Problem: paediatric speech referrals bury milestones in narrative — the reader cannot see what the child does versus should do, or which pathway fits. Answer in brief: timeline tables (age, expected, observed) plus red-flag routing (hearing? autism features? regression?) place every toddler case in one paragraph of evidence. This guide teaches timeline routing with two worked toddler referrals, and OET Writing for Speech Pathologists — Course 1 trains tense practice and early referrals across 12 topic sections.
Tense practice on a patient timeline
Paediatric histories layer three times: birth and early history (past), developmental trajectory (past-to-present-perfect: “has used no words to date”), today (present). The common fault is past-tense today (“he pointed” for a current ability) or present-tense history. Rule: milestones achieved stay past with ages (“sat at 7 months, walked at 14”); current abilities stay present (“uses 3 single words, points to request”); absent expectations use present perfect negative (“has not combined words”). Timelines make tense visible — draw one before drafting.
The milestone table: expected vs observed
Three columns in prose: domain (expressive, receptive, play, social, hearing behaviours), expected at this age, observed with dates. Red-flag routing follows: hearing concerns (inconsistent response, infections, glue-ear history) → ENT/audiology; social-communication differences (joint attention, pointing, eye contact, repetitive behaviours) → paediatrician developmental pathway; regression of any skill → urgent paediatric review. Route by features, never by parental anxiety level alone.
Train early referrals supervised? The full OET Writing for Speech Pathologists — Course 1 covers tense-on-timeline practice and toddler referrals across 12 topic sections with mock tests. Explore the course →
Worked case: suspected glue ear (ENT referral)
Fictional case, newly written: Noah Williams, 2½, speech delay with suspected glue ear. History: recurrent ear infections (six this year), inconsistent response to name, speaks 5 single words, understands little beyond routine; hearing never formally tested; otherwise well; nursery reports frustration behaviours.
Shape: milestone table compressed (5 words at 30 months vs 50+ expected; receptive gap; infection history). Routing logic: hearing must be established before speech therapy can plan — hence ENT/audiology first. Request: “I would appreciate audiology assessment with a view to glue-ear management; nursery strategies provided meanwhile.” Route argued — roughly 170 words.
Worked case: suspected ASD (paediatrician referral)
Fictional case, newly written: Adam Novak, 3 years 2 months, no speech with suspected ASD. History: no words, rarely responds to name, limited eye contact and pointing, lines up toys, distressed by routine change; hearing normal on newborn screen, no formal test since; development otherwise typical; parents worried, seeking direction.
Shape: features reported behaviourally, never labelled (“does not point to share interest” not “autistic features”). Hearing status honestly qualified. Parent concern validated in one line. Request: “I would appreciate developmental paediatric review for suspected autism-spectrum features with a view to formal assessment and early-intervention planning.” Behaviours, not labels — roughly 175 words.
FAQs
Should I write “suspected ASD” in the letter?
As the referral reason with behavioural evidence, yes — that is honest routing. As a diagnosis, never; assessment decides. Evidence first, label last, question explicit.
What if hearing was screened normal at birth?
Say so with the date and its limits: newborn screening does not exclude later glue ear. “Passed newborn screen 2023; recurrent infections since” routes correctly.
What is in the course?
Twelve topic sections on tense practice over patient timelines and early speech, hearing and developmental referrals, with 5 complete mock tests.
The matching course
OET Writing for Speech Pathologists — Course 1 starts where speech starts: timelines, milestones, toddler referrals done right — 12 topic sections with 5 mock tests. For early cases with lifelong impact, train here.
Sources and note
- OET Writing format per the official OET site: oet.com — Writing. Milestones above are illustrative; follow local guidance in practice and current OET format guidance for the exam.
- Course details verified from its public staging page (read-only): 12 topic sections, 5 mock tests.
- Cases and letter lines are newly written and fictional; other valid structures exist.
Put this into practice
Compare these course outlines and choose the practice that matches your next goal.
