5.3.1 Specialist Services for Children with Disabilities - Eligibility Criteria

Introduction
Eligibility Criteria for Specialist Services
Social Model of Disability

1. Introduction

Specialist services are provided for children with disabilities by the Special Educational Needs and Children with Disabilities Service within Children's Services.

Section 17 of the Children Act 1989 identifies all children with disabilities as Children in Need.

The definition of disability in the Children Act 1989 mirrors the National Assistance 1948 definition, which is:

"A child is disabled if he is blind, deaf or dumb, or suffers from mental disorder of any kind or is substantially and permanently handicapped by illness, injury or congenital deformity or such other disability as may be prescribed." (Please note the above quote is taken directly from the Act and is not language that would be used by this service to describe disabilities.)

Specialist services for Children with Disabilities sets the criterion for eligibility based on this definition, requiring that the child's illness, injury or congenital deformity results in a substantial and permanent disability.

This criterion for eligibility is consistent with the Disability Discrimination Act 1995 definition of a person with a disability, as someone with:

"a physical or mental impairment which has substantial and long-term adverse effects on his ability to carry out normal day-to-day activities."

This Service also works within the Disability Discrimination Act 2005 to promote disability equality.

2. Eligibility Criteria for Specialist Services

2.1 Eligibility for an Assessment of Need

In order to be eligible for an assessment of need for specialist services from the Children with Disabilities service, the child must:

Be aged under 18 years old,
Live within Croydon, and
Have a permanent and substantial disability, from one or more of the following categories:
- Learning disability
- Physical disability
- Visual disability
- Hearing disability

The table below can be used to categorise the severity of the impact of the impairment on the child's functioning, within a disability type.

	Meets Criteria		Does Not Meet Criteria
Disability Category	Profound Impairment	Severe Impairment	Moderate Impairment	Mild Impairment
Learning	Has a Statement of Educational Needs. Attends a Special School for children with severe learning difficulties	Has a Statement of Educational Needs. Attends a Special School for children with severe learning difficulties	Has a Statement of Educational Needs Attends a mainstream school with limited support.	Does not have a Statement of Educational Needs
Mobility	Unable to walk. Totally dependent on others for mobility. Wheelchair user.	Unable to walk without aids or assistance. Able to manoeuvre self some of the time. May be able to stand or transfer with support.	Able to walk, but occasionally requires aids or assistance.	Able to walk/move independently, but with some limitation of function. May have poor co-ordination of movement.
Gross & Fine Motor Skills	Unable to use hands for any purposeful movement.	Mostly unable to use hands to complete tasks effectively. Able to use switch systems	Considerable difficulties with control of hands. Requires some assistance to complete tasks.	Some difficulties with control of hand movement for precise work.
Health	Unable to take part in normal social and educational activities.	Frequent or daily interruption of normal services. Significant interference with development and / or learning.	Intermittent but regular limitations on ability to perform everyday tasks. The child's development or learning may be affected.	Known health condition, which is under control and only occasionally interfering with everyday activities in a minor way.
Vision	Mobility restricted without special provision. Requires education by non-sighted method. Eligible for registration as blind.	Unable to read large print without assistance or aids. Severe visual field defect with impaired visual acuity. Eligible for registration as blind or partially sighted.	Able to read print with simple aids or assistance. Defect of at least half visual field. May be eligible for registration as partially sighted.	Severe or profound problem with one eye. Defect of less than half visual field. Able to function independently.
Hearing	Hearing loss over 95 dB.	Hearing loss between 71 - 95 dB.	Hearing loss between 41 - 79 dB	Severe or profound hearing loss in one ear. Hearing loss between 20 - 40 dB.

	Meets Criteria		Does Not Meet Criteria
INDICATORS	Profound Impairment	Severe Impairment	Moderate Impairment	Mild Impairment
Communication	Unable to communicate needs by any method. Unable to use communication aids.	Limited or no verbal communication. Able to communicate basic needs without the use of language.	Delayed or disordered communication, including language disorders. Speech supplemented by another method of communication.	Mild delay of language development.
Personal Care	Total assistance required for bathing, dressing, toileting and eating.	Assistance required for bathing, dressing, toileting or eating.	Some supervision or assistance required for bathing, dressing, toileting or eating.	Occasional difficulties meeting own self-care needs.
Consciousness	Comatose. Intractable seizures, in frequent succession.	Regular seizures on a daily basis. Impacts on the child's learning or development.	Seizures day or night on a regular basis, usually once per week.	Occasional daytime seizure (up to one per month)
Behaviour & Social Integration	The challenging behaviours are impacting on all aspects of the child's functioning. The behaviours pose a significant risk to the safety of the child or others.	The challenging behaviours are impacting on some aspects of the child's functioning. Specialist provision is required for the child to function socially or within the family group.	The frequency or severity of the behaviours requires some specialist advice or provision.	Behaviours are occasionally difficult to manage. Special provision not required when managing the behaviour.
Safety and Supervision	Needs constant supervision both day and night. No ability to perceive danger to self or others.	Needs constant supervising during the day. Would place themselves or others at serious risk without supervision.	Requires supervision to perform daily tasks. Requires supervision significantly greater than that expected for children of the same age. Limited perception of danger to self or others.	On occasion, requires more supervision than other children of the same age.

These indicators assist in classification of severity of disability only. They do not constitute disability classifications.

Children attending the following schools usually meet our criteria: Red Gates, Priory, St Giles (Physical Disabled), Bensham Paperjack Unit, Castle Hill (Autistic Unit), St Nicks (Autistic Unit) and Kingsley Hearing Unit.

It is more difficult to establish whether the eligibility criteria are met for children under the age of five, using the earlier severity continuum. The table below illustrates that children under the age of 5 will meet the eligibility criteria when significant developmental delay is demonstrated.

	Meets Criteria		Does Not Meet Criteria
Age	Profound Impairment	Severe Impairment	Moderate Impairment	Mild Impairment
Under 5 years	Significant failure to meet developmental milestones.	Functioning moderately behind the level expected for age.	Functioning moderately behind the level expected for age.	Functioning slightly behind the level expected for age.
Over 5 years	Child is completely dependent on others to perform tasks.	Child is unable to perform tasks without aids or assistance most of the time.	Child requires some assistance to perform some tasks.	Some limitation evidenced, but able to function independently.

Information must demonstrate that the referred child needs more help or supervision than other children of the same age.

It is important to note that the eligibility criteria precludes children with:

Emotional and behavioural disorders
Mental Health difficulties, and
Medical conditions that are not permanent.
If the presenting problem is not related to the child with a disability (e.g. another family member).

Demonstrating that the Eligibility Criteria is met

Services for Children with Disabilities does not diagnose disability. Professionals who diagnose disability must provide evidence to support a claim that a child has a substantial and permanent disability.

As a guide, an assessment of disability will be accepted from the following professional groups, by disability type:

1.	Learning Disability Statement of Special Educational Needs recommending considerable 1:1 support in a mainstream school or attendance at a Special School. Head teacher of child's school or nursery. Health professional
2.	Physical Disability Child Health Professionals including General Practitioner, Community paediatrician, Occupational Therapist, Physiotherapist. Disability Living Allowance higher rate mobility component. Education professional
3.	Visual Disability Ophthalmologist or General Practitioner Registration as blind or partially sighted Disability Living Allowance higher rate mobility component
4.	Hearing Disability Audiologist or General Practitioner Disability Living Allowance higher rate mobility component Croydon Sensory Impairment Team.
5.	Serious and chronic illness Child Health Professionals including General Practitioner, Community Paediatrician or Children's Hospital at Home Team. Disability Living Allowance middle or highest rate personal care component, and / or higher rate mobility component.
6.	Developmental Delay Child Health Professionals including General Practitioner, Community Paediatrician or Health Visitor.
7.	Autism or Pervasive Developmental Disorder Child and Adult Mental Health Service, Psychologist or Psychiatrist.

Receipt of the Disability Living Allowance is an important indicator of eligibility for an assessment of need, by Services for Children with Disabilities. Eligibility for the Disability Living Allowance is based on the following:

Mobility Component

The rate depends on the type of help and/or supervision the child needs and the child's age.

Higher rate

The child is 3 or more years old and has a:
1. Physical disability which significantly affects mobility, or
2. Significant hearing and sight loss impacting on mobility outdoors, or
3. Learning disability with severe behavioural problems, and needs help with personal care day and night.
Lower rate

The child is 5 or more years, and able to walk, but:
1. Requires close supervision
2. Requires support to find way around

Personal Care Component

The rate depends on the amount of help or supervision the child needs and the sort of help or supervision needed.

Lower Rate: Some help or supervision needed during the day
Middle Rate: Help needed during the day or during the night
Highest Rate: Help needed day and night.

2.2 Eligibility for Services

In order to be eligible for a specialist service from the Children with Disabilities service, the child must:

Meet the eligibility criteria for assessment of need as set out in Section 2.1, and
The completed assessment of need must identify the provision of services as appropriate.

A child or family will only be eligible for services when the assessment of need identifies the provision of services as appropriate. These services will be specified in the Child in Need Plan, and can only be provided subject to available resources.

Child in Need Plans will be reviewed regularly - see Child in Need Plans and Reviews Procedure.

In most instances the services identified will be fully subscribed requiring that the child or family be added to a waiting list. Services for Children with Disabilities allocate resources according to the Social Services Priority Matrix.

3. Social Model of Disability

Within the disabled people's movement, and within some services and some professional groups, there has been a move from an individual to a social model of disability.

Services for Children with Disabilities uses this model to inform practice, incorporating the philosophy that the term disability does not only refer to impairment (functional limitation) but also describes the effects of prejudice and discrimination. It is recognised that many of the problems faced by children with disabilities are not caused by their conditions or impairments, but by societal values, service structures or adult behaviour.

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