Children 1st Referrals-Why It’s Important

Monique Davis-Smith, M.D., FAAFP, Residency Directory- Department of Family Medicine Medical Center of Central Georgia

Tenesha Wallace, MA, Communication and Public Health Manager


Children 1st Referrals-Why It’s Important

The early years of life are the most critical time for child development. Identifying issues early and providing interventions can make a world of difference for children and their families. During well-child visits, if a child is at risk for developmental delays or a developmental delay is identified, there are programs available within the Georgia Department of Public Health (DPH) to assist physicians with linking families to early intervention services and support available in their communities. Physicians may also refer families with medically complex children and youth (birth to 21 years of age) with chronic medical conditions to the Department for care coordination services, access to specialty care clinics, and transition from pediatric to adult health care preparation and planning. Early intervention and children and youth with special health care needs services are accessed through the Children 1st program.

Children 1st serves as the single point of entry into all DPH, Maternal and Child Health programs. Services are designed to provide family support, education, linkage to a medical home, and community resources to improve health and developmental outcomes for children as well as enhance parenting skills.

Who should be referred? If there are children in your practice with suspected or confirmed developmental delays, families needing additional support to care for their child with a chronic illness as well as children with significant biological, social and/or emotional risk factors, make a referral to Children 1st. See Table 1.

How do I make a referral?  Referring to Children 1st is simple and can be completed during an office visit. Children 1st is available in every county in Georgia.  Physicians can refer a child by completing the Children 1st Screening and Referral Form and faxing it to their local Children 1st office. Referrals can also be made online and by phone.

  1. Visit the Children 1st website ( to download and complete the Screening and Referral form. When completing the Screening and Referral form, please ensure:


  • There is clear patient information on referral form (Name, address, phone number) to reach the family being referred.
  • Identified risk factors are clearly indicated on both pages of the screening and referral form.
  • Physician notes, discharge summaries and all other associated paperwork with the child’s diagnosis, including ICD-10 codes are attached with the referral form.
  • Any developmental screenings that have been completed are attached to the referral form.
  • The physician order for therapy or other services being requested are attached to the referral form.
  • The physician’s name and contact information is clearly identified on the screening and referral form.


  1. Fax the completed Screening and Referral form to the local Children 1st District Coordinator. Using the Maternal and Child Health Locator (!mch.coord_search), select the county in which the child currently resides; select the Children 1st program and click search for locations.
  1. Contact a local public health Children 1st District Coordinator and make the referral by phone (See the Maternal and Child Health Locator).
  1. Complete a referral via the Georgia Department of Public Health’s central intake referral system by phone 1-855-707-8277 or online (

Common Risk Factors for Referral to the Children 1st Program

Table 1

Prenatal Risk Factors


  • History of maternal alcohol or substance abuse
  • Lack of prenatal care
  • Illness or traumatic injury during pregnancy
  • Prenatal exposure to therapeutic drugs with known potential for developmental implications
Birth Risk Factors


  • Premature birth
  • Extended stays in the hospital/ NICU
  • Congenital infections/abnormalities
  • Low/very low birth weight
Infancy/Childhood Risk Factors


  • Exposure to environmental lead or other toxic
  • Suspected or confirmed hearing or vision impairment
  • Congenital and heritable disorders
  • Traumatic injury to the child
Childhood Chronic Illnesses


  • Asthma
  • Endocrine disorders (including diabetes)
  • Neurological and neurosurgical disorders (including epilepsy)
  • Orthopedic and neuromuscular disorders
  • Craniofacial anomalies (including cleft lip and/or palate)
Parental/Family Risk Factors


  • Parental concern about the child’s development
  • Parental developmental disabilities or mental illness
  •  Homelessness or parental unemployment
  • Family history of child abuse or neglect


“I have personally had the opportunity to work with Children 1st with several of my patients. Premature births, babies born to teenage mothers, and developmental delay noted on the exam are just a few of the clinical situations that prompted the referral. I found the experience to be extremely simple to initiate. I completed the paper form and my office staff faxed it to the appropriate office. The patient’s families appreciated the care and concern of the Children 1st staff. The communication and feedback I received from the organization was timely and well documented. The patients benefited greatly from the experience. More than half of the children eligible for these services are not identified or referred until school age. This is very unfortunate because early interventions are more effective and less costly than those initiated later in the process. The Children 1st Coordinator is a true friend of the family physician. Please utilize the services and resources Children 1st has to offer your patients. “

-Y. Monique Davis-Smith, M.D., FAAFP