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Review of DETA Criteria for
Physical Impairment
education adjustment program
Department of Education, Training and the Arts
Key Issues
The working party identified there was a need to:
•
align DETA definition and criteria with national and
international standards
•
clarify the relationship between diagnosed medical
conditions and impairment
•
describe the nature and extent of a physical impairment
•
clarify how the impairment is linked with activity
limitations/ participation restrictions in the school context
•
evaluate the effectiveness of the current verification form
for this category
•
identify when a review of verification is required
education adjustment program
Department of Education, Training and the Arts
Definition of Physical Impairment
International Definitions
Variety of definitions including physical/motor/motion/orthopaedic
and disability/handicap/impairment.
Students with disabilities or impairments viewed in medical terms
as organic disorders attributable to organic pathologies
(e.g. in relation to sensory, motor or neurological defects).
The educational need is considered to arise primarily from
problems attributable to these disabilities.
Organisation for Economic Cooperation and Development
(OECD) 2005
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Department of Education, Training and the Arts
Definition of Physical Impairment
Nationally
Variety of definitions including physical, disability, disorder, and
impairment – some include separate category of ABI. Definitions
also related to funding.
Physical/diverse disability – “the presence of an impairment, which
may have diverse effects within and among individuals, including
effects on physical activities such as mobility. Included in this broad
category is the subcategory Acquired brain injury which is used to
describe multiple disabilities arising from damage to the brain
acquired after birth. Note: Due to its low prevalence among
children, acquired brain injury has not been reported separately in
this bulletin.
Australian Institute of Health and Welfare 2005 Disabilities
Updates: Children with disabilities
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Department of Education, Training and the Arts
DETA Criteria for Physical Impairment
pre 2005
• Significant physical impairment
and
• Student requires regular specialised support
for access and participation in schooling.
Source: Senate Employment, Workplace Relations and Education
References Committee report, Education of students with
disabilities (2002), Appendix 5, pp.157-166 and ACT Student
Disability Criteria (ACT Government), July 2003.
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Department of Education, Training and the Arts
Criteria (until 12 November 2007)
A Physical Impairment is a dysfunction of neurological and musculoskeletal systems which affects the
ability to move or coordinate and control movement when performing tasks.
(A Physical Impairment may also affect the ability to use or feel certain parts of the body. Different)
The body systems (may be) involved:
–
musculoskeletal – involving the joints, limbs and associated muscles
–
neurological – involving the central or peripheral nervous systems (brain, spinal cord or
nerves).
There are a wide range of conditions that may result in a Physical Impairment including cerebral palsy,
spina bifida, muscular dystrophy, arthritis, osteogenesis imperfecta, congenital malformations of
the limbs, some acquired brain injury, some orthopaedic conditions.
A Physical Impairment may result from neurological damage, congenital malformation, genetic
disorders, orthopaedic impairment , accidents resulting in brain injury, loss of limbs, severe
burns.
There is a broad continuum of Physical Impairment and resulting implications for students. Some
students may experience a mild impact on their access to, participation in, and outcomes from
schooling, while others will experience a more significant impact. A Physical Impairment may be:
•
present from birth (congenital) or acquired later (for example through an accident or illness)
•
progressive or non-progressive (this refers to whether or not the condition increases in extent or
severity over time).
The diagnosis of the body structure and function that is affected must be provided by medical
specialist. Education Queensland recognises a diagnosis of a condition that affects these body
systems and which may result in a Physical Impairment provided by a paediatrician, neurologist,
orthopaedic surgeon, + rheumatologist and/or geneticist
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Department of Education, Training and the Arts
Criteria (until 12 November 2007)
Students functioning not to be accounted for existing
diagnosis of IntelIectual Impairment, Autism Spectrum
Disorder or Learning Difficulties
 High incidence of combination of physical impairment with
other impairments according to Australian Institute of Health
and Welfare 2004 analysis of Australian Bureau of Statistics
data (49% comorbidity in 2006 verifications)
 No substantiated evidence provided in 2006 to exclude
students with II, ASD or LD
Recommendation - No exclusion of students with these
impairments but must have a musculoskeletal and/or
neurological diagnosis and be able to demonstrate
difficulties with movement
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Department of Education, Training and the Arts
The Impairment – dysfunction in body
structure and function
Under the ICF - “Impairments are the problems in body function or
structure
• Body structure - anatomical parts of the body
– Structures of the nervous system e.g. spinal cord and related
structures Chapter 1
– Structures related to movement e.g. structure of head and neck
region Chapter 7
• Body function - the physiological functions of body systems
– Neuromusculoskeletal and movement-related functions Chapter 7
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Department of Education, Training and the Arts
New Criteria (from November 12 2007)
Criterion 1
Diagnosis of a Musculoskeletal and/or
Neurological Condition (body structure)
which affects the ability to move or coordinate
movement (body function)
•
•
Musculoskeletal conditions - involving joints and muscles
– e.g. Congenital or acquired physical malformations, joint
conditions, skin conditions where impact on joints and
muscles, Neurofibromatosis where impact on joints and
muscles
Neurological conditions - involving brain, spinal cord or
nerves
– e.g. Cerebral Palsy, Muscular Dystrophy, Spinal Atrophy,
Spina Bifida, spinal tumours, Genetic Degenerative
Diseases/Syndromes, Acquired neurological conditions
including acquired brain injuries
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Department of Education, Training and the Arts
Some musculoskeletal and/or neurological
conditions may not affect the ability to move or
coordinate movement e.g.
• Epilepsy
• Acquired Brain Injury
• Hydrocephalus
• Mild Cerebral Palsies
Evidence needed to determine the nature and
extent of the impairment in body function - Ability to
move or coordinate movement
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Department of Education, Training and the Arts
Additional information required in 2005
Section 3 information provided by the school
1. Student’s difficulty with activities in their
education program
2. Impact on access, participation and
educational outcomes + adjustments
3. Disability specific needs to be identified
From 2006 all students verified are eligible for a
profile to be submitted so information on
adjustments is not required for verification
Physical Impairment - Activity
Limitation/ Participation
Restriction in the school
context
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Department of Education, Training and the Arts
“The range and extent of activity limitation
and participation restriction will vary with
the extent of impairment as well as with
environmental factors. Environmental
adjustments and support needs are related
to areas of activity limitation and
participation restriction”
Australian Institute of Health and Welfare 2005
Disabilities Updates: Children with disabilities
education adjustment program
Department of Education, Training and the Arts
New Criteria (from November 12 2007)
Criterion 2
Information to be provided by the school on Activity
Limitations and Participation restrictions i.e. extent of
the impairment (limitation in function) and the effect of the
physical condition on the student’s functional performance
(at the level of the individual) within the school setting
(consideration of context of learning and environment)
How to record this information for a physical
impairment?
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Department of Education, Training and the Arts
Activity Limitations
Activity is described as the nature and extent of functioning at
the level of the person. Activities may be limited in nature,
duration and quality. (Physical Disability Council of Australia)
Activity is the execution of a task or action by an individual. Also
described as “capacity”. ICF, 2001
Activity Limitations are the difficulties an individual may
have in executing activities
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Department of Education, Training and the Arts
Educational Impact
2006 verification data collected
70% of students verified demonstrated difficulties with Mobility
e.g mobility around classroom - transfers, hoists, assistance,
equip
mobility around school - walking, stairs, wheelchair
90% with Gross Motor difficulties
gross motor skills (age related) - GM programs, modified HPE
82% with Fine Motor difficulties
hand/arm function - writing FM programs, AT, assistance
60% Self care difficulties
dressing, eating, toileting
50% Leisure often incorporated with Mobility and Gross Motor swimming, sport, playground
35% Communication - assistive technology
30% Social - assistance with peers
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Department of Education, Training and the Arts
ICF’s nine domains of life
• Learning and applying knowledge
• General Tasks
• Communication
• Mobility
• Self Care
• Domestic Life
• Interpersonal interactions and relationships
• Major Life areas
• Community, social and civic life
All 9 domains affected by a physical impairment
however 3 domains provide disability specific
information required – Mobility, Communication,
Self Care
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Department of Education, Training and the Arts
Activity Limitations and Participation
Restrictions
- Mobility, Self Care and Communication domains
provide disability specific information for Physical
Impairment
- Mobility (ICF) includes gross motor and fine motor but
some conditions affect only one of these – separated
Mobility to Gross mobility and Fine mobility
This information should be as recent as possible to
accurately reflect student’s current functioning.
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Department of Education, Training and the Arts
Mobility
Gross Mobility
Ability to
• Maintain positions –
sitting, standing
• Change positions
• Move indoors
• Move outdoors
• Move (other) –
run/hop/jump, use
playground equipment,
be involved in play/sports
activities
Fine Mobility
Ability to
• Access and transport
materials
• Manipulate environment
fittings and furniture
• Manipulate materials
• Produce written work
• Other
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Self Care
Ability to
• Manage mealtime
• Manage toileting
• Manage hygiene
• Manage clothing
• Other
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Communication
Ability to
• Use physical structures to
speak
• Use physical movement to
gesture
• Use augmentative and
alternative communication
• Other
Verification Form
education adjustment program
Department of Education, Training and the Arts
Review of form - Key considerations
• How to provide information simply and easily –
open boxes difficult to complete
• Difficulty with access to specialists (medical and
educational)
• Need to scaffold best practice and consistency
• Need to encourage communication between
schools and the AVT: PI
• Need to link impairment to activity limitation and
participation restriction to assist schools to
determine appropriate educational adjustments
education adjustment program
Department of Education, Training and the Arts
PI Verification Form – Part B
Criteria 1 Diagnosis by Medical Specialist
• Dysfunction of musculoskeletal and/or
neurological systems which affects the ability to
move or coordinate movement diagnosed by
- Paediatrician (79% in 2006), Neurologist (7%), Orthopaedic
Specialist (7%), Geneticist (6%), Rheumatologist (3%)
• Diagnosis by letter or signature on form with
condition named. This diagnosis needs to be as
current as possible.
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Department of Education, Training and the Arts
PI Verification Form – Part B
Criterion 2
Activity Limitations
Student’s ability to move within the school
setting
Qualifiers
0 = inability to move
1 = partial ability to move
2 = ability to move
Can include comments – how child performs movement ie
with equipment, assistance, physical or verbal cues etc
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Department of Education, Training and the Arts
PI Verification Form – Part B
Criterion 2
Participation restrictions
Student’s access to Foundation or Key Learning
areas
Qualifiers
N/A = not applicable an option
1 = 1 Learning area affected
2 = 2 or more learning areas affected
3 = All learning areas affected
Can specify area if only 1 or 2 learning areas affected e.g. HPE,
Home Economics
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Department of Education, Training and the Arts
Students Needs
Optional tick boxes of assistance, equipment and
programs
• Links the verification information to student’s IEP
goals, school program and profile
Diagnosis + difficulty with movement (Activity
Limitations) + curriculum access/participation
leads to decisions around how to best support
students needs
Verification Reviews and
Removal from Category
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Department of Education, Training and the Arts
Verification Reviews
• No mandatory review for most diagnoses
- a review of the diagnosis not necessary
as many conditions do not change
• Reviews required for:
– Perthes
– Recent Acquired Brain Injury
• Review and date of review determined by
the verifier
Removals from category
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Department of Education, Training and the Arts
Contact Details
• [email protected]
• For PI Verification questions
– Ph: 3240 9382
• For general Verification questions
– Ph: 3240 9348 (Jeannie Grace)
– Fax: 3240 9300EAP Verification Team
141 Merton Rd
WOOLOONGABBA Q 4102