When to refer a student is probably THE biggest hurdle that a teacher faces each year only to be followed by the HOW. In this article, I address the initial concern of when to refer. Warning: It’s never easy, though depending on your school’s administration and their approach to this and the parents whom you are dealing with… it could be slightly easier!

Firstly, you should know that there is no magical booklet handed out to teachers that gives them a checklist of what to tick for and when to refer. This all comes back to initial teacher training knowledge (e.g. child development norms), regular observations, and their comparisons to other same aged peers. Having a lot of experience in the classroom can be beneficial, then again, I have certainly seen a lot of experienced teachers not refer students when I have tended to disagree. This last sentence is a segue into the fact that a lot of this also comes down to teacher judgement.

As education professionals, we all have some degree of knowledge about what is expected cognitively, socially and emotionally for students in the year group that we are teaching. We also link this to our knowledge of learning difficulties, disabilities and special needs that are known to us. Putting these two puzzle pieces together tends to inform our decision on whether to refer or not.

Sometimes, I have had parents approach me and request a referral very early on in the year and this certainly saves some time. This does not usually happen though and is something that we are usually expected to do in our teaching role.

refer to a specialist

When I say refer, there are several agencies that your student can be referred to and these depend upon where you are located.

1. Child Development Services (named different titles and can often have a paediatrician, speech therapist, psychologist and occupational therapist)

2. Paediatrician

3. Speech Therapist (private)

4. Occupational Therapist (private)

5. Psychologist (private)

So, firstly, I will give you some general pointers on when to refer. Honestly, this can be one of the toughest decisions when you are teaching early childhood students. There is always that tendency to go with the very logical approach, of giving them time to develop and grow on their own accord. You often think, will they grow out of this, will they catch up, can I help them overcome this XYZ habit?

1 – Form a picture of where this student is (cognitively…) compared to peers of their same age. 

Look at the following documents to give you some clues:

Childhood developmental norms – Being even a little bit familiar with what is expected as far as cognitive, social, emotional, physical and behavioural growth is concerned will be beneficial.

Curriculum outcomes – These can be vaguely helpful but are often very broad. What I mean by curriculum outcomes, is the content you are aiming to teach. This is found in the state curriculum you teach. We all know that students vary a lot within such year levels but it is a useful start if you do not have years of experience.

Classroom observations & comparisons – When you teach a year group, you begin to know what is the “norm” for students of this age. There are always going to be very broad abilities within each year level and you will need to keep this in mind.

2 –Learning approaches – Once you have formed a picture of where the student sits academically (or socially, etc.) have a think about how they learn. Are they quick to learn new content? Does it take a long time? Do you have to constantly repeat new content? These behaviours and habits of learning will impact your decision to refer. For example, if I explicitly teach the initial sounds (satpin) over a term (e.g. 10 week program) and the student does not remember these sounds at all. Should a more intense and targeted approach  be trialled (with more intense teaching approaches) and the same results occur, this is a concern.

Some students will naturally pick learning content up through whole group instruction with little need for revision. Some students will struggle a little and require some small group instruction on top of their regular classroom program. All of these “ways of learning” will contribute to your decision. If “good” teaching approaches (using research-based methods of teaching) have been used over a regular period of time and you are seeing no improvement, this is an indication of the need to refer.

It cannot be dismissed that teachers generally have a broad understanding of learning difficulties, disabilities and special needs (depending on their job and experience). Sometimes we have a habit of trying to put the puzzle pieces (of what we observe) together to see if it “fits” the puzzle of a special needs classification. One reason this is done is purely to try and gauge the correct approach that will help such a student.

Some students come to us with a diagnosis so you’d think that situation would be easier. Well, the truth is… sometimes it is and sometimes it is not easier. You see, people are complex and students can have multiple conditions going on. Just because one is diagnosed does not (unfortunately, depending on your opinion) mean that no other diagnosis needs to be made. I have taught many students that have multiple diagnoses just like many other teachers out there.

what to look for when deciding to refer

Ok, so now what? When do I refer, I hear you say. Here are just a few pointers;

• Forgetting key learning content that has been explicitly taught and often revised

• Not showing improvements after an intensive learning intervention (e.g at least a ten week program)

• Not remembering visual content such as letters and numbers

• Difficulty comprehending text that is being read to them and recalling key information (e.g. the characters, place, events, feelings)

• Communicate difficulties with peers and adults (e.g. to express their basic needs, use manners and ask and answer basic questions)

• Emotional difficulties (excessive sadness, anger, irritability, and so forth)

• Self-management difficulties that are age-appropriate (e.g. packing away, getting organised, lining up, following class routines that have been taught)

• Poor fine motor skills (e.g. inability to hold a crayon, pencil, scissors, paint brush and control it, threading, building with small blocks)

• Gross motor skills (e.g. a walk that appears uncoordinated, bumping into furniture and difficulty with sport activities)

• Attentional behaviours (e.g. difficulty sitting for a short time on the mat for a lesson, focusing one task, etc.)

• Speech articulation difficulties (e.g. and also speech-language difficulties such as grammar errors)

Junior Primary School

• Forgetting what was read from one page to the next (the content of what they read, which is most likely that the student is focusing on decoding and not comprehending)

• Forgetting a word read just a few seconds earlier

• Difficulty remembering phonics taught

• Phonological awareness difficulties

• Difficulty remembering some basic math facts

Obviously, there are so many that can be listed.  The above points are just to help you know where to start. 

Finally, I always say, if in doubt just refer. If a paediatrician does not think there are any concerns, they will move you on quicker than you can sneeze. They are busy! Also, the wait-list can be very long so it is better to refer early. Hint: the following years teacher will be appreciative that you have done the referral BEFORE that student arrives to them. 

I always recommend that parents seek more than one opinion too. This is not easy when the wait time for referrals is often long however, it is worth it.

I also suggest that parents seek the following areas to be checked while waiting for an appointment;

1. School nurse – ear and eye check

2. Optometrist – vision check

3. GP – ear check (or, audiologist)

I hope this information helps. It is not usually easy because you are dealing with a little human! I do this every year and dread it. Yep, I dread it. I know that parents can be upset, I will be dealing with countless forms to fill in (all in my own time) and I will have several meetings. Having a lot of teacher experience can make it a little bit easier and knowing the processes involved but it is what it is!

For additional information, I find the dsf website a fantastic resource.

https://dsf.net.au/learning-difficulties