Core Generalist#



Define the rights of children and adolescents including individual rights, use of chaperones, age of consent, confidentiality, and power of guardians over the rights of minors


Describe the range of normal growth and development in infants, children and adolescents


Discuss links between early childhood development and the early origins of chronic disease, including:

  • providing appropriate advice and management for conditions that affect normal childhood development and education, such as otitis media, urinary tract infections, intestinal conditions, skin conditions and upper respiratory infections
  • providing nutritional advice appropriate to the child’s age, food supply, family income and social situation
  • providing regular antenatal care, including intervention and follow up for common conditions of pregnancy such as urinary tract infections, hypertension, anaemia and poor weight gain
  • showing an understanding of the importance that remote Aboriginal and Torres Strait Islander mothers may place on delivering their babies on their homelands
  • identifying and following up children at risk, and
  • participating in childhood immunisation programs


Explain specific developmental issues and psychological issues of children and infants including:

  • normal and abnormal growth and development
  • failure to thrive
  • growth velocities in early life
  • the parent held record
  • the inter-relationship of physical and mental well-being
  • role of achievement
  • early detection and management of vision and hearing problems
  • behaviour
  • disability
  • family development and dynamics


Describe the aetiology and pathogenesis, investigations and pharmacological and non-pharmacological treatment options for conditions in childhood and adolescence


Discuss the need to adjust the consultation style and management plan to respond to influencing factors such as:

  • beliefs and expectations of the wider family which shape the presentation of the problem
  • the effect on treatment compliance of parental attitudes to illness, medication, fever and alternative remedies
  • pressures of work, and the necessity to maintain employment by both parents (as they affect the capacity to care for sick children)
  • the quality of family and community support, ie the immediate environment in which care occurs (the same clinical situation may require home or hospital management)
  • linguistic, ethnic and cultural barriers (which may exclude a parent from part of the consultation)
  • anxiety, sleep deprivation and level of understanding affecting potential expectations of the consultation both in the family and the practitioner


Describe specific nutritional and physical fitness issues in children of infant, toddler and school-aged years including:

  • nutritional goals by age group
  • flexible feeding patterns
  • risk factors for deficits
  • iron and calcium deficiency
  • vegetarian and vegan diets
  • food allergy, sensitivity
  • age specific exercise
  • recreation and fitness
  • obesity


Define problems common in adolescence including:

  • acne, seborrhoea, tinea, scabies
  • sporting injuries, spinal pains
  • interaction of lifestyle issues
  • anxiety and mood disorders
  • drugs
  • eating disordered behaviour
  • organic weight loss
  • chronic illness and disability
  • learning disorders
  • developmental disorders
  • use of anabolic steroids


Discuss common developmental issues for adolescents including individuation, sexual maturation, cognitive development and self-esteem


Discuss the barriers perceived by adolescents which may limit access to effective medical care


Describe a range of adolescent communication/assistance strategies including:

  • emergency strategies
  • engagement strategies
  • family counselling
  • organising support
  • resources
  • drop in centres


Describe how to plan emergencies at home and in the community including preparing an asthma action plan, use of medical alert tags and Epi-Pens®


Discuss mandatory reporting requirements for children, including child abuse and neglect



For common and important conditions and presentations, with consideration of clinical services capability:

  • recognise the presentation of illness
  • establish a provisional diagnosis
  • plan and arrange appropriate investigations
  • initiate appropriate medical manage for uncomplicated disease
  • monitor for complications
  • recognise if there are complications, or if procedural intervention is required, provide initial emergency management and refer appropriately


Independently perform the following assessments:

  • height, weight, head circumference evaluation
  • use standard growth charts
  • physical and functional clinical assessment
  • growth and developmental assessment
  • home, education, activities/employment, drugs, suicidality, sex, eating and safety (HEADSSS) assessment for adolescents
  • suicide risk assessment
  • paediatric neurological assessment
  • hearing assessment


Independently perform the following procedures on children and adolescents:

  • use medication delivery devices
  • use spacer devices
  • nebulisation therapy
  • nasogastric tube insertion
  • local anaesthesia administration
  • superficial skin lacerations repair
  • subcutaneous foreign body removal
  • urethral catheterisation
  • suprapubic aspiration
  • venous blood sampling


Assist with performing the following procedures on children and adolescents:

  • child sedation
  • fracture reduction
  • dislocated joint reduction
  • thoracentesis
  • intercostal catheter insertion


Perform emergency procedures specific to children and adolescents including

  • endotracheal intubation (child and neonate)
  • resuscitation (child and neonate)
  • external cardiac massage
  • bag/mask ventilation
  • oropharyngeal airway
  • defibrillation
  • synchronised direct current (DC) cardioversion
  • intravenous access
  • umbilical catheter (neonate)
  • intraosseous access








Advanced Specialised#



Describe the physiological differences between a neonate, child and adolescent


Discuss the principles and issues relating to patterns of inheritance, newborn screening and counselling


Describe early attachment theory


Demonstrate knowledge and understanding of the causes of inter-uterine conditions likely to cause developmental delay, including:

  • anomalies of the central nervous system
  • low birth weight – especially less than 1000 grams
  • chromosomal abnormalities – including fragile X syndrome
  • congenital infections
  • cerebral palsy
  • disorders of the sense organs
  • inborn errors of metabolism
  • neuromuscular disorders
  • foetal alcohol spectrum disorder (FASD) and maternal drug ingestion
  • orthopaedic abnormalities
  • poverty and maternal malnutrition


Demonstrate advanced understanding of the five domains of developmental disability:

  • speech and language delay
  • gross motor delay
  • fine motor delay
  • personal and social delay
  • global delay


Discuss pervasive developmental disorders, including:

  • Autistic Spectrum Disorder (ASD)
  • Rett’s Syndrome
  • childhood disintegrative disorder
  • pervasive developmental delay not otherwise specified


Describe learning disabilities and the protocols for administering and interpreting the results of the Wechsler Intelligence Scale for Children (WISC)


Explain aspects relating to nutrition, including

  • causes and implications of low birth weight, prematurity and intrauterine growth retardation
  • the principles and issues associated with nutritional goals by age group including flexible feeding patterns, risk factors for deficiencies, as well as food allergy and sensitivity.
  • the application of knowledge to age-specific exercise, recreation and fitness programs and reducing the risk of obesity and other related diseases


Describe when a child can consent to medical treatment on their own behalf, and without their parents’ knowledge.


Discuss issues relating to adolescents, including:

  • rights of children and adolescents including individual rights, use of chaperones, age of consent, confidentiality, and power of guardians over the rights of minors, in everyday patient care
  • normal striving for independence and the issues of concern to young people as they progress through adolescence
  • barriers perceived by adolescents which may limit access to effective medical care and how best to address these
  • effect of peer pressure, school, mass media and employment prospects on the attitude and behaviour of adolescents
  • common developmental issues for adolescents including individuation, sexual maturation, cognitive development and self-esteem
  • strategies to manage problems that can arise during adolescence including peer issues, and problems with body image, support/alienation from family/school/peers, oppositional behaviour, school dysfunction and self-harm
  • strategies to manage psycho-social issues in adolescents including effects of homelessness, unemployment and their health impact, risk-taking behaviour including substance misuse (normal, experimentation, at risk, out of control), suicidal intention or self-harm, dysfunctional families, eating disorders
  • financial and compliance issues when prescribing for adolescents
  • family development and dynamics affecting children including parental substance use, the effects of smoking, childhood caffeine use and high-risk families


Discuss issues relating to Aboriginal and Torres Strait Islander children, including:

  • knowledge of the diseases over-represented in Aboriginal children,
  • understanding the impact of poor living conditions and over-crowding
  • management of acute episodes of disease
  • long-term management of chronic conditions
  • population health initiatives for disease prevention and management
  • understanding Cultural Safety
  • understanding Guardianship within communities
  • understanding barriers to effective prevention, treatment, and compliance with advised care


Discuss sexual health issues, including:

  • knowledge of child protection including knowing the relevant laws in their state or territory
  • knowing the role of chlamydia testing and screening in teenagers
  • knowing when to take a more detailed sexual history
  • having information and resources available regarding common sexually transmitted diseases
  • know the local resources
  • know local treatment protocols


Describe toxicology, poisoning and envenomation, including:

  • know the venomous animals etc in their area of work and the principles of treatment – local spiders, snakes, marine animals
  • know the treatment of common childhood poisons and overdoses and be competent in their treatment
  • be familiar with the Poisons Information Centre including the phone numbers


Discuss palliative care in childhood, including:

  • principles of palliative care in the paediatric setting
  • knowledge of local resources and referral protocols
  • knowledge of local support services and other patient resources
  • understanding the importance of supporting the child and family in a culturally appropriate manner
  • pain management


Discuss vaccine preventable infectious diseases:

  • advanced knowledge of the immunisation schedule
  • ability to describe the complications of immunisations
  • ability to discuss the myths of immunisations
  • knowledge of the immunisation preventable diseases


Discuss growth and nutrition including:

  • growth faltering/failure to thrive,
  • overweight/obesity,
  • specific nutritional deficiencies including iron deficiency,
  • vitamin D deficiency outside of the neonatal period


Discuss diagnostic testing in children, including:

  • understanding of the indications, contra-indications and techniques for an extended range of paediatric diagnostic investigations
  • how to arrange a wide range of paediatric tests and interpret their results, taking into consideration age variation and findings relevant to different age groups
  • explaining to parents and caregivers the relevance of the results


Discuss principles and practices for pharmaceutical prescribing in children, including differences between paediatric and adult prescribing, including but not limited to:

  • thrombolytic therapy
  • treatment of bleeding disorders
  • inotropic therapy
  • disease modifying anti-rheumatic drugs
  • insulin therapy
  • chemotherapy
  • advanced palliative care
  • anticoagulation
  • mental health conditions


Discuss the indications, contra-indications and techniques for an extended range of paediatric diagnostic investigations


Describe formulas for paediatric resuscitation, including:

  • weight
  • endotracheal tube size
  • fluid resuscitation
  • dose of adrenaline
  • joules for electrical shock


Describe appropriate pain relief: oral sucrose for infants, topical amethocaine


Discuss characteristics of rural and remote settings and their implications for child and adolescent health practice, including:

  • types of conditions likely to be encountered
  • impact of rural and remote attitudes
  • impact of distance – including delays in transport/referrals
  • impact of limited resource availability


Utilisation of technology where useful, including video/tele conferencing, video-otoscopy, picture archiving and communication system (PACS) utilisation including USS 'quality control', and microscopy of CSF



For the less common or more serious conditions and presentations of childhood and adolescence with consideration of clinical services capability:

  • recognise the presentation
  • establish a provisional diagnosis
  • plan and arrange appropriate initial investigation
  • initiate empiric therapy
  • discuss broad therapeutic options
  • refer appropriately
  • provide ongoing management


Obtain a clinical history including:

  • maternal
  • family – including cultural and social factors
  • genetic
  • birth
  • neonatal
  • developmental
  • nutritional
  • immunisation
  • environmental
  • past medical


Engage with and perform a relevant physical examination and developmental assessment including:

  • elucidation of a wide range of clinical signs including subtle clinical signs indicative of dysmorphology
  • investigation for negative signs (i.e. signs that are absent)
  • assessment of developmental age and/or learning ability
  • neonatal examination
  • growth and serial measurement
  • examination and assessment of a child with a convulsion and/or altered level of consciousness
  • assessment for physical signs of nutritional and metabolic disorders including growth failure, obesity and insulin resistance
  • identify physical signs and behaviour patterns associated with neglect and abuse
  • examination of all joints for differential diagnosis


Order and/or perform diagnostic tests, including:

  • full blood count – understand and advise on normal blood results
  • Point of care testing and interpretation of urine, Hb, WCC, chem8, chem4, international normalized ratio (INR), brain natriuretic peptide (BNP)
  • gram stain on cerebrospinal fluid (CSF)
  • specialised blood tests – including arterial blood gases, renal biochemistry, liver function tests (LFTs), bacterial serology and viral serology
  • chest X-ray – interpretation of chest X-rays in children and adolescents, understanding and advising on age-appropriate variations and abnormalities
  • growth charts – understand the normal growth patterns in childhood, and appropriate use and interpretation of growth charts
  • abdominal ultrasound
  • bronchoscopy
  • CT scan interpretation
  • MRI interpretation
  • electroencephalogram (EEG)
  • electrocardiogram (ECG)
  • bone marrow examination
  • behavioural assessments and specialised developmental testing


Manage abnormal results, including:

  • screening of high-risk pregnancies – including cervical cytology
  • vitamin D deficiency
  • screening for Haemoglobinopathies
  • varicella, cytomegalovirus and toxoplasmosis serology
  • chlamydia screening
  • thyroid function test
  • ‘triple’ or’ quadruple’ testing
  • ultrasound for nuchal translucency
  • neonatal fever and suspected neonatal sepsis
  • neonatal jaundice
  • neonatal hypoglycaemia
  • ability to perform a heel prick test and discuss with parents the conditions it is used to test for
  • reasons for administration of Vitamin K, BCG and Hepatitis B vaccine at birth
  • respiratory distress in the newborn
  • feeding of the newborn
  • management of the infant of a diabetic mother


Assess and manage children with psychosocial issues including:

  • behaviour management – including children with challenging behaviours
  • sleep difficulties
  • nocturnal enuresis
  • parenting issues
  • eating disorders
  • swearing problems
  • issues relating to the context of childhood within the family
  • children at risk of child abuse
  • grief responses
  • school performance issues


Assess and manage mental health conditions, including:

  • ability to perform a mental health screen for children and adolescents
  • high prevalence anxiety and mood disorders
  • the child whose mother has depression especially post-natal depression
  • intervening in a case where a child or adolescent is at risk for suicide
  • early psychosis with appropriate support or referral


Identify early indicators of ‘at risk’ behaviours of adolescents and initiate harm minimisation strategies


Use range of adolescent communication/assistance strategies including:

  • emergency strategies
  • confidential history taking
  • minimising anxiety
  • encouraging compliance
  • direct family counselling and
  • assist in coping with imprisonment


Prevent occurrence and recurrence of primary conditions and prevent secondary complications from primary conditions


Recognise conditions in childhood that may only show their consequences in adulthood e.g. obesity, bone health, rapid weight gain in growth retarded infants


Manage acute conditions requiring inpatient admission specific to children and adolescents including:

  • head injury
  • hypovolaemia
  • hyper and hypoglycaemia
  • acidosis
  • hypoxia and
  • blood transfusion


Estimate and administer fluid requirements for ongoing maintenance


Manage neonates admitted with common neonatal medical conditions


Meet mandatory reporting requirements, as relevant to state or territory


Manage conditions overrepresented in Aboriginal and Torres Strait Islander children


Competent, confident and independent performance of the child and adolescent procedural logbook skills








Paediatric presentations and conditions#

  • Upper respiratory, mouth, eye and ear, including recurrent viral infections, croup (acute, recurrent), stridor, laryngomalacia, rhinitis, sinusitis, nasal septal haematoma, epistaxis, sleep apnoea, hearing loss, otitis media, chronic suppurative otitis media, otitis externa, cholesteatoma, stomatitis, thrush, herpes, coxsackie virus, teething, caries prevention, tonsillitis, epiglottitis, cervical adenopathy, congenital glaucoma, cataract, blocked tear duct, conjunctivitis: infectious & allergic, unilateral red eye, retinoblastoma, amblyopia, squint, periorbital cellulitis
  • Lower respiratory, including recurrent bronchitis, bronchiolitis, asthma, wheezy cough under three years, cough, psychogenic cough, pneumonia, atypical pneumonia, pertussis, cystic fibrosis, tuberculosis, bronchiectasis
  • Cardiac, including murmurs (innocent and pathological), coarctation of the aorta, supraventricular tachycardia, abnormal blood pressure, subacute bacterial endocarditis prophylaxis
  • Gastrointestinal, including abdominal pain, acute abdomen, headache, vomiting, diarrhoea, acute and chronic, dehydration as a factor in acute illness, rehydration techniques, gastro-oesophageal reflux disease, pyloric stenosis, coeliac disease, appendicitis, hernia, abdominal mass, intussusception, constipation, encopresis, rectal bleeding, jaundice, hepatitis
  • Genitourinary, including abnormal/ambiguous genitalia, fluid - electrolyte imbalance, hydrocoele, undescended testis (early, late), inguinal hernia, urinary tract infection, vesicoureteral reflux, congenital abnormality urinary tract, acute urinary obstruction, glomerulonephritis, nephrotic syndrome, enuresis, vulvitis, labial adhesions, phimosis, paraphimosis, torsion of testis, circumcision, tumours
  • Dermatological, including normal skin variation, aboriginal skin problems, birth marks, viral exanthems (specific and non-specific), solar pathology/prevention, napkin rash, thrush, tinea, kerion, eczema, psoriasis, seborrheic dermatitis, scabies, lice, molluscum contagiosum, orf, pityriasis, perianal streptococcus, infections, impetigo, urticaria, drug/food rashes, septicaemia, meningococcus
  • Musculoskeletal, including limp, Perthes’ disease, hip dysplasia, lower limb problems, patello-femoral syndromes, epiphysitis, apophysitis, soft tissue trauma, minor dislocations, progressive muscular weakness, sepsis, bone/joint infections
  • Infections, including measles, mumps, rubella, Epstein-Barr virus, herpes simplex, haemophilus influenza B, meningococcus, varicella zoster, streptococcus, staphylococcus, chronic viral, HIV, hepatitis, tropical infestations, congenital (rubella, cytomegalovirus, hepatitis)
  • Haematological, immunological, and rheumatological, including normal age haematology, anaemia, lymphoma, leukaemia, inherited conditions, purpura, haemophilia, thalassaemia, sickle cell disease, allergies (general concepts and fads), vasculitides, angioedema, Kawasaki syndrome, autoimmune disease, general arthralgia, systemic lupus erythematosus, rheumatoid arthritis, immunodeficiency, human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS)
  • Endocrine, including diabetes, thyroid disorder/s, short stature, abnormal puberty
  • Neonatal, including respiratory distress, asphyxia, cyanosis, hypoglycaemia, hypothermia, vomiting, failure to pass meconium, physiological jaundice, non-physiological jaundice, intraterm and neonatal infection, seizures, maternal syphilis, hepatitis B & C, HIV
  • General issues, including neonatal checks, Well/Normal baby/child checks, Growth problems, failure to thrive, obesity, behavioural issues, (normal versus 'problem'), the social context, developmental delay, disruptive children, attention deficit hyperactivity disorder (ADHD), autism spectrum disorder, sleep disorder, the crying baby, oppositional behaviour and alienation, disability, (learning: specific/general), intellectual disability (sub normality), physical disability, language disability, sudden infant death syndrome (SIDS) prevention and management
  • Over represented in Aboriginal and Torres Strait Islander children, diarrhoeal disease, chronic, malnutrition, Type II diabetes and insulin resistance, failure to thrive, urinary tract infections and renal stones, chronic suppurative otitis media and associated hearing loss, chronic suppurative lung disease/bronchiectasis, trachoma, iron deficiency, scabies, parasitic infestations, impetigo, rheumatic fever, post strep glomerulonephritis, and other infectious diseases such as parasitic diseases
Last updated on by acrrmbot