Does anybody know when a child needs to refer?

You’re welcome.

Thanks a lot.

When a child's behaviour, internalizing or externalizing, interferes with a child's functioning (e.g., peer or family relationships, academic functioning, emotional well-being, and physical health), it is recommended that the child be referred for additional assessment. For example, when a child is acting out in school and therefore is unable to focus on his or her work and is not achieving as expected, the child should be referred for a psychological evaluation and perhaps psychotherapy. When a child's behaviour changes dramatically, such as when a child who is generally outgoing suddenly becomes very withdrawn and shy, a referral should be considered.