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Toddlers & Preschoolers
Last Reviewed September 2014

Play, Learning and Development

Doctor & Nurses with child

18 month doctor's visit

Information for parents | Information for health professionals |

Information for health professionals

Background:

  • The province is now funding an in-depth 18-month well baby visit: Enhanced 18-Month Well baby Assessment fee of $61 on a child between ages 17 to 24 months.
  • The billing code is GP/FP-A002 or Paediatrics – A268.
  • It's a standardized developmental assessment for all children aged 18 months that incorporates the use of the Nipissing District Developmental Screen (NDDS) and the Rourke Baby Record.
  • It's carried out with the 18 month well baby visit because this visit is the last scheduled primary care visit coupled with immunizations before a child enters school.
  • The Enhanced 18-Month Well-Baby Visit is a collaborative initiative between the Ministries of Health and Long Term Care, Children and Youth Services and Health Promotion based on the 2005 expert panel report "Getting it Right at 18 Months…Making it Right for a Lifetime."

How This Will Help You and Your Patients:

  • Provides primary health care professionals the tools and time to have comprehensive discussions about child development, parenting, community services and early literacy in addition to a full physical examination.
  • Promotes collaboration between primary care, public health, child development services and parents to improve outcomes for children.

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Frequently Asked Questions

What is the Enhanced 18 Month Well Baby Visit?

  • Standardized developmental assessment for all children aged 18 months that incorporates the use of the Nipissing District Developmental Screen (NDDS) and the 2009 Rourke Baby Record.
  • Carried out with the 18-month well-baby visit because this visit is the last scheduled primary care visit coupled with immunizations before a child enters school.
  • A collaborative initiative between the Ministries of Health and Long Term Care, Children and Youth Services and Health Promotion based on the 2005 expert panel report "Getting it Right at 18 Months…Making it Right for a Lifetime."

Will I be reimbursed for this Enhanced Visit?

  • Yes.
  • The province is now funding an in-depth 18 month well baby visit: Enhanced 18 Month Well baby Assessment fee of $61 on a child between ages 17 to 24 months.
  • Billing code: GP/FP – A002; Paediatrics – A268.

What is the purpose of this visit?

  • To assess the child's progress in achieving developmental milestones.
  • To provide early identification of developmental concerns and referral to a specialized service if required.
  • To discuss the parent's role in influencing their child's development.
  • To encourage parents to use resources in the community that promote literacy, reading, and play.

What steps are involved?

  1. Parents complete the Nipissing District Developmental Screen (NDDS) (ideally prior to their appointment).
  2. You will review the NDDS results and complete an assessment using the 2009 Rourke Baby Record (RBR).
  3. The clinician will refer the family to the appropriate community services. The " Enhanced 18 Month Well Baby Visit – Resource Pathway" (1 page, 489 KB) will guide physicians and other primary care providers with referrals.

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How do I order a copy of the Enhanced 18-Month Well Baby Visit – Resource Pathway?



  • You can download a free copy (1 page, 489 KB).
  • You can request a laminated copy to be mailed to you by contacting a Public Health Nurse at 905-799-7700.

Where can I/my patients get the Nipissing District Developmental Screen (NDDS)?

  • To order copies of the NDDS, please visit www.ndds.ca or call 1-705-752-5081.
  • Parents can order a free copy at the NDDS website.
  • Parents can also call to speak with a Public Health Nurse at 905-799-7700.

What if my patients don't know how to fill out the NDDS?

  •  Instructions, sample screens and FAQs are available online at www.ndds.ca.
  • It is recommended that a member of your team be familiar with the tool so they may support your patients in completing the screen.
  • Additional support is available from a Public Health Nurse at 905-799-7700.

Are translated versions of the NDDS available?

  • This tool is currently available in English, French, Spanish, Chinese and Vietnamese through the NDDS website.

Where do I get the 2009 Version of the Rourke Baby Record?

This document is available for download online at:

Is the 2009 Rourke Baby Record (RBR) different from the 2006 version?

  • Yes, revisions have been made in several areas:
    • Growth
    • Nutrition
    • Injury prevention
    • Behaviour
    • Family
    • Developmental milestones
    • Physical examination
    • Immunization
  • The 2009 RBR uses the WHO 2006 Growth Standard instead of the CDC 2000 growth charts.
  • For information on specific changes, refer to the RBR website.

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Where do I learn more about the Enhanced 18 Month Well Baby Initiative?

  • This information is available online through the McMaster Health University portal.
  • This site contains:
    • Supporting literature for the initiative.
    • Learning Modules (including a "How to" Section).
    • Downloadable forms (RBR and NDDS).
    • Resources.

Quick Links

McMaster University Health Sciences
This site provides background information, learning modules and downloadable versions of the Rourke Baby Record, Nipissing District Developmental Screen and pamphlets.

Rourke Baby Record
This site provides a downloadable copy or the Rourke Baby Record as well as comprehensive information on using this tool.

Nipissing District Developmental Screen
This site provides information on use of the Nipissing District Developmental Screen as well as order forms to obtain copies.

Ministry of Children and Youth Services
Information for professionals about the 18 Month Well Baby Visit.

For more information:

Region of Peel - Public Health
905-799-7700
Monday to Friday 8:30 a.m. to 4:30 p.m.
to speak with a Public Health Nurse

Caledon residents call free of charge at 905-584-2216


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Revised: Thursday October 02 2014

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