Toddler Track: Streamlining Developmental Assessments-A Retrospective Cohort Study

To design, implement and evaluate a novel model of care, Toddler Track Model (TTM), at a specialist outpatient developmental assessment service to determine whether the model: (1) reduced wait times to access the service; (2) reduced length of time to complete developmental assessment; (3) resulted in any change to the formulation of developmental profiles.

TTM utilised a Plan-Do-Study-Act (PDSA) framework to redesign service delivery. Children aged 18 months to 3 years 11 months were triaged into one of four streams based on clinical information, with tailored pathways involving allied health and paediatrician input. Outcomes were measured through a retrospective chart audit, comparing key time points and service metrics before and after implementation of TTM.

The average time from initial clinical session (ICS) to diagnostic formulation decreased from 116 to 63 days (p < 0.001), with statistically significant reductions observed at all measured service time points. The number of children assessed in 2024 increased substantially (n = 132). Importantly, diagnostic outcomes did not differ between cohorts, indicating no change in clinical formulation. Service-wide wait times declined by 61.5%, with 68% of this reduction estimated to be associated with TTM.

The findings suggested that TTM is a novel model of care for children aged 18 months to 3 years 11 months. Its implementation successfully reduced wait times and assessment duration while increasing service capacity, without altering diagnostic outcomes or clinical practice standards.