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Decision Tree: Child with Special Needs Referral Process

What is the Decision Tree?

The Decision Tree: Child with Special Needs Referral Process is an easy-to-read reference guide. The purpose of the Decision Tree is to help primary care providers, and other community providers, readily identify the key contact person(s) in their County who can help families of children with special needs access the following:

  • Further developmental assessment and diagnosis
  • Intervention services such as nutrition services, occupational therapy, physical therapy, special education, speech and language therapy, etc.
  • Care coordination support

It is intended that a county agency or Local Health Jurisdiction customize the Decision Tree to fully represent the referral and resource systems unique to the local region. The Decision Tree is provided in two electronic formats, Microsoft Word and Microsoft PowerPoint Tree, both of which allow for individual customization.

Background Information

The Decision Tree was developed in response to requests from primary care providers for an easy-to-use diagram to key community services for children with special needs.
The Decision Tree was developed by the Washington State Department of Health – Children with Special Health Care Needs (CSHCN) Program, in partnership with Department of Early Learning – Early Support for Infants and Toddlers Program (ESIT) Program and local public health nurses.

Target Audience

  • Primary care providers and their office staff
  • Community health, education, and social service providers who are in a position to identify and refer children with suspected concerns

Instructions for Customizing the Decision Tree

  1. Open the electronic file
  2. Type in the name of the county and the appropriate phone numbers
    in the designated spots on the diagram.
  3. As needed, you may make additional changes to the Decision Tree to best represent the referral and resource systems in your county.

Ideas for Using the Decision Tree

  • Create a flyer that can be posted in physician offices. Consider printing the Decision Tree in color, or print it in black and white on brightly colored paper. Laminate the flyer.
  • Send an email announcement to physicians’ offices with the Decision Tree attached to the email. Offer suggestions for how the Decision Tree can be used by the physician and office staff.
  • Post the Decision Tree on the Local Health Jurisdiction website, or other community agency websites.
  • Use the PowerPoint version of the Decision Tree in presentations.
  • A Child Health Note is dedicated to the Decision Tree: Child with Special Needs Referral Process. For more information about Child Health Notes, go to