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Referring to a specialist PDF Print E-mail
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Saturday, 05 February 2011 04:31

Referral to a specialist is indicated when a child fails to meet the motor milestones as described in the “Signs of Weakness by Age” surveillance aid.

Indications of the need for urgent referral to a neurologist:

  • Tongue fasciculations
  • Loss of motor milestones
  • CK greater than 3x normal
  • Anticipated surgery, due to anesthesia concerns in children with neuromuscular disorders

If a patient has an indication for urgent referral, you should consider direct contact with the neurologist’s office to share concerns, as this may expedite the appointment.

Note: Urine the color of cola/tea, especially with muscle pain: send child immediately to the ER for urgent emergency intervention


When referral to neurology is not urgent, additional referrals to consider:

  • Therapy services (PT ,OT, speech therapy) and early intervention
    • Therapists will perform a more detailed motor evaluation.
    • Therapists do not make diagnoses.
    • Therapists may detect a need for additional referrals.
    • Therapists monitor progress over time.
    • In benign forms of motor delay, physical and occupational therapy may promote acquisition of skills.
    • Therapists may help parents feel more comfortable working with their children and achieve a greater sense of control.
  • Referral to developmental pediatrician or pediatric rehab specialty may be an appropriate first referral for patients who do not have an indication for urgent referral.
  • The referring practitioner should continue to evaluate the child’s motor development over time, in partnership with the therapists and other specialists. Evaluate whether the child improves, stay the same, or regresses. Referral to a neurologist is warranted for children without improvement after 6 months.
  • Appreciate that a diagnosis will inform the care given by therapists and other specialists.
Last Updated on Monday, 06 February 2012 21:24

Did you know?

Listen to the parents. 80% of parent concerns are correct and accurate.