What is paediatric rehabilitation?

Paediatric rehabilitation is goal directed, multidisciplinary care, which focuses on addressing activity limitations and/or participation restrictions a child or young person may be experiencing. It is a family-centred, specialised domain of paediatric medicine.

Activity limitations and participation restrictions

Activity limitations are ‘difficulties an individual may have in executing activities’¹, such as feeding themselves or getting upstairs in their home.

Participation restrictions are ‘problems an individual may experience in life situations’¹, such as being unable to participate in school due to fatigue or behavioural changes.

Goals

Paediatric rehabilitation is goal-focused and based upon measurable goal attainment. Goals should be specific, measurable, achievable, realistic and have a time target (SMART). Goals should be determined in collaboration with the child or young person and their family.

Ensuring that paediatric rehabilitation is based upon on patient and family-centred goals has a positive impact on the health and wellbeing of children and young people requiring these services, as well as their families.

Goal-setting in rehabilitation Clinical Excellence Queensland

Inpatient paediatric rehabilitation

Inpatient paediatric rehabilitation is paediatric rehabilitation for children or young people in an admitted, inpatient setting. It is generally of a higher intensity than other rehabilitation programs that may be available in an ambulatory or community setting. This higher intensity is extremely important, as outlined below.

Children and young people admitted for inpatient rehabilitation are not managed like other patient cohorts, who may be discharged as soon as they are medically stable. Inpatient rehabilitation patients remain as inpatients to allow access to high intensity therapy, which will optimise their recovery and outcomes. At times they may be discharged if they can be managed safely at home and an ambulatory or community program is available to support functional improvements at a sufficient intensity.

Why is intensive rehabilitation important?

When a child or young person experiences a significant loss of functional skills, either due to injury or illness, they may require intensive inpatient rehabilitation. Research has shown that high intensity rehabilitation programs optimise functional recovery and produce better long-term outcomes, across a variety of conditions.²

When undergoing intensive rehabilitation following an injury or illness periods of rapid change are often seen followed by periods of slower progression. Having access to intense rehabilitation during times of rapid change can have positive long-term impact on recovery and functional skills, while a less intense program may slow progression.

References

1. Australian Institute of Health and Welfare. ICF Australian User Guide Version 1.0. Canberra, ACT: Australian Institute of Health and Welfare; 2003.
2. Australasian Faculty of Rehabilitation Medicine. Standards for the provision of paediatric rehabilitation medicine inpatient services in public and private hospitals. Sydney, NSW: Royal Australian College of Physicians; 2015.