20 April 2023

The COVID lockdowns limited children’s exposure to structured environments such as childcare where they have typically developed their social skills and emotional resilience. 

This has resulted in many children presenting with challenging behaviours.

Examples of challenging behaviour include:

  • Defiance/ refusing age appropriate requests
  • Overly fussy such as difficultly settling
  • Hurting self/ others
  • Excessively angry when refused their wishes
  • Ongoing or frequent emotional outbursts

When to refer?

Challenging behaviour is part of typical development. However, families need support if their child’s behaviour is impacting on family functioning, the child’s engagement in daily tasks and learning environments, or if there are safety concerns.

Some behaviours may be due to an undiagnosed developmental delay (eg social, emotional, communication), disability or trauma.

Where to refer?

  • Psychologist or family therapist
  • Parent Child Interaction Therapist (PCIT)
  • Parenting education program such as Circle of Security or Tuning in to Kids

Find more information

This article was written by members of the ‘Stronger Seeds, Taller Trees’ project which includes professionals from a number of government and non-government organisations in South Western Sydney. The group aims to support GPs working with families to navigate and access timely services when they have a concern about a child’s development.

07 March 2023

Multilingualism has been linked with numerous benefits for children and families.

Children may learn multiple languages simultaneously and may show a preference for one language.

Receptive language skills are key in determining if speech pathology intervention is required for multilingual children.

The limited amount of exposure to languages because of the COVID-19 lockdowns may have directly impacted language acquisition, and the trajectory of language development for multilingual children could differ from monolingual children. 

Early referral to speech pathology is critical if a child is having difficulty with understanding and following verbal information in their primary language.

Where and how to refer

Resources for Multilingual Homes

Webinar: The Benefits of Multilingualism

Interview: Teaching multiple languages to under fives

Expert in the field of multilingualism

16 February 2023

One in in four children in South Western Sydney are at risk of delayed fine motor skills.

Since COVID-19 lockdowns, many children who had reduced opportunities to attend early childhood education are presenting with delayed skills.

The importance of fine motor skills

Fine motor skills allow children to participate in play, self-care and school-based tasks.

Early intervention services can maximise outcomes for children who may be having difficulty learning these skills.

Fine motor skills include:

  • Hand and finger strength
  • Hand preference
  • Using two hands together
  • Hand-eye coordination
  • Object and pencil grasp
  • Cutting skills
  • Drawing and handwriting skills


Screen and refer

Every appointment is an opportunity to screen a child’s fine motor skills.

It is more important than ever to refer to occupational therapy early as waiting times in both public and private services have increased since the COVID-19 lockdowns.


How to identify a fine motor delay

Quick checklist by age

Occupational therapy

Where and how to refer
17 November 2022

One in five children in South Western Sydney are at risk of poor language outcomes.

The COVID-19 lockdowns have increased the risk of developing communication delays as social interactions and engagement in early learning environments have been limited.

The importance of language skills

Language skills are needed to understand and communicate across different environments. A child’s early language skills are predictive of long-term outcomes.

The harm of watching and waiting

Watching and waiting as children return to pre-COVID community activities will not rectify a language delay. It is better for a child to wait on a waiting list for early intervention which will maximise their outcomes.

It’s more important than ever to refer early, as waiting times in both public and private services have significantly increased since the COVID-19 lockdowns.

Instead: screen and act

Every consultation is an opportunity to screen a child’s communication.

In addition to the Blue Book, you can use this screening checklist (communication milestone checklist) to identify when a referral to a speech pathologist is needed (where and how to refer).

20 October 2022

What do GPs need to know about the Early Childhood Approach (formerly ECEI) following COVID-19? Who needs this program and why?

Parents and carers, more than ever before, have concerns about their children’s development. As families often go to their GP for support, it is important for their concerns to be acknowledged and investigated. This support may include connecting families to the Early Childhood Approach through their local NDIS Early Childhood Partner.

The Early Childhood Approach helps children from birth to six years, through developmental supports which build a family’s capacity to assist their child participate in everyday activities and be included in mainstream environments which were restricted during the COVID-19 pandemic.

For children who need longer term supports, the Early Childhood Partner will assist families access the NDIS. Children do not need a diagnosis to be supported through the Early Childhood Approach.

21 September 2022

The COVID-19 lockdowns have resulted in a cohort of children whose development is delayed. Young children have had limited access to social interactions and early learning environments during the critical period of their brain development, which has both created and compounded existing developmental delays. Due to this, the need for early intervention is the highest that it’s ever been.

The importance of early intervention: Early intervention is linked with positive outcomes for children. It can positively impact all aspects of development including social, physical, communication, cognitive and psychological development.

Referrals: Early referral to intervention services is crucial in maximising outcomes. It is more important than ever to refer early as the COVID-19 lockdown has increased waiting times in both public and private services. Please consider referring to both public and private services (using Medicare rebate options) so families are offered supports in the timeliest manner.

Early intervention – where and how to refer

22 July 2022

Aboriginal and Torres Strait Islander children experience some of the highest rates of Otitis Media and associated hearing loss in the world.Stronger Seeds Taller Trees logo

Left untreated, these conditions are directly linked to serious and long-term deficits. These include poor medical health, delayed communication and social skill development, challenging behaviour, and learning difficulties.

Regular ear checks, hearing assessments and onward referrals to ENTs are crucial in supporting positive outcomes for Aboriginal and Torres Strait Islander children with Otitis Media.

Information for families about Otitis Media:

Deadly Ears Program

Middle ear disease

Children’s Health Queensland

Empowering Aboriginal and Torres Strait Islander families to connect with health and community services is another important part of supporting their children’s health and wellbeing.

Aboriginal Health Services:

South Western Sydney Local Health District Aboriginal Health Service Directory

AH-ServiceDirectory.pdf (nsw.gov.au)

Macarthur Family & Youth Services

NABU – Macarthur Family & Youth Services (mfys.org.au)

Tharawal Aboriginal Corporation – Airds

Tharawal Aboriginal Corporation | (tacams.com.au)

Gandangara Aboriginal Health Services – Liverpool

Health Services | Gandangara

KARI Aboriginal Community Programs – Liverpool

Community Programs | KARI

21 June 2022

Fussy eating can lead to stressful and prolonged mealtimes, delayed oro-motor skills, and poor health outcomes including nutrient deficiencies (eg iron), slow growth and constipation.

Early intervention is required when fussy eating is caused by sensory sensitivities with food textures, or when it leads to highly restricted diets (less than 15 to 20 different foods) or

Stronger Seeds Taller Trees logo final_210705

 challenging behaviours at mealtimes.

Mealtime Strategies

1) Set up routines – serve food at the same time and in the same place each day.

2) Create an engaging mealtime environment – remove distractions (eg screens, toys) and share meals together as a family to model positive mealtime behaviours like trying new foods.

3) Encourage food exploration and play – participate together in food preparation and play games with food like sorting by colour or texture, or building houses.

Start Them Right: A parent’s guide to eating for under 5s 

Is your child a fussy eater? Parent handout



11 May 2022

Some children have difficulty processing and responding to information from their senses. This includes sight, sound, taste, touch, smell, proprioception (body awareness) and vestibular (movement) input.

Signs of sensitivities:

  • Seeking sensations (touching, smelling or licking textures, closely watching moving objects, difficulty sitting still)
  • Reacting to sensations (becoming upset when touched, easily distracted by noise/light, picky with food textures and smells)
  • Under responding to sensations (appearing to ‘tune out’, low response to sound/touch, poor pain perception)

Sensory seeking versus sensory sensitive

When to refer:

Refer to an Occupational Therapist when a child’s sensory sensitivities interfere with everyday routines or engagement in learning. Early referral is key to improving functional, social and academic outcomes.

Where and how to refer


Further information about sensory sensitivities

Making sense of your child’s senses – handout

21 April 2022

Transition to school has an impact on a child’s educational trajectory. A successful transition to school requires more than academic skills. It requires social, emotional, communication and motor skills. GPs have a role in partnering with schools and supporting families to:

Did you find this article helpful?


Further links: