Initial assessment in general practice

The role of the general practitioner (GP) in initial assessment of a person with developmental disability is outlined in Practitioner roles in developmental disability assessment. If developmental delay or disability is suspected, a comprehensive formal assessment by a general or developmental paediatrician (in children) or multidisciplinary team (see Referrals for further assessment) is important to establish the diagnosis, identify the cause and any treatable health conditions, and address the psychosocial context. Allied health referrals are often appropriate to identify functional difficulties.

The GP can assist in assessment by ensuring parents or carers receive assessment reports, and by discussing the findings with them. See also advice on Discussing a developmental disability diagnosis with the person or their parents.

Regular GP consultations are important while a diagnosis is being established to ensure the family is well supported and that any recommendations are implemented. See also Support for carers and family of people with developmental disability.

Figure 1. Practitioner roles in developmental disability assessment.

[NB1]

General practitioner

monitor for developmental problems in childhood

record developmental history

perform physical examination, including tests as clinically indicated or as directed by a specialist (eg vision, hearing, full blood examination)

identify health problems and consider unmet needs if the person has behavioural concerns; refer for further assessment (see Challenging behaviour)

refer for specialist assessment and diagnosis

refer for further assessments, as indicated, while awaiting specialist review (eg allied health)

review psychosocial factors (eg access to resources, family stress) and provide support to the person and their family or carers

consider other relevant family factors (eg other family members with intellectual disability)

Specialist (eg paediatrician) or multidisciplinary team

perform developmental, adaptive and cognitive assessment (see developmental and cognitive assessment)

order investigations

obtain detailed family history

request genetic testing if indicated

confirm diagnosis

complete assessment report or management plan

provide information for the person and their family or carers

provide or refer for genetic counselling

review and monitor in collaboration with general practitioner

Note: NB1: Roles may overlap depending on individual expertise and access to specialist practitioners.