This chapter explores child spirituality and development as theoretical underpinnings of paediatric spiritual assessment and care. It looks at the implications of the work of key theorists in the field and the implications of their work for paediatric spiritual assessment. It explores approaches to spiritual assessment focusing on the use of Interpretive Spiritual Encounters through spiritual play. It aims to enable multidisciplinary staff to gain an understanding of the importance and role of spirituality in the life of the child and introduces a range of accessible ways that they may be involved in spiritual assessment. This chapter includes a sample spiritual care pathway, good practice principles and some of the issues involved in spiritual assessment in a paediatric context.