About the Rehabilitation Medicine Department
As part of the Clinical Center's comprehensive care for children enrolled in clinical trials, a child may be referred for services from the Rehabilitation Medicine Department (RMD).  RMD services include: 

• physiatrist (rehabilitation physician) consultation
• physical therapy
• occupational therapy
• speech & language pathology
• therapeutic recreation
• vocational rehabilitation consultation
• specialized gait analysis
• specialized swallowing analysis 

Pediatric specialists are available in each discipline to see both inpatients and outpatients.  RMD team members can address a variety of patient concerns including developmental issues, problems with daily life skills, rehabilitation equipment needs, emotional or coping issues and pain.  Patients can be prescheduled before or soon after their arrival.  For more information about the department follow this link: Rehabilitation Medicine at the NIH Clinical Center.

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Contacting Rehabilitation Medicine
Rehabilitation Medicine services are ordered via the CRIS system. Type the name of the desired rehabilitation service into the order screen and follow the instructions for completing the CRIS order form. You may also type in and complete a "Rehab Quick Order" to request more than one rehabilitation service at a time. If the patient has significant rehabilitation needs (e.g. will need more than one rehabilitation therapy or is medically complex), it is recommended that a "Physiatry" consult be submitted as well as specific therapy consults. If you have questions about ordering a consult, please call the Clinical Center Rehabilitation Medicine Department reception desk at (301) 496-4733.
 
After hours (5 p.m. to 8:30 a.m.) and on weekends, the physiatrist on-call is available for urgent rehabilitation issues. Call the page operator at (301) 496-1211. 

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When should I consult Rehabilitation Medicine?
These questions may help you decide when to consult the Rehabilitation Medicine Department. 

Question	Consult Rehabilitation Medicine
Developmental issues
Is there a need for formalized assessment/testing of language, fine or gross motor development?	If yes, consult Physiatry.
Does the child seem to be delayed in verbal, auditory skills or written expression?	If yes, consult Speech and Language Pathology.
Does the child seem to be delayed in understanding of directions and sequencing of tasks?	If yes, consult Physiatry, Occupational Therapy and Speech and Language Pathology.
Does the child seem to be delayed in fine motor skills/ability to manipulate objects?	If yes, consult Physiatry and Occupational Therapy.
Does the child seem to be delayed in visual/perceptive function (spatial relations, recognizing shapes)?	If yes, consult Physiatry and Occupational Therapy.
Does the child seem to be delayed in gross motor skills/mobility?	If yes, consult Physiatry and Physical Therapy.
Does the child demonstrate social/interpersonal skills and interactions at an age appropriate level?	If no, consult Recreation Therapy.
Problems with daily life skills
Does the child have difficulty with swallowing different types of foods and foods of varying textures?	If yes, consult Speech and Language Pathology.
Is the child's speech understandable at level expected for his/her age?	If no, consult Speech and Language Pathology.
Is the child impaired in mobility (e.g., rolling, crawling, walking, running)?	If yes, consult Physiatry and Physical Therapy.
Can the child feed her/himself at the level expected for his/her age?	If no, consult Physiatry and Occupational Therapy.
Can the child bathe, groom, and dress him/herself at the level expected for his/her age?	If no, consult Physiatry and Occupational Therapy.
Does the child show an interest in and play with toys at his/her age level?	If no, consult Physiatry and Occupational Therapy.
Is the child having difficulties performing previously enjoyed leisure activities?	If yes, consult Physiatry and Occupational Therapy.
Rehabilitation equipment needs
Does the child wear or appear to need an arm or leg brace?	If yes, consult Physiatry.
Does the child require something other than a regular bathing situation in order for parents to wash the child?	If yes, consult Physiatry and Occupational Therapy.
Does the child require specialized tools for eating or drinking (e.g., built-up grips on silverware, special handles on cups)?	If yes, consult Physiatry and Occupational Therapy.
Does the child need special tools or adapted clothing to dress independently (e.g., Velcro closures, elastic shoelaces)?	If yes, consult Physiatry and Occupational Therapy.
Does the child need adapted toileting equipment?	If yes, consult Physiatry and Occupational Therapy.
Does the child need a cane or other support for ambulation?	If yes, consult Physiatry and Physical Therapy.
Does the child use a wheelchair or appear to need one?	If yes, consult Physiatry, Occupational Therapy and Physical Therapy.
Emotional or coping issues
Is the child feeling anxious about medical procedures as minor as needle sticks or as major as surgery?	If yes, consult Recreation Therapy  for modalities including medical play, pre-operative teaching and/or instruction in relaxation/coping techniques.
Pain
Is the child suffering from pain of musculoskeletal or neurological origin?	If yes, consult Physiatry.

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This information is prepared specifically for caregivers involved in clinical research at the NIH Clinical Center at the National Institutes of Health.