Rehabilitation Medicine - Paediatric

PAEDIATRIC

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Patients with severe symptoms indicating potential life-threatening complications or immediate neurological risks, such as:
      • Rapidly deteriorating consciousness or sudden confusion
      • Increasingly restless, agitated, or combative behaviours
      • Acute neurological change (e.g., before severe weakness, hypertonicity, sensory changes)
      • Seizures or uncontrollable vomiting
      • Signs of raised intracranial pressure (severe headache, vision changes, unequal pupils)
    • Autonomic dysreflexia not responding to home management plan.
    • Acute change in functional ability
    • Severe acute on chronic pain or pain crises not manageable with existing pain management plan.
    • Significant deterioration in mental health, self-harm or suicidal ideation not able to be managed through community outpatient services
    • New bowel or bladder incontinence: A sudden loss of control, indicating a need for urgent care.
    • Refer to HealthPathways for assessment and management recommendations.
    • Adolescents and Young Adults (AYA) considerations (16–18 years):
      • Given the diversity within this age group, inclusion in adult rehabilitation services should be based on functional context rather than age alone. AYAs aged 16–18 who are engaged in adult lifestyles or activities (e.g. employment, apprenticeships) are best suited to adult rehabilitation pathways.
      • Eighteen-year-olds in their final year of school should not be automatically excluded from adult rehabilitation services, as input from paediatric rehabilitation (e.g. QPRS) would likely be short-term due to limited time remaining at school. In exceptional cases, QPRS may assist with outpatient rehabilitation for 18-year-olds with brain or spinal cord injuries where goals are specifically related to return-to-school outcomes. This is only done via direct referral from adult rehabilitation specialists, who retain primary responsibility for ongoing rehabilitation.

    Request for advice

    • GPs may use the Request for Advice (RFA) pathway when patients present with, stable conditions that does not meet criteria for urgent referral. This allows specialist input while supporting ongoing management in primary care and avoiding unnecessary waitlisting.
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Out of home care
  • New diagnosis where child has a reduced ability to manage safely at home or school or significant decline in ability to perform activities compared to the individual’s baseline secondary to accepted condition above.
  • Acute carer distress: Caregiver is unable to sustain patient care due to stress or burnout.
  • Acute patient distress due to condition related issues where person is at significant risk of hospital presentation or harm (e.g. significant pain associated with the condition, adverse mental health concerns)
  • Complications secondary to accepted conditions (e.g. pressure areas, recurrent autonomic dysreflexia) requiring early but not emergency review.
  • Antenatal counselling for spinal dysraphism, achondroplasia or limb difference.
  • Presurgical amputation counselling.
  • Early post-amputation rehabilitation requirements.
  • New diagnosis for child with spinal dysraphism.
  • New diagnosis for children with achondroplasia (for manual handling support and education and prevention and management strategies for cervico-medullary compression).
  • Neuropsychology assessments for children referred by neurologist or neurosurgeon for children with planned epilepsy surgery anticipated within 1 month

    • NB: For adolescents aged 16–18 who are engaged in adult roles (e.g. apprenticeships or employment), referral to adult rehabilitation services may be more appropriate, and referral pathways should be considered accordingly.
Category 2
(appointment within 90 calendar days)
  • Pre-existing or newly diagnosed disability secondary to accepted condition with impairments requiring interventions to optimise function in home / school / community or to limit required carer support.
  • Recent rehabilitation admission where outpatient follow-up is required. This may include those who attended inpatient rehabilitation in another state/HHS.
  • Children with spinal cord injury or spinal dysraphism transitioned from another HHSD where surveillance and management is likely required within 3 months.
  • Neuropsychology assessments for children referred by neurologist or neurosurgeon for children with planned epilepsy surgery anticipated within 3 months.
  • Neuropsychology assessments required within 3 months as part of paediatric oncology international protocols.
Category 3
(appointment within 365 calendar days)
  • Pre-existing disability secondary to accepted condition with no obvious rehabilitation goals or surveillance indicated for within 3 months.
  • Neuropsychology assessments for children referred by neurologist or neurosurgeon for children with planned / post epilepsy surgery anticipated not within 3 months
  • Routine neuropsychology assessments required as part of paediatric oncology international protocols.

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • Diagnosis and relevant medical history: E.g. lowest GCS, duration of PTA and neuroimaging results for children with traumatic brain injury.
  • Out of home care / Department of Child Safety involvement (Triage Cat 1).
  • Name and contact details of patient’s guardian

3. Additional referral information Useful for processing the referral

  • Comorbid conditions e.g. Mental health conditions, ADHD, Autism
  • Current medications: List medications being taken by the patient.
  • Current social situation: Detail the patient’s living arrangements, functional status, and any support services in place (e.g., family support, carers, community allied health assistance, NDIS / NIISQ or LTCS participation).
  • Carer stress or burden if present
  • Please comment on child’s engagement in learning.
  • Children with spinal dysraphism receive care through clinics coordinated with multiple sub/specialist involvement. Please ensure referral is sent to all involved specialist groups.

4. Request

  • Patient's demographic details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring practitioner details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service.  Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
    • A change in patient circumstance (such as condition deteriorating or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 5 May 2026

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