More children in Northern Ireland are waiting to see a consultant for the first time.
A review of child health waiting lists revealed that in the past 12 months, there had been an 184% increase in children waiting more than four years.
Waiting times have also grown in other services for children, including mental health, speech and language therapy and autism assessments.
The Department of Health said it welcomed the focus on waiting times.
This latest review by the commissioner for children and young people is an update on a report titled More than a Number – A Rights Based Review of Child Health Waiting Lists, which was published in 2021.