a life as possible.