Child Development Clinic

111 views 11:07 am 0 Comments September 10, 2023

Child Development Clinic

Northern Districts Community Hospital

Main Road, Charlestown, Victoria 3999

Better health for children and families

Intake Officer
Victorian Early Assessment Clinic Olga Tennison Autism Research Unit La Trobe University
Bundoora Victoria 3086

To whom it may concern,

RE: Sam Brown (DOB: 25/01/2021)

Please except my referral of this child to your early assessment clinic. I have recently seen Sam with his parents, Alex and Jo Brown, who have some concerns about his development. He presents with some delays in his language and communication skills, and there is some repetitiveness to his behaviour. Alex and Jo have an older son, Joshua (8 years), who I diagnosed two years ago with Autism Spectrum Disorder with Level 1 (requiring support) severity for both his social- communication/interaction difficulties and restricted/repetitive behaviours. Given the family history, Alex and Jo are aware of the increased likelihood that Sam also has an ASD.

I would appreciate if you could complete a full diagnostic assessment for ASD for Sam at your earliest convenience. Please do not hesitate to contact me if you have any further questions about Sam and his family. I attach the SACS-R 24-month checklist which I completed at my recent appointment with Sam.

Best wishes,

ESpence

Dr Eliza Spence

Developmental Paediatrician
Northern Districts Community Hospital Main Road, Charlestown, Victoria 3999 Ph: 03 9999 1111
Fax: 03 9999 2222
e: [email protected]

1 February 2023

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