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Disability Care Load Assessment (Child) Determination 2020

Authoritative Version
  • - F2020L01025
  • In force - Superseded Version
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Determinations/Other as made
This instrument enables the Secretary of the Department of Social Services to determine a method for a treating health professional to assess the disability, emotional state, behaviour and special care needs of a person under the age of 16 (child). This instrument provides a method for rating the special care needs of a child. It also provides a method for assigning a qualifying rating to a person (the carer) who is caring for the child by taking into account the care provided for the child by the carer, and the assessment completed by the treating health professional. It will determine the persons, or classes of persons, to be considered treating health professionals for the purposes of the Social Security Act 1991 other than for the purposes of the Adult Disability Assessment Tool.
Administered by: Social Services
Registered 17 Aug 2020
Tabling HistoryDate
Tabled HR24-Aug-2020
Tabled Senate24-Aug-2020

 

Disability Care Load Assessment (Child) Determination 2020

 

 

 

I, Kathryn Campbell, Secretary of the Department of Social Services, make the following Determination.

Dated 13 August 2020

Kathryn Campbell AO CSC

Secretary of the Department of Social Services

 

 

 


Contents

Part 1Preliminary                                                                                                     1

1  Name........................................................................................................................................ 1

2  Commencement........................................................................................................................ 1

3  Authority.................................................................................................................................. 1

4  Definitions................................................................................................................................ 1

5  Repeals..................................................................................................................................... 2

6  Disability assessment care load components............................................................................ 2

7  Recognised disabilities............................................................................................................. 2

8  Treating health professional...................................................................................................... 2

9  Questionnaires.......................................................................................................................... 3

10  Rating method........................................................................................................................ 3

11  ACL questionnaire................................................................................................................. 3

12  Professional questionnaire...................................................................................................... 4

Part 2Disability Care Load Assessment (Child) (Carer Payment)                       5

13  Carer of a child with a severe disability or severe medical condition...................................... 5

14  Carer of 2 or more children with a disability or medical condition......................................... 5

15  Carer of 1 or more children with a disability or medical condition and a lower ADAT score adult   5

Part 3Disability Care Load Assessment (Child) (Carer Allowance)                    7

16  Carer of a single disabled child............................................................................................... 7

17  Carer of 2 disabled children.................................................................................................... 7

Schedule 1—Questionnaires                                                                                         8

Part 1  Assessment of care load questionnaire                                                         8

Part 2  Professional questionnaire                                                                          31

Schedule 2—Rating Methods                                                                                     38

Part 1 Scoring for ACL questionnaire                                                                   38

Part 2 Scoring for professional questionnaire                                                        53

Schedule 3—List of Recognised Disabilities                                                             61

Part 1 Recognised Disabilities                                                                               61

Part 2 Medical Conditions                                                                                     63

Schedule 4—Repeals                                                                                                   65

Disability Care Load Assessment (Child) Determination 2010                                                 65

Social Security (Treating Health Professionals) Determination 2010                                     65

 

 


Part 1Preliminary

1  Name

                   This instrument is the Disability Care Load Assessment (Child) Determination 2020.

2  Commencement

             (1)  Each provision of this instrument specified in column 1 of the table commences, or is taken to have commenced, in accordance with column 2 of the table. Any other statement in column 2 has effect according to its terms.

 

Commencement information

Column 1

Column 2

Column 3

Provisions

Commencement

Date/Details

1.  The whole of this instrument

The day after this instrument is registered.

Note:          This table relates only to the provisions of this instrument as originally made. It will not be amended to deal with any later amendments of this instrument.

             (2)  Any information in column 3 of the table is not part of this instrument. Information may be inserted in this column, or information in it may be edited, in any published version of this instrument.

3  Authority

                   This instrument is made under sections 38E and 38F of the Social Security Act 1991.

4  Definitions

                   In this instrument:

ACL means assessment of care load, as determined under the ACL questionnaire.

ACL questionnaire means the assessment of care load questionnaire contained in Part 1 of Schedule 1.

Act means the Social Security Act 1991.

child means a person aged under 16.

contributing ACL means a score from an ACL questionnaire which contributes to a rating of intense.

contributing professional questionnaire means a score from a professional questionnaire which contributes to a rating of intense.

domain means a particular category of questions in the ACL questionnaire or the professional questionnaire.

professional questionnaire means the questionnaire contained in Part 2 of Schedule 1.

qualifying rating means a rating mentioned in section 10 of this instrument that must be achieved by a person for that person to be qualified to receive:

                     (a)  a carer payment under the Act for the care of a child; or

                     (b)  a carer allowance under the Act for the care of a disabled child.

treating health professional has the meaning set out in section 8.

Note:          A number of expressions used in this instrument are defined in the Act, including the following:

(a)    disabled child;

(b)    lower ADAT score adult;

(c)    officer;

(d)    Secretary; and

(e)    Adult Disability Assessment Tool.

5  Repeals

                   The instruments that are specified in Schedule 4 to this instrument are repealed as set out in the applicable items of the Schedule, and any other item in a Schedule to this instrument has effect according to its terms.

6  Disability assessment care load components

             (1)  Part 2 of this instrument sets out the Disability Care Load Assessment (Child) (Carer Payment) in respect of a person claiming for carer payment.

             (2)  Part 3 of this instrument sets out the Disability Care Load Assessment (Child) (Carer Allowance) in respect of a person claiming for carer allowance.

7  Recognised disabilities

                   Schedule 3 of this instrument declares, for the purposes of section 953 of the Act, recognised disabilities.

8  Treating health professional

                   For the purposes of the Act (other than for the purposes of the Adult Disability Assessment Tool), a person in each of the following classes of persons is a treating health professional:

                     (a)  a person registered or licensed as a medical practitioner under a law of a State or Territory that provides for the registration or licensing of medical practitioners;

                     (b)  a person registered or licensed as a nurse under a law of a State or Territory that provides for the registration or licensing of nurses;

                     (c)  an occupational therapist who is registered as an occupational therapist with the Australian Health Professional Regulation Agency;

                     (d)  a person registered or licensed to practise physiotherapy under a law of a State or Territory that provides for the registration or licensing of physiotherapists;

                     (e)  a person registered as a psychologist under a law of a State or Territory that provides for the registration of psychologists;

                      (f)  a person employed in a clinical role as an Aboriginal or Torres Strait Islander health worker, by a health service, in a geographically remote location;

                     (g)  a person:

                              (i)  registered or licensed to practise speech pathology under a law of a State or Territory that provides for the registration or licensing of speech pathologists; or

                             (ii)  employed as a speech pathologist who is a member of The Speech Pathology Association of Australia Limited if registration or licensing of speech pathologists is not available in a State or Territory.

9  Questionnaires

             (1)  Part 1 of Schedule 1 of the instrument sets out a questionnaire (the ACL questionnaire) about the functional ability, behaviour and special care needs of a child.

             (2)  The ACL questionnaire must only be completed by a person seeking to claim:

                     (a)  a carer payment under the Act for the care of a child; or

                     (b)  a carer allowance under the Act for the care of a disabled child.

Note:  Subsection 11(6) of this instrument allows the Secretary to amend a completed ACL questionnaire in certain circumstances.

             (3)  Part 2 of Schedule 1 of the instrument sets out another questionnaire (the professional questionnaire) about the functional ability, behaviour and special care needs of a child.

             (4)  The professional questionnaire must only be completed by a treating health professional.

10  Rating method

                   A person will achieve a qualifying rating if they achieve a rating of intense in accordance with Part 2 or Part 3 of the instrument.

11  ACL questionnaire

Scoring method

             (1)  The questions in the ACL questionnaire are grouped into 4 categories (domains):

                     (a)  2 Behavioural domains; and

                     (b)  Functional Abilities domain; and

                     (c)  Special Care Needs domain.

Note:  The Functional Abilities and Special Care Needs domains are further divided into subdomains.

             (2)  If a person marks more than 1 answer to any question, excluding questions 51 and 52 which allow multiple responses, only the answer that gives the highest score will be taken into account.

             (3)  Part 1 of Schedule 2 of the instrument sets out details of the scoring for questions within each domain, and the method used to determine the total score for each ACL questionnaire.

             (4)  The total score for each domain must not be less than 0.

Secretary to be satisfied

             (5)  The Secretary must be satisfied that a completed ACL questionnaire is an accurate reflection of the functional ability, behaviour and special care needs of the child to whom it relates.

             (6)  If the Secretary is not satisfied that the completed ACL questionnaire is an accurate reflection of the child’s functional ability, behaviour and special care needs, the Secretary may amend the scores for any of the domains if a question is deemed to have been missed or misinterpreted.

             (7)  Additional points may only be added by the Secretary to the scores for any of the domains to reflect unaccounted for care load that is not presently recognised by the ACL questionnaire.

12  Professional questionnaire

Scoring method

             (1)  Part 2 of Schedule 2 of the instrument sets out the method for scoring a child, on the basis of the answers given by the treating health professional as completed in relation to the child.

             (2)  For all calculations for the purposes of Part 2 of Schedule 2 of the instrument, numbers extending to more than 2 decimal places must be rounded to 2 decimal places.

             (3)  The total professional questionnaire score may be less than 0.

Secretary to be satisfied

             (4)  The Secretary must be satisfied that a completed professional questionnaire is an accurate reflection of the functional ability, behaviour and special care needs of the child to whom it relates.

             (5)  If the Secretary is not satisfied that the professional questionnaire is an accurate reflection of the child’s functional ability, behaviour and special care needs, the Secretary may request a replacement professional questionnaire that is to be completed by a different treating health professional.


 

Part 2Disability Care Load Assessment (Child) (Carer Payment)

13  Carer of a child with a severe disability or severe medical condition

             (1)  This section applies to a person who is caring for a child with a severe disability or severe medical condition.

             (2)  If this section applies to a person:

                     (a)  a professional questionnaire must be completed for the child; and

                     (b)  the person must complete an ACL questionnaire for the child.

             (3)  For the purposes of paragraph 197B(1)(b) of the Act, the person achieves a qualifying rating of intense if:

                     (a)  the total score for the ACL questionnaire is 85 or more; and

                     (b)  the score on the professional questionnaire is greater than 0.

14  Carer of 2 or more children with a disability or medical condition

             (1)  This section applies to a person who is caring for 2 or more children with a disability or medical condition.

             (2)  If this section applies to a person:

                     (a)  1 professional questionnaire must be completed for each child; and

                     (b)  the person must complete an ACL questionnaire for each child.

             (3)  No more than 4 contributing ACL questionnaires and 4 contributing professional questionnaires can be used to contribute to a qualifying rating.

             (4)  For the purposes of paragraph 197C(1)(b) of the Act, the person achieves a qualifying rating of intense if:

                     (a)  the total score from combining the contributing ACL questionnaires is 85 or more; and

                     (b)  the contributing professional questionnaire for each child has a score of greater than 0.

             (5)  For subsection (4), an ACL questionnaire is a contributing ACL only if the total score for that ACL questionnaire is 20 or more.

15  Carer of 1 or more children with a disability or medical condition and a lower ADAT score adult

             (1)  This section applies if a person is caring for 1 or more children with a disability or medical condition and a lower ADAT score adult.

             (2)  If this section applies to a person:

                     (a)  professional questionnaire must be completed for each child; and

                     (b)  the person must complete an ACL questionnaire for each child.

             (3)  For the purposes of paragraph 197D(1)(b) of the Act, a qualifying rating of intense is achieved if:

                     (a)  the total combined score for the contributing ACL questionnaires is 85 or more; and

                     (b)  the score on the contributing professional questionnaire for each child is greater than 0.

             (4)  For subsection (3), the adult is taken to contribute 40 to the total combined score for the contributing ACL questionnaires.

             (5)  No more than 2 contributing ACL questionnaires and 2 contributing professional questionnaires can be used to contribute to a qualifying rating.

             (6)  For subsection (3), an ACL questionnaire is a contributing ACL questionnaire only if the total score for that ACL questionnaire is 20 or more.


 

Part 3Disability Care Load Assessment (Child) (Carer Allowance)

16  Carer of a single disabled child

             (1)  If a person is caring for a disabled child:

                     (a)  a professional questionnaire must be completed for the child; and

                     (b)  the person must complete an ACL questionnaire for the child.

             (2)  For the purposes of subparagraph 953(1)(e)(ii) of the Act, the person achieves a qualifying rating of intense if:

                     (a)  the total score for the ACL questionnaire is 85 or more; and

                     (b)  the score on the professional questionnaire is greater than 0.

17  Carer of 2 disabled children

             (1)  If a person is caring for 2 disabled children:

                     (a)  1 professional questionnaire must be completed for each child; and

                     (b)  the person must complete an ACL questionnaire for each child.

             (2)  No more than 2 contributing ACL questionnaires and 2 contributing professional questionnaires can be used to contribute to a qualifying rating.

             (3)  For the purposes of paragraph 953(2)(e) of the Act, the person achieves a qualifying rating of intense if:

                     (a)  the total score from combining the contributing ACL questionnaires is 85 or more; and

                     (b)  the contributing professional questionnaire for each child has a score of greater than 0.

             (4)  For subsection (3), an ACL questionnaire is a contributing ACL questionnaire only if the total score for that ACL questionnaire is 20 or more.


 

Schedule 1—Questionnaires

(Section 9)

Part 1  Assessment of care load questionnaire

 

Domain A – Behaviour 1

                   For each question, the claimant must tick only the response code that best describes how well the child in care usually manages.

Question 1

 

The child’s ability to do everyday things (e.g. eating, bathing, talking, walking and mixing with other people etc) is:

 

Improving over time (i.e. the child is likely to require less help in the future)

c

Becoming worse over time (i.e. the child is likely to require more help in the future)

c

Relatively stable (i.e. the child is likely to require the same level of help in the future)

c

Fluctuating or episodic (i.e. the child’s condition and ability to do everyday things goes up and down from day to day or week to week)

c

Unsure

c

 

Question 2

 

Settling down to sleep at night

(e.g. repeated efforts needed to get the child to go to sleep at night

 

The child never has difficulty settling down to sleep at night

c

The child sometimes has difficulty settling down to sleep at night (e.g. one or two nights a week)

c

The child often has difficulty settling down to sleep at night (e.g. more than two nights a week)

c

The child always has difficulty settling down to sleep at night (e.g. every night)

c

 

Question 3

 

Disrupted sleep at night

(e.g. waking up many times during the night, awake for long periods during the night, or having nightmares)

 

The child never has disrupted sleep at night

c

The child sometimes has disrupted sleep at night (e.g. one or two nights a week)

c

The child often has disrupted sleep at night (e.g. more than two nights a week)

c

The child always has disrupted sleep at night (e.g. every night)

c

 

Question 4

 

Irritable behaviour

(e.g. crying all the time, not able to be calmed down, or for an older child, continually agitated, prone to angry outbursts)

 

The child never has irritable behaviour

c

The child sometimes has irritable behaviour (e.g. one or two days a week)

c

The child often has irritable behaviour (e.g. more than two days a week)

c

The child always has irritable behaviour (e.g. every day)

c

 

Question 5

 

Speaking and Communicating

(i.e. speaking and communicating everyday needs)

 

The child’s speech and communication is appropriate for their age (e.g. the child can speak and communicate their everyday needs in the same way as other children of the same age.  For young babies this may include crying when hungry, smiling or babbling.)

c

The child has difficulty speaking or communicating their needs in other ways (e.g. speech is unclear and can only be understood by people who know the child very well or the child is aged over 4 years and can only say or sign a few words)

c

The child uses other ways to communicate (e.g. sign language, picture board, electronic communicator, gestures, pointing)

c

The child cannot talk or communicate their needs effectively in any way

c

 

Question 6

 

Understanding speech

(i.e. the child understanding what you say to him or her)

 

The child is able to understand everything that I would expect for a child of this age

c

The child sometimes needs me to speak more simply, repeat things or give reminders (e.g. once or twice a day)

c

The child often needs me to speak more simply, repeat things or give reminders (e.g. the child has a lot of difficulty understanding what I say several times a day)

c

The child cannot understand most things I say (e.g. the child does not appear to understand simple instructions or questions such as ‘do you want a drink?’)

c

 

Question 7

 

Playing and mixing with other children

 

The child plays and mixes with other children as expected for a child of their age

c

The child sometimes needs help to play and mix appropriately with other children (e.g. once or twice a week)

c

The child often needs help to play and mix appropriately with other children (e.g. several times a week)

c

The child cannot play or mix with other children at all (e.g. the child has extreme behaviour problems or the child cannot play with other children because of a severe disability or medical condition)

c

 

Question 8

 

Is the child aged under 3 years?

 

No

c

Go to next question

Yes

c

Go to question 20 (domain C)

 

Domain B – Behaviour 2

 

Please read this before answering the following questions

 

Questions 9 to 19 ask you about the child’s behaviour (e.g. running away, aggressive behaviours, self‑harming behaviours, extreme anxiety or withdrawal).  For each question, please select the response that best describes the child’s behaviour and the effect that this behaviour has on you during the day and the night.

Question 9

 

Does the child have severe behaviour difficulties?

 

No

c

Go to question 20 (domain C)

Yes

c

Go to next question

Not sure

c

Go to next question

 

Question 10

 

The child wanders, escapes or runs away from home, school or community settings

 

Never (The child never has this behaviour)

c

Sometimes (e.g. the child sometimes wanders or runs away but not every week)

c

Often (e.g. the child would wander or run away at least once a week if not closely supervised)

c

Always (e.g. the child continually wanders or runs away unless hand is held or doors and gates are locked)

c

 

Question 11

 

The child shouts, screams at, or threatens other people or makes so much noise that other people become alarmed.

 

Never (The child never has this behaviour)

c

Sometimes (The child sometimes has this behaviour, but not every week)

c

Often (The child often has this behaviour e.g. at least once a week)

c

Always (The child has this behaviour all the time e.g. every day)

c

 

Question 12

 

The child becomes physically aggressive and harms others by hitting, pushing, kicking, biting or throwing objects.

 

Never (The child never has this behaviour)

c

Sometimes (The child sometimes has this behaviour, but not every week)

c

Often (The child often has this behaviour e.g. at least once a week)

c

Always (The child has this behaviour all the time e.g. every day)

c

 

Question 13

 

The child gets extremely upset for little or no apparent reason (e.g. the child has episodes of intense crying or screaming and is very difficult to calm down).

 

Never (The child never has this behaviour)

c

Sometimes (The child sometimes has this behaviour, but not every week)

c

Often (The child often has this behaviour e.g. at least once a week)

c

Always (The child has this behaviour all the time e.g. every day)

c

 

Question 14

 

The child gets extremely anxious, fearful or becomes emotionally withdrawn.

 

Never (The child never has this behaviour)

c

Sometimes (The child sometimes has this behaviour, but not every week)

c

Often (The child often has this behaviour e.g. at least once a week)

c

Always (The child has this behaviour all the time e.g. every day)

c

 

Question 15

 

The child has very strange behaviours such as unusual routines, repetitive or obsessive behaviours, hearing voices or seeing things that are not there.

 

Never (The child never has this behaviour)

c

Sometimes (The child sometimes has this behaviour, but not every week)

c

Often (The child often has this behaviour e.g. at least once a week)

c

Always (The child has this behaviour all the time e.g. every day)

c

 

Question 16

 

The child displays high‑risk behaviour that causes a danger to themself or to others, including family members.  The child requires supervision and actions such as locking away household items that would not normally have to be locked away, preventing the child from running into traffic, etc.

 

Never (The child never has this behaviour)

c

Sometimes (The child sometimes has this behaviour, but not every week)

c

Often (The child often has this behaviour e.g. at least once a week)

c

Always (The child has this behaviour all the time e.g. every day)

c

 

Question 17

 

The child behaves in ways that result in injury to themself.  This may include head‑banging, hand‑biting or other self-harming behaviours.

 

Never (The child never has this behaviour)

c

Sometimes (The child sometimes has this behaviour, but not every week)

c

Often (The child often has this behaviour e.g. at least once a week)

c

Always (The child has this behaviour all the time e.g. every day)

c

 

Question 18

 

The child has displayed suicidal behaviours (e.g. the child has suicidal thoughts and has planned or attempted suicide).

 

Never (The child has never displayed suicidal thoughts or behaviours)

c

Sometimes (The child has displayed suicidal behaviours once or twice in the past two years)

c

Often (The child has displayed suicidal behaviours more than twice in the past two years)

c

Always (The child is continually displaying suicidal thoughts or behaviours e.g. suicidal thoughts every week and several suicide attempts in the past two years)

c

 

Question 19

 

The child does or says things that are sexually inappropriate.

 

Never (The child never has this behaviour)

c

Sometimes (The child sometimes has this behaviour, but not every week)

c

Often (The child often has this behaviour e.g. at least once a week)

c

Always (The child has this behaviour all the time e.g. every day)

c

 

Domain C – Functional Abilities

 

Question 20

 

Does the child have more problems and need more help doing everyday tasks (e.g. eating, grooming, bathing, using the toilet, walking) than other children of the same age?

 

No

c

Go to question 37 (domain D)

Yes

c

Go to next question

Not sure

c

Go to next question

 

Question 21

 

Is the child aged under 12 months?

 

No

c

Go to next question

Yes

c

Go to question 37 (domain D)

 

Instructions for domain C

 

Please read this before answering the following questions

 

Questions 22 to 36 ask you to rate the child’s ability to perform a number of different tasks.  You must answer all of these questions.

 

For each question, select the response that best describes the child’s ability.  Please base your responses on what the child does when using any aids, appliances or home modifications that assist with the care of the child.

 

If the child has a condition that changes from day to day, please base your answers on the child’s usual ability i.e. what the child is able to do most of the time.  Help includes supervision, prompting, reminding or training required as well as physical help.

The child’s age will be taken into account when assessing your responses.

Domain C – Functional abilities – subdomain 1

 

Question 22

 

Does the child feed themself once food is prepared?

 

The child feeds themself with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child is completely dependent on me to feed him/her (e.g. I have to hold the child’s bottle, spoon feed the child or feed the child through a naso‑gastric feeding tube, gastrostomy or Percutaneous Endoscopic Gastrostomy (P.E.G.))

c

 

Question 23

 

Does the child do everyday grooming tasks (e.g. brush teeth, brush/comb hair, wash and rinse hands and face)?

 

The child grooms themself with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child is completely dependent on me to do their grooming

c

 

Question 24

 

Does the child wash themself from the neck down (except for their back) in the bath, shower or sponge/bed bath?

 

The child washes themself with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child is completely dependent and needs me to wash them

c

 

Question 25

 

Does the child dress themself from the waist up (e.g. putting on singlets, t‑shirts, jumpers, jackets)?

 

The child dresses themself from the waist up with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child is completely dependent and needs me to dress them

c

 

Domain C – Functional abilities – everyday tasks

Question 26

 

Does the child dress themself from the waist down (e.g. putting on underpants, skirts/pants/trousers, socks, shoes)?

 

The child dresses themself from the waist down with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child is completely dependent and needs me to dress them

c

 

Question 27

 

Does the child wipe themself and adjust their clothing before and after using the toilet?

 

The child uses the toilet with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child is completely dependent for toileting, or wears nappies or incontinence pads day and night

c

 

Domain C – Functional abilities – subdomain 2

 

Question 28

 

Does the child have bladder accidents (i.e. wets their pants or nappy)?

 

The child never has bladder accidents (e.g. the child is dry during the day and at night)

c

The child has bladder accidents during the night but is dry during the day (e.g. the child wets the bed or nappy at night only)

c

The child has occasional bladder accidents during the day and at night (e.g. the child sometimes wets their pants or nappy during the day and wets the bed at night)

c

The child has frequent bladder accidents during the day and at night (e.g. the child wets their pants or nappy several times during the day AND wets the bed or nappy most nights, or the child has a catheter or stoma to pass urine)

c

 

Question 29

 

Does the child have bowel accidents (i.e. soils their pants or nappy)?

 

The child never has bowel accidents

c

The child sometimes has bowel accidents (e.g. the child occasionally soils their pants or nappy during the day or night)

c

The child often has bowel accidents (e.g. the child soils their pants or nappy several times a week)

c

The child is completely incontinent of faeces (e.g. the child has no bowel control, or the child needs an enema or suppository to have a bowel motion, or the child has a stoma to pass faeces such as from a colostomy or ileostomy)

c

 

Domain C – Functional abilities – subdomain 3

 

Question 30

 

Does the child sit down and get up from the toilet or potty?

 

The child sits down and gets up from the toilet or potty with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child is completely dependent for toileting (e.g. the child needs to be lifted on and off the toilet or potty or cannot sit on a toilet or potty)

c

 

Question 31

 

Does the child sit down and get up from a chair or wheelchair?

 

The child sits down and gets up from a chair with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child cannot sit in a chair or is completely dependent (e.g. the child needs to be lifted on and off the chair or wheelchair)

c

 

Question 32

 

Does the child get into or out of a bath or shower (whichever is used more often)?

 

The child gets into and out of a bath or shower with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. prompting, reminding or a small amount of physical help)

c

The child needs a lot of help (e.g. a lot of physical help)

c

The child is completely dependent (e.g. the child cannot get into or out of a bath or shower and needs complete physical help or lifting)

c

 

Question 33

 

How does the child move around?

 

The child moves around by walking

c

The child moves around using a wheelchair or other mobility aids (e.g. stroller, crutches, walking sticks, walking frame or other mobility equipment)

c

The child moves around by crawling, rolling or bottom‑hitching (e.g. the child does not walk but can move around on the floor)

c

The child is not able to move around by themself

c

 

Question 34

 

Does the child move around by themself indoors on an even surface?

 

The child moves around on an even surface with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. supervision or a small amount of physical help from me)

c

The child needs a lot of help (e.g. a lot of physical help from me)

c

The child is completely dependent (e.g. the child cannot move around indoors by themself)

c

 

Question 35

 

Does the child move around by themself outdoors on uneven surfaces?

 

The child moves around outdoors on uneven surfaces with no help (e.g. the child needs no help from me)

c

The child needs a little help (e.g. supervision or a small amount of physical help from me)

c

The child needs a lot of help (e.g. a lot of physical help from me)

c

The child is completely dependent (e.g. the child cannot move around outdoors by themself)

c

 

Question 36

 

Does the child go up and down stairs?

 

The child goes up and down a flight of stairs with no help from me

c

The child goes up and down two or three steps with no help from me

c

The child goes up and down a single step or kerb with no help from me

c

The child needs physical help from me to go up and down steps or stairs OR the child cannot use steps or stairs at all

c

 

Domain D – Special care needs

 

Instructions for special care needs questions

 

Please read this before answering the following questions

 

Questions 37 to 53 ask you to indicate the child’s special care needs.

 

If the child has a condition that changes from day to day, please base your answers on the child’s usual and ongoing needs.

 

Domain D – Special care needs – subdomain 1

 

Question 37

 

Does the child use any of the following to help with breathing?

Please tick any that apply.

 

Tracheostomy  (A tracheostomy is an opening made by a surgeon through the front of the child’s neck into the windpipe.  A tracheostomy tube is used to keep the tracheostomy open)

c

Ventilator  (A ventilator is a machine which breathes for the child and connects to the child’s airway – usually through a tube into the windpipe known as a tracheostomy tube)

c

Oxygen  (The child is regularly given extra oxygen to breathe from an oxygen cylinder at home as directed by a medical practitioner)

c

CPAP/BiPAP  (A CPAP or BiPAP machine helps to keep the child’s airway open by providing a flow of air at pressure, usually through a mask fitted firmly to the face)

c

NO ‑ Go to next question

c

Question 38

 

Does the child receive dialysis (due to a kidney condition)?

 

(Dialysis is the assisted removal of waste products from the body for people with kidney failure.)

 

No

c

Yes

c

 

Question 39

 

Do you provide Total Parenteral Nutrition (TPN) for the child?

 

TPN is a technique in which nutrients are given to a person through a tube directly into their veins, usually because they cannot digest regular food.

 

No

c

Yes

c

 

Question 40

 

Do you do postural drainage for the child?

 

Postural drainage means using positioning to help drain mucus from the child’s lungs and airways.  This often includes physical techniques such as patting the child’s chest with cupped hands (percussion) to help clear the secretions.

 

No

c

Go to next question

Yes

c

Please indicate how often you provide postural drainage for the child

 

During the day

 

Less than daily

c

Once or twice a day

c

Three or more times a day

c

During the night (i.e. 10pm to 6am)

 

Less than nightly

c

Once a night

c

Two or more times a night

c

 

Question 41

 

Do you clear the child’s airways through suctioning?

 

Suctioning is the use of a tube connected to equipment to remove mucus or saliva from the child’s mouth, throat or airway.

 

No

c

Go to next question

Yes

c

Please indicate how often you provide suctioning for the child

 

During the day

 

Less than daily

c

Once or twice a day

c

Three or more times a day

c

During the night (i.e. 10pm to 6am)

 

Less than nightly

c

Once a night

c

Two or more times a night

c

 

Question 42

 

Do you physically assist or position the jaw of the child to help with chewing and/or swallowing?

 

No

c

Go to next question

Yes

c

Please indicate how often you physically assist with chewing and/or swallowing

 

Less than daily

c

Once or twice a day

c

Three or more times a day

c

 

Question 43

 

Do you Percutaneous Endoscopic Gastrostomy (P.E.G.) feed or use a feeding tube to feed the child?

 

When a child is P.E.G. fed they have a tube or button that goes directly into their stomach, and are fed through that tube.

 

No

c

Go to next question

Yes

c

Please indicate how often you P.E.G. feed or use a feeding tube for the child over a 24 hour period

 

Less than daily

c

Once or twice a day

c

Three or more times a day

c

 

Question 44

 

Do you provide physical assistance to turn or position the child because they are unable to do so independently?

 

No

c

Go to next question

Yes

c

Please indicate how often you physically assist the child to turn or position themself

 

During the day

 

Less than daily

c

Once or twice a day

c

Three or more times a day

c

During the night (i.e. 10pm to 6am)

 

Less than nightly

c

Once a night

c

Two or more times a night

c

 

Question 45

 

Do you manage any wounds and/or dressings for the child?

 

No

c

Go to next question

Yes

c

Please indicate how much time you spend managing wounds or dressings for the child

 

Less than 30 minutes per day

c

30-60 minutes per day

c

1-2 hours per day

c

More than 2 hours per day

c

 

Question 46

 

Do you give emergency medication or first aid for poorly controlled seizures?

 

No

c

Go to next question

Yes

c

Please indicate how often you give emergency medication or first aid for poorly controlled seizures

 

Less than monthly

c

Once or twice a month

c

Three or more times a month

c

 

Question 47

 

Do you provide stoma care (e.g. colostomy, ileostomy) for the child?

 

A stoma is an opening in the abdominal wall and is used to enable waste materials from the intestines to empty into a pouch or bag.

 

No

c

Go to next question

Yes

c

Please indicate how often you provide stoma care for the child over a 24 hour period

 

Less than daily

c

Once or twice a day

c

Three or more times a day

c

Domain D – Special care needs – subdomain 2

 

Question 48

 

Does the child have an eating disorder that has been diagnosed by a medical practitioner (e.g. anorexia nervosa or bulimia)?

 

No

c

Yes

c

 

Question 49

 

Is the child receiving a course of chemotherapy or radiotherapy treatment?

 

No

c

Yes

c

 

Question 50

 

Do you prepare or administer medications related to the child’s medical condition?

(Medications include tablets, other oral medicines, injections, puffers/inhalers, suppositories, enemas, ointments or creams prescribed by a medical practitioner)

 

No

c

Go to next question

Yes

c

Please indicate how many minutes PER DAY on average you spend preparing and/or administering medications

 

minutes per day

 

Question 51

 

Do you provide any of the following supports of treatments for the child?

Please tick any that apply.

 

Attending health care appointments related to the child’s disability or medical condition multiple times per month

c

Exercises prescribed by a physiotherapist, speech therapist, occupational therapist or other specialist at least twice a week

c

Applying daily splints, braces, special garments or mobility aids recommended by a health practitioner

c

Behavioural program recommended by a psychologist, psychiatrist or other therapist

c

Early childhood intervention activities recommended by a teacher, therapist or other disability specialist

c

Sign language or hearing equipment where the child is deaf or has a severe hearing impairment

c

Equipment or tactile aids or other assistance around the home where the child is blind or has a severe visual impairment

c

Blood testing or urine testing performed by you at least three times a day

c

 

Question 52

 

Do any of these other care needs apply to you and the child you care for?

Please tick any that apply.

 

I am unable to access general child care, after‑school hours care or vacation care programs due to this child’s special care needs

c

I am often called to the child’s school or child care to attend to their special care requirements or collect them due to their health or behavioural problems

c

This child has been excluded from school or child care for more than one day in the last school term because of their health care needs or behavioural issues

c

This child can only attend school part‑time due to the severity of their disability or medical condition or because school supports are not available

c

I have to attend and stay at school or child care to provide care for my child due to the severity of their disability or medical condition or because school supports are not available

c

I can only leave this child in the care of others when they have had specific training and are willing to manage the child’s care needs

c

 

Question 53

 

Please describe any other care needs that the child has.

 

 

 

 

 

 

Question 54

 

Please describe any other effects that the child’s disability or medical condition has on you (e.g. any other effects on your daily routine, ability to take up paid employment, your health, social activities or emotional effects).

 

 

 

 

 

 

Question 55

 

If there are any other comments about your situation that you feel are relevant, please write them in the space below.

 

 

 

 

 


 

 

Part 2  Professional questionnaire

Functional domains – abilities

 

·           Please indicate the statement that describes the child’s usual ability.

·           If the child cannot do any of the skills listed in a question, tick the last box.

·           If the child’s ability is appropriate for the age of the child, tick the first box.

·           The child’s abilities include what they can do when using their aids, appliances or special equipment items.

·           Where the child’s disability or medical condition is episodic or is only apparent at certain times, the question should be answered for what the child is currently able to do most of the time.

 

Question

Response Code

1

Receptive language skills (listening, reading and understanding)

 

 

Child’s ability is age appropriate

M‑1l

 

Child understands adult speech or signed language of normal speed and complexity.  Child demonstrates full understanding of why they are interacting with a health professional

M‑1j

 

Child can read and interpret a paragraph from the front page of a daily newspaper

M-1i

 

Child can read a paragraph or page from a children’s storybook appropriate for the child’s age group.  Child can recall a list of three common objects 30 seconds after the list is read to them

M-1h

 

Child understands and responds appropriately to simple questions such as ‘do you go to school?’ and ‘what is your favourite colour?’

M‑1g

 

Child follows 2 step instructions such as ‘pick up the book and put it on the chair’.  Child uses toys appropriately for their intended purpose in meaningful play

M‑1f

 

Child knows the difference between ‘big’ and ‘little’.  Child can demonstrate what common objects are used for

M‑1e

 

Child recognises pictures of common objects, for example points appropriately when asked ‘where’s the dog?’ or ‘which one is the truck?’

M‑1d

 

Child responds appropriately to very simple questions, for example points to, or looks at, mother when asked ‘where’s mummy?’.  Child uses objects purposefully, for example to make a sound

M‑1c

 

Child responds to sound. Child tracks noise‑making objects

M‑1b

 

Child looks momentarily at speaker’s face

M‑1a

 

Child cannot do any of the things listed above

M‑1k

2

Expressive language skills (talking or signing)

 

 

Child’s ability is age appropriate

M‑2l

 

Child has almost a full adult vocabulary.  Child can discuss and debate complex issues such as politics or religion with an adult

M‑2j

 

Child can describe his or her experiences in detail using complex sentences

M‑2i

 

Child can tell a complex story involving several characters.  Child can write a short story

M‑2h

 

Child can write his or her own first name by handwriting or typing.  Child can state his or her name and home address

M‑2g

 

Child talks or signs well and can use 6 or more words in a sentence.  Child can describe an event, for example a visit to a special place

M-2f

 

Child can say sentences with 3 to 4 words.  People other than family members can understand the child’s speech

M-2e

 

Child can clearly say or sign more than 20 words and can use 2 words in combination, for example ‘Daddy’s car’

M-2d

 

Child can say or sign 3 or more simple words, for example ‘mum’, ‘dad’, ‘drink’, ‘bed’

M-2c

 

Child smiles and babbles or makes purposeful sounds, for example to attract attention.  Child demonstrates good eye contact

M-2b

 

Child makes a vocal sound other than crying

M-2a

 

Child cannot do any of the things listed above

M-2k

3

Feeding and mealtime skills

 

 

Child’s ability is age appropriate

M‑3l

 

Child can use all cooking equipment and kitchen appliances, for example, a microwave oven, electric frypan, or mixer, without assistance

M‑3j

 

Child can follow a recipe and prepare a simple meal

M‑3i

 

Child can cook a simple snack, for example, toast

M-3h

 

Child can prepare a simple uncooked snack, for example, a sandwich

M-3g

 

Child can use a fork and spoon at mealtimes

M-3f

 

Child can eat most solid foods if the food is cut up, for example, a raw apple

M-3e

 

Child uses spoon well

M-3d

 

Child can drink from a normal cup without help and can feed himself or herself with finger foods

M-3c

 

Child can drink from a modified cup when the cup is held by an adult

M-3b

 

Child can suck from a breast or baby’s feeding bottle

M-3a

 

Child cannot do any of the things listed above

M-3k

4

Hygiene and grooming skills

 

 

Child’s ability is age appropriate

M-4k

 

Child can style own hair and clean and cut own finger and toe nails without assistance

M-4i

 

Child can attend to basic hygiene, for example toileting, showering and brushing hair, without assistance

M-4h

 

Child manages basic hygiene, for example toileting, showering and brushing hair, with little assistance

M-4g

 

Child can wash hands and face and brush own teeth

M-4f

 

Child is reliably toilet trained during the day and can manage own toileting with minimal assistance

M-4e

 

Child can indicate toilet needs during the day but needs some assistance with clothing and wiping

M-4d

 

Child is toilet timed during the day or is indicating toilet needs, for example asking for the toilet or potty even if it’s too late or telling parent that pants or nappy are wet

M-4c

 

Child requires full assistance with toileting

M-4b

 

Child cries when nappy is soiled or wet

M-4a

 

Child cannot do any of the things listed above

M-4j

5

Dressing skills

 

 

Child’s ability is age appropriate

M-5l

 

Child can purchase and care for own clothing without assistance

M-5j

 

Child can wash and iron own clothing if required to with little assistance

M-5i

 

Child can choose own clothing appropriate to the weather and can dress and undress without any assistance

M-5h

 

Child can do up buckles and untie shoelaces

M-5g

 

Child can do up buttons and zippers

M-5f

 

Child dresses and undresses themself but needs assistance with buttons, laces or tight clothing

M-5e

 

Child can undress with little assistance

M-5d

 

Child tries to help with dressing

M-5c

 

Child lifts arms to be picked up

M-5b

 

Child snuggles in to an adult when cuddled

M-5a

 

Child cannot do any of the things listed above

M-5k

6

Social and community skills

 

 

Child’s ability is age appropriate

M-6l

 

Child can use all major community facilities, for example shops, banks, doctors, with little assistance.  Child has basic understanding of community laws and regulations

M-6j

 

Child is able to undertake basic activities in the community, for example shopping, with little supervision

M-6i

 

Child understands basic personal safety, for example how to cross the road and not to go with strangers.  Child relates well to both children and adults

M-6h

 

Child is aware of being left in the care of others, for example a school teacher or child care worker, without getting unduly upset.  Child understands basic concepts of right and wrong

M-6g

 

Child plays with other children and forms close friendships with other children.  Child joins in simple games such as ‘chasey’ and ‘hide and seek’ but may not understand or follow rules of a game

M-6f

 

Child takes turns in conversations, for example speaks and then listens.  Child knows whether they are a boy or a girl

M-6e

 

Child initiates contact with other people and involves other people in games or activities.  Child is starting to cooperate in play with other children

M-6d

 

Child responds to affection from familiar people.  Child recognises the difference between strangers and familiar people

M-6c

 

Child laughs and giggles when happy and cries when upset or angry.  Child is interested in people and enjoys attention

M-6b

 

Child smiles.  Child settles when picked up and cuddled

M-6a

 

Child cannot do any of the things listed above

M-6k

7

Mobility – fine motor

 

 

Child’s ability is age appropriate

M-7l

 

Child can use a variety of tools or hobby items with accuracy, for example for woodwork, sewing, painting or model building

M-7j

 

Child can write clearly

M-7i

 

Child can write all letters of the alphabet clearly

M-7h

 

Child can hold a pencil and draw basic shapes such as squares and triangles.  Child can clearly write his or her own first name

M-7g

 

Child can manipulate smaller objects accurately, for example jigsaw puzzle pieces.  Child can draw at least a head and body on a person stick figure style

M-7f

 

Child can build a tower of 9 blocks.  Child can copy a circle and a cross

M-7e

 

Child can manipulate larger objects and toys, for example can push or pull toys, use posting box toys or build small tower of blocks.  Child can copy a straight vertical line

M-7d

 

Child can make purposeful movements with objects, for example bang on a drum or clap hands

M-7c

 

Child grasps and releases objects such as rattle or feeding bottle

M-7b

 

Child can grasp an adult finger but may need assistance to release it

M-7a

 

Child cannot do any of the things listed above

M-7k

8

Mobility – gross motor

 

 

Child’s ability is age appropriate

M-8k

 

Child can hit a ball with a bat and can kick a ball with reasonable accuracy

M-8i

 

Child can catch a small ball, for example a tennis ball.  Child skips well or rides a two wheel bike

M-8h

 

Child can jump and can hop on each leg.  Child can bounce a ball and catch it

M-8g

 

Child can run fast. Child can balance on 1 leg for 3 seconds.  Child can hop on 1 leg

M-8f

 

Child can balance briefly while standing on 1 leg.  Child can pedal a tricycle

M-8e

 

Child can walk and can run a few steps.  Child can walk up and down steps

M-8d

 

Child has even muscle tone and strength in all limbs.  Child can pull himself or herself from floor to a standing position and may be able to stand independently

M-8c

 

Child can independently move between prone and supine positions.  Child can crawl or otherwise propel himself or herself along

M-8b

 

Child can lift head when in prone position.  Child makes random movements with arms and legs

M-8a

 

Child cannot do any of the things listed above

M-8j

Functional domains – behaviour and needs

 

For the functional domains numbered 9 and 10, the treating health professional must mark any statement that describes the child’s behaviours or special care needs in each functional domain. The response should be based on an assessment by the treating health professional and, if available, any clinical assessments and written reports on the child from other treating health professionals (if any) who have assessed the child. If the child is receiving prescribed medication, the response should be based on the child’s behaviours when the child is receiving the prescribed medication.

Note  The treating health professional may mark more than 1 statement for each domain.

 

 

Question

Response Code

9

Behaviour

 

 

Child is consistently uncooperative and disruptive during treatment or assessment episodes

M-9a

 

Child demonstrates self injurious behaviour such as head banging or hand biting and has injuries or signs of past injuries consistent with such behaviours

M-9b

 

Child displays aggressive behaviour or violence towards other people or property in the treatment or assessment setting

M-9c

 

Child persistently attempts to leave or abscond from the treatment or assessment setting

M-9d

 

Child is extremely active and is unable to concentrate on a task for more than 30 seconds

M-9e

 

Child displays obsessional repetitive behaviours, for example obsession with particular objects or twirling or spinning objects for extended periods of time

M-9f

10

Special care needs

 

 

Child receives all food and fluids by nasogastric or gastrostomy tube or percutaneous enterogastric tube (PEG)

M‑10a

 

Child has a tracheostomy

Child requires a ventilator to support respiration.

Child requires regular oxygen therapy at home.

Child requires a CPAP or BiPAP machine.

M‑10b1

M‑10b2

M‑10b3

M‑10b4

 

Child is aged over 4 years and is incontinent both day and night

M‑10c

 

Child is aged over 3 years and cannot stand without support

M‑10d

 

Child requires a wheelchair and requires assistance to propel the wheelchair

M‑10e

 

Child requires a wheelchair, quad sticks, prosthesis, crutches or walking frame but can move around with little assistance using the equipment

M‑10f

 

Child uses an electric wheelchair

M‑10g

 

Child requires urinary catheterisation several times each day

M‑10h

 

Child requires specialised equipment, prosthesis or technology to communicate, for example a computerised communicator, telephone typewriter (TTY), voice synthesiser, cochlear implant, hearing aids or adaptations to a standard computer

M‑10i

 

Child is over the age of 5 years and has persistent difficulties with memory, concentration, planning and organisation

M‑10j

 

Child has chronic and progressive suppurative lung disease for which ongoing daily airway clearance is provided or enzyme replacement therapy and nutritional supplements are required and provided on a daily basis

M‑10k

 

Child is receiving a course of chemotherapy or radiotherapy treatment for cancer

M‑10l

 

The child has poorly controlled seizures which frequently require emergency medication or first aid?

M‑10m

 

Child is assisted on a daily basis with at least 2 blood tests to measure blood glucose levels, injections and special dietary management and the child is not capable of determining medication levels, food intake or self administration of medication

M‑10n

 

Child has a severe eating disorder such as anorexia nervosa or bulimia.

M‑10o

 


 

Schedule 2—Rating Methods

Part 1 Scoring for ACL questionnaire

Step 1  Terminal phase [Note: this Step 1 only relates to Carer Payment.]

                   No further steps need to be taken in the assessment of care load, if a medical practitioner has certified that:

                     (a)  a child has a terminal condition; and

                     (b)  the average life expectancy for a child with the same or similar condition is not substantially longer than 24 months.

Step 2  Domain A score

             (1)  Calculate a score for each question in domain A of the ACL questionnaire as follows:

                     (a)  locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;

                     (b)  copy this value into column 4 of the table.

             (2)  Calculate the total score for domain A by adding the scores in column 4 of the table.

Domain A – Behaviour

 

Question number

Answer code

Value

Score

1

a

No score

 

 

b

No score

 

 

c

No score

 

 

d

No score

 

 

e

No score

 

2

a

0

 

 

b

1

 

 

c

2

 

 

d

5

 

3

a

0

 

 

b

1

 

 

c

3

 

 

d

6

 

4

a

0

 

 

b

1

 

 

c

5

 

 

d

8

 

5

a

0

 

 

b

2

 

 

c

5

 

 

d

10

 

6

a

0

 

 

b

1

 

 

c

5

 

 

d

10

 

7

a

0

 

 

b

2

 

 

c

4

 

 

d

10

 

 

Step 3  Care load score for domain A

                   Calculate the care load  for domain A as follows:

                     (a)  locate the score range in column 1 of the following table into which the total score for domain A fits;

                     (b)  the care load score is the corresponding conversion score in column 2 of the table.

 

Score range

Conversion score

Care load score

0 to 4

0

 

5 to 16

10

17 to 30

20

31 or more

40

 

Step 4  Score for domain B

             (1)  Calculate a score for each question in domain B of the ACL questionnaire as follows:

                     (a)  locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;

                     (b)  copy this value into column 4 of the table.

             (2)  Calculate the total score for domain B by adding the scores in column 4 of the table.

Domain B – Behaviour 2

 

Question number

Answer code

Value

Score

10

a

0

 

 

b

1

 

 

c

10

 

 

d

15

 

11

a

0

 

 

b

1

 

 

c

6

 

 

d

10

 

12

a

0

 

 

b

2

 

 

c

12

 

 

d

20

 

13

a

0

 

 

b

1

 

 

c

5

 

 

d

10

 

14

a

0

 

 

b

1

 

 

c

5

 

 

d

10

 

15

a

0

 

 

b

1

 

 

c

5

 

 

d

10

 

16

a

0

 

 

b

2

 

 

c

4

 

 

d

10

 

17

a

0

 

 

b

2

 

 

c

10

 

 

d

20

 

18

a

0

 

 

b

2

 

 

c

10

 

 

d

20

 

19

a

0

 

 

b

2

 

 

c

10

 

 

d

20

 

 

Step 5  Care load score for domain B

                   Calculate the care load score for domain B as follows:

                     (a)  locate the score range in column 1 of the table into which the total score for domain B fits;

                     (b)  the care load score is the corresponding conversion score in column 2 of the table.

 

Score range

Conversion score

Care load score

0 to 9

0

 

10 to 19

15

20 to 29

30

30 or more

85

 

Step 6  Score for subdomain C (1)

             (1)  Calculate a score for each question in subdomain C (1) as follows:

                     (a)  locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;

                     (b)  copy this value into column 4 of the table.

             (2)  Calculate the age‑adjusted score for each question as follows:

                     (a)  locate the score for the appropriate age category in the age adjustment table in step 13, and copy this score into column 5 of the following table;

                     (b)  divide the raw score in column 4 by the score in column 5.

             (3)  Calculate the total score for subdomain C (1) by adding the age‑adjusted scores in column 6.

Note 1  The age‑adjusted score can never be less than zero.

Note 2  The lower the age adjusted total score, the greater the disparity between the functional ability expected of a child of that age and the child’s actual ability, and the higher the likelihood of care load for the carer.

Domain C – Functional abilities – self care subdomain C (1)

 

Question number

Answer code

Raw Value

Raw Score

Score from age adjustment table

Age adjusted score

22

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

23

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

24

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

25

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

26

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

27

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

 

Step 7  Adjusted score for subdomain C (1)

                   Calculate the adjusted score for subdomain C (1) as follows:

                     (a)  locate the score range in column 1 of the following table into which the total score for subdomain C (1) fits;

                     (b)  the adjusted score is the corresponding conversion score in column 2 of the table.

 

Score range

Conversion score

Care load score

0 to 2.20

40

 

2.21 to 4.04

20

4.05 to 100

0

 

Step 8  Score for subdomain C (2)

             (1)  Calculate a score for each question in subdomain C (2) as follows:

                     (a)  locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;

                     (b)  copy this value into column 4 of the table.

             (2)  Calculate the age‑adjusted score for each question as follows:

                     (a)  locate the score for the appropriate age category in the age adjustment table in step 13, and copy this score into column 5 of the following table;

                     (b)  divide the raw score in column 4 by the score in column 5.

             (3)  Calculate the total score for subdomain C (2) by adding the age‑adjusted scores in column 6.

Domain C – Functional abilities – self care subdomain C (2)

 

Question number

Answer code

Raw Value

Raw Score

Score from age adjustment table

Age adjusted score

28

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

29

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

 

Step 9  Adjusted score for subdomain C (2)

                   Calculate the adjusted score for subdomain C (2) as follows:

                     (a)  locate the score range in column 1 of the following table into which the total score for subdomain C (2) fits;

                     (b)  the adjusted score is the corresponding conversion score in column 2 of the table.

Score range

Conversion score

Care load score

0 to 0.73

60

 

0.74 to 1.34

40

1.35 to 100

0

 

Step 10  Score for subdomain C (3)

             (1)  Calculate a score for each question in subdomain C (3) as follows:

                     (a)  locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;

                     (b)  copy this value into column 4 of the table.

             (2)  Calculate the age‑adjusted score for each question as follows:

                     (a)  locate the score for the appropriate age category in the age adjustment table in step 13, and copy this score into column 5 of the following table;

                     (b)  divide the raw score in column 4 by the score in column 5.

             (3)  Calculate the total score for subdomain C (3) by adding the age‑adjusted scores in column 6.

Domain C – Functional abilities – mobility subdomain C (3)

 

Question number

Answer code

Raw Value

Raw Score

Score from age adjustment table

Age adjusted score

30

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

31

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

32

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

33

a

No score

 

 

 

 

b

No score

 

 

 

 

c

No score

 

 

 

 

d

No score

 

 

 

34

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

35

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

36

a

4

 

 

 

 

b

3

 

 

 

 

c

2

 

 

 

 

d

1

 

 

 

 

Step 11  Adjusted score for subdomain C (3)

                   Calculate the adjusted score for subdomain C (3) as follows:

                     (a)  locate the score range in column 1 of the following table into which the total score for subdomain C (3) fits;

                     (b)  the adjusted score is the corresponding conversion score in column 2 of the table.

 

Score range

Conversion score

Care load score

0 to 2.20

30

 

2.21 to 4.04

15

4.05 to 100

0

 

Step 12  Total score for domain C

                   Calculate the total score for domain C by adding the adjusted scores for subdomains C (1), (2) and (3).

Step 13  Care load score for domain C

                   Calculate the care load score for domain C as follows:

                     (a)  use the total score for domain C as derived at Step 12 and locate it within an applicable score range in column 1 of the following table;

                     (b)  the care load score is the corresponding conversion score in column 2 of the table;

                     (c)  if the total score for domain C is 0, the care load score is 0.

 

Score range

Conversion score

Care load score

1 to 20

20

 

30 to 55

40

60 to 75

60

80 to 130

85

 


Age adjustment table

 

Age

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Age grouping in months

12 to < 15

15 to < 18

18 to < 21

21 to < 24

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q22  Eating

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q23  Grooming

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q24  Bathing

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q25  Dressing upper

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q26  Dressing lower

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q27  Toileting

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q28  Bladder

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q29  Bowel

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q30  Mobility Toilet

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q31  Mobility Chair/Wheelchair

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q32  Mobility Bath/Shower

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q34  Mobility Walk/ Wheelchair (indoors)

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q35  Mobility Walk/ Wheelchair (outdoors)

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q36  Mobility Stairs

1

1

1

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Note  Questions 20, 21 and 33 are excluded from this table as they are non‑scoring questions.

 


Step 14  Total score for subdomain D (1)

             (1)  Calculate a score for each question in subdomain D (1) as follows:

                     (a)  locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;

                     (b)  copy this value into column 4 of the table.

             (2)  Calculate the total score for subdomain D (1) by adding the scores in column 4.

 

Subdomain D (1) – Special care needs – interventions

Question

Answer

Value

Score

37

a

85

 

 

b

85

 

 

c

30

 

d

20

e

0

38

a

0

 

 

b

85

 

39

a

0

 

b

70

40

a

0

 

b

0

b.1

0

b.2

15

b.3

30

b.4

0

b.5

15

b.6

30

41

a

0

 

 

b

0

 

 

b.1

0

 

 

b.2

5

 

 

b.3

10

 

 

b.4

0

 

 

b.5

10

 

 

b.6

20

 

42

a

0

 

b

0

b.1

0

b.2

2

b.3

5

43

a

0

 

b

0

b.1

0

b.2

20

b.3

40

44

a

0

 

b

0

b.1

0

b.2

5

b.3

10

b.4

0

b.5

10

b.6

20

45

a

0

 

b

0

b.1

0

b.2

15

b.3

30

b.4

50

46

a

0

 

 

b

0

 

 

b.1

20

 

 

b.2

60

 

 

b.3

80

 

47

a

0

 

b

0

b.1

0

b.2

20

b.3

40

 

Step 15  Total score for subdomain D (2)

             (1)  Calculate the score for question 53 in subdomain D (2) as follows:

                     (a)  copy the number of hours into column 3 of the following table;

                     (b)  locate the range of hours in column 4 of the table into which the number of hours fits;

                     (c)  the score is the corresponding final score in column 5 of the table.

             (2)  For all other questions, locate the value in column 3 that corresponds with the answer provided in column 2, this is the score for that question.

             (3)  Calculate the total score for subdomain D (2) by adding the final scores for the questions.

Subdomain D (2) – Special care needs – time

Question

Answer

Value

48

a

0

 

b

10

49

a

0

 

b

10

 

 

 

Question

Answer code

Time in Minutes

Time calculation

Final score

50

a

 

 

0

b

 

if 1 hour or less

0

if more than 1 hour

5

 

 

 

Question

Answer

Value

51

a

2

 

b

2

 

c

1

 

d

2

 

e

2

 

f

2

 

g

1

 

h

1


52

a

1

 

b

1

 

c

1

 

d

1

 

e

1

 

f

1

 

Step 16  Total score for domain D

                   Calculate the total score for domain D by adding the total scores for subdomains D (1) and (2).

Step 17  Care load score for domain D

                   The care load score for domain D is the total score for domain D.

Step 18  ACL grand total

                   Calculate the ACL grand total by adding the care load scores for domains A, B, C and D.

Step 19  Additional points for score of ACL if Secretary is not satisfied

                   If the Secretary is not satisfied that the completed ACL questionnaire is an accurate reflection of the child’s functional ability, behaviour and special care needs, the Secretary may amend the scores for any of the domains if a question is deemed to have been missed or misinterpreted.

Step 20  ACL adjusted grand total

                   Calculate the ACL adjusted grand total by adding any extra points from the Secretary to the ACL grand total.

Part 2 Scoring for professional questionnaire

Step 1  Chronological age

                   Calculate the child’s chronological age at the date of completion of the questionnaire.

Step 2  Scores for functional domains 1, 2, 3, 5, 6 and 7

             (1)  Calculate the child’s scores for functional domains 1, 2, 3, 5, 6 and 7 from the following table based on:

                     (a)  the child’s chronological age calculated in step 1; and

                     (b)  the child’s functional age, based on the responses marked in functional domains 1, 2, 3, 5, 6 and 7 in the questionnaire.

             (2)  Record the scores in column 2 of the table in step 6.

 

Chronological age

Functional age

Birth
to <6 months

6 months to <1 year

1 year to <2 years

2 years to <3 years

3 years to <4 years

4 years to <6 years

6 years to <9 years

9 years to <12 years

12 years to <15 years

15 years or older

Birth to <6 months (response a)

0

+1

+2

+3

+4

+5

+6

+7

+8

+9

6 months to <1 year (response b)

‑1

0

+1

+2

+3

+4

+5

+6

+7

+8

1 year to <2 years (response c)

‑2

‑1

0

+1

+2

+3

+4

+5

+6

+7

2 years to <3 years (response d)

‑3

‑2

‑1

0

+1

+2

+3

+4

+5

+6

3 years to <4 years (response e)

‑4

‑3

‑2

‑1