This paper presents key concepts related to spirituality that are meaningful to a community-based paediatric rehabilitation centre in Ontario, Canada, for the provision of holistic care for children and youth with disabilities and their families. These key concepts were identified through an extensive review of quantitative and qualitative studies from relevant areas of research. Discussions around the concepts then took place with service providers from multiple disciplines, administrators, advisory board members, childhood disability researchers and parents of children and youth with disabilities. Practice implications from the literature and from the discussions resulted in six recommendations related to implementation of holistic care to address the spiritual needs of children and youth with disabilities and their families within the context of paediatric rehabilitation. Copyright © 2008 John Wiley & Sons, Ltd.