{"id":"F2020L01025","name":"Disability Care Load Assessment (Child) Determination 2020","slug":"disability-care-load-assessment-child-determination-2020","collection":"legislative_instrument","jurisdiction":"commonwealth","status":"in_force","isInForce":true,"actNumber":null,"makingDate":null,"administeringDepartment":null,"currentVersion":{"id":100411,"registerId":"commonwealth-F2020L01025-current","compilationNumber":null,"startDate":"2026-04-02","status":"InForce","reasons":null,"registeredAt":null},"sections":[{"sectionNumber":"Part 1","sectionType":"part","heading":"Preliminary","content":"Part 1—Preliminary\n\n1 Name\n\n2 Commencement\n\n3 Authority\n\n4 Definitions\n\n5 Repeals\n\n6 Disability assessment care load components\n\n7 Recognised disabilities\n\n8 Treating health professional\n\n9 Questionnaires\n\n10 Rating method\n\n11 ACL questionnaire\n\n12 Professional questionnaire\n\nPart 2—Disability Care Load Assessment (Child) (Carer Payment)\n\n13 Carer of a child with a severe disability or severe medical condition\n\n14 Carer of 2 or more children with a disability or medical condition\n\n15 Carer of 1 or more children with a disability or medical condition and a lower ADAT score adult\n\nPart 3—Disability Care Load Assessment (Child) (Carer Allowance)\n\n16 Carer of a single disabled child\n\n17 Carer of 2 disabled children\n\nSchedule 1—Questionnaires\n\nPart 1 Assessment of care load questionnaire\n\nPart 2 Professional questionnaire\n\nSchedule 2—Rating Methods\n\nPart 1 Scoring for ACL questionnaire\n\nPart 2 Scoring for professional questionnaire\n\nSchedule 3—List of Recognised Disabilities\n\nPart 1 Recognised Disabilities\n\nPart 2 Medical Conditions\n\nSchedule 4—Repeals\n\nDisability Care Load Assessment (Child) Determination 2010\n\nSocial Security (Treating Health Professionals) Determination 2010\n\nEndnotes 66\n\nEndnote 1—About the endnotes 66\n\nEndnote 2—Abbreviation key 67\n\nEndnote 3—Legislation history 68\n\nEndnote 4—Amendment history 69\n\nPart 1—Preliminary\n\n1 Name\n\nThis instrument is the Disability Care Load Assessment (Child) Determination 2020.\n\n","sortOrder":0},{"sectionNumber":"2","sectionType":"section","heading":"Commencement","content":"2 Commencement\n\n(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.\n\n

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.

\n```\n\nNote: 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.\n\n(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.\n\n","sortOrder":1},{"sectionNumber":"3","sectionType":"section","heading":"Authority","content":"3 Authority\n\nThis instrument is made under sections 38E and 38F of the Social Security Act 1991.\n\n","sortOrder":2},{"sectionNumber":"4","sectionType":"section","heading":"Definitions","content":"4 Definitions\n\nIn this instrument:\n\nACL means assessment of care load, as determined under the ACL questionnaire.\n\nACL questionnaire means the assessment of care load questionnaire contained in Part 1 of Schedule 1.\n\nAct means the Social Security Act 1991.\n\nchild means a person aged under 16.\n\ncontributing ACL means a score from an ACL questionnaire which contributes to a rating of intense.\n\ncontributing professional questionnaire means a score from a professional questionnaire which contributes to a rating of intense.\n\ndomain means a particular category of questions in the ACL questionnaire or the professional questionnaire.\n\nprofessional questionnaire means the questionnaire contained in Part 2 of Schedule 1.\n\nqualifying 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:\n\n(a) a carer payment under the Act for the care of a child; or\n\n(b) a carer allowance under the Act for the care of a disabled child.\n\ntreating health professional has the meaning set out in section 8.\n\nNote: A number of expressions used in this instrument are defined in the Act, including the following:\n\n(a) disabled child;\n\n(b) lower ADAT score adult;\n\n(c) officer;\n\n(d) Secretary; and\n\n(e) Adult Disability Assessment Tool.\n\n","sortOrder":3},{"sectionNumber":"5","sectionType":"section","heading":"Repeals","content":"5 Repeals\n\nThe 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.\n\n","sortOrder":4},{"sectionNumber":"6","sectionType":"section","heading":"Disability assessment care load components","content":"6 Disability assessment care load components\n\n(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.\n\n(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.\n\n7 Recognised disabilities\n\nSchedule 3 of this instrument declares, for the purposes of section 953 of the Act, recognised disabilities.\n\n8 Treating health professional\n\nFor 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:\n\n(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;\n\n(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;\n\n(c) an occupational therapist who is registered as an occupational therapist with the Australian Health Professional Regulation Agency;\n\n(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;\n\n(e) a person registered as a psychologist under a law of a State or Territory that provides for the registration of psychologists;\n\n(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;\n\n(g) a person:\n\n(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\n\n(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.\n\n","sortOrder":5},{"sectionNumber":"9","sectionType":"section","heading":"Questionnaires","content":"9 Questionnaires\n\n(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.\n\n(2) The ACL questionnaire must only be completed by a person seeking to claim:\n\n(a) a carer payment under the Act for the care of a child; or\n\n(b) a carer allowance under the Act for the care of a disabled child.\n\nNote: Subsection 11(6) of this instrument allows the Secretary to amend a completed ACL questionnaire in certain circumstances.\n\n(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.\n\n(4) The professional questionnaire must only be completed by a treating health professional.\n\n","sortOrder":6},{"sectionNumber":"10","sectionType":"section","heading":"Rating method","content":"10 Rating method\n\nA person will achieve a qualifying rating if they achieve a rating of intense in accordance with Part 2 or Part 3 of the instrument.\n\n","sortOrder":7},{"sectionNumber":"11","sectionType":"section","heading":"ACL questionnaire","content":"11 ACL questionnaire\n\nScoring method\n\n(1) The questions in the ACL questionnaire are grouped into 4 categories (domains):\n\n(a) 2 Behavioural domains; and\n\n(b) Functional Abilities domain; and\n\n(c) Special Care Needs domain.\n\nNote: The Functional Abilities and Special Care Needs domains are further divided into subdomains.\n\n(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.\n\n(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.\n\n(4) The total score for each domain must not be less than 0.\n\nSecretary to be satisfied\n\n(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.\n\n(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.\n\n(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.\n\n","sortOrder":8},{"sectionNumber":"12","sectionType":"section","heading":"Professional questionnaire","content":"12 Professional questionnaire\n\nScoring method\n\n(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.\n\n(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.\n\n(3) The total professional questionnaire score may be less than 0.\n\nSecretary to be satisfied\n\n(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.\n\n(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.\n\n","sortOrder":9},{"sectionNumber":"Part 2","sectionType":"part","heading":"Disability Care Load Assessment (Child) (Carer Payment)","content":"Part 2—Disability Care Load Assessment (Child) (Carer Payment)\n\n","sortOrder":10},{"sectionNumber":"13","sectionType":"section","heading":"Carer of a child with a severe disability or severe medical condition","content":"13 Carer of a child with a severe disability or severe medical condition\n\n(1) This section applies to a person who is caring for a child with a severe disability or severe medical condition.\n\n(a) a professional questionnaire must be completed for the child; and\n\n(b) the person must complete an ACL questionnaire for the child.\n\n(3) For the purposes of paragraph 197B(1)(b) of the Act, the person achieves a qualifying rating of intense if:\n\n(a) the total score for the ACL questionnaire is 85 or more; and\n\n(b) the score on the professional questionnaire is greater than 0.\n\n","sortOrder":11},{"sectionNumber":"14","sectionType":"section","heading":"Carer of 2 or more children with a disability or medical condition","content":"14 Carer of 2 or more children with a disability or medical condition\n\n(1) This section applies to a person who is caring for 2 or more children with a disability or medical condition.\n\n(a) 1 professional questionnaire must be completed for each child; and\n\n(3) No more than 4 contributing ACL questionnaires and 4 contributing professional questionnaires can be used to contribute to a qualifying rating.\n\n(4) For the purposes of paragraph 197C(1)(b) of the Act, the person achieves a qualifying rating of intense if:\n\n(a) the total score from combining the contributing ACL questionnaires is 85 or more; and\n\n(b) the contributing professional questionnaire for each child has a score of greater than 0.\n\n(5) For subsection (4), an ACL questionnaire is a contributing ACL only if the total score for that ACL questionnaire is 20 or more.\n\n","sortOrder":12},{"sectionNumber":"15","sectionType":"section","heading":"Carer of 1 or more children with a disability or medical condition and a lower ADAT score adult","content":"15 Carer of 1 or more children with a disability or medical condition and a lower ADAT score adult\n\n(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.\n\n(a) professional questionnaire must be completed for each child; and\n\n(3) For the purposes of paragraph 197D(1)(b) of the Act, a qualifying rating of intense is achieved if:\n\n(a) the total combined score for the contributing ACL questionnaires is 85 or more; and\n\n(b) the score on the contributing professional questionnaire for each child is greater than 0.\n\n(4) For subsection (3), the adult is taken to contribute 40 to the total combined score for the contributing ACL questionnaires.\n\n(5) No more than 2 contributing ACL questionnaires and 2 contributing professional questionnaires can be used to contribute to a qualifying rating.\n\n(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.\n\n \n\n","sortOrder":13},{"sectionNumber":"Part 3","sectionType":"part","heading":"Disability Care Load Assessment (Child) (Carer Allowance)","content":"Part 3—Disability Care Load Assessment (Child) (Carer Allowance)\n\n","sortOrder":14},{"sectionNumber":"16","sectionType":"section","heading":"Carer of a single disabled child","content":"16 Carer of a single disabled child\n\n(1) If a person is caring for a disabled child:\n\n(a) a professional questionnaire must be completed for the child; and\n\n(b) the person must complete an ACL questionnaire for the child.\n\n(2) For the purposes of subparagraph 953(1)(e)(ii) of the Act, the person achieves a qualifying rating of intense if:\n\n(a) the total score for the ACL questionnaire is 85 or more; and\n\n(b) the score on the professional questionnaire is greater than 0.\n\n","sortOrder":15},{"sectionNumber":"17","sectionType":"section","heading":"Carer of 2 disabled children","content":"17 Carer of 2 disabled children\n\n(1) If a person is caring for 2 disabled children:\n\n(a) 1 professional questionnaire must be completed for each child; and\n\n(2) No more than 2 contributing ACL questionnaires and 2 contributing professional questionnaires can be used to contribute to a qualifying rating.\n\n(3) For the purposes of paragraph 953(2)(e) of the Act, the person achieves a qualifying rating of intense if:\n\n(a) the total score from combining the contributing ACL questionnaires is 85 or more; and\n\n(b) the contributing professional questionnaire for each child has a score of greater than 0.\n\n(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.\n\n \n\n","sortOrder":16},{"sectionNumber":"Sch 1","sectionType":"schedule","heading":"Questionnaires","content":"Schedule 1—Questionnaires\n\n(Section 9)\n\nPart 1 Assessment of care load questionnaire\n\nDomain A – Behaviour 1\n\nFor each question, the claimant must tick only the response code that best describes how well the child in care usually manages.\n\nQuestion 1\n\n| The child’s ability to do everyday things (e.g. eating, bathing, talking, walking and mixing with other people etc) is: | |\n| --------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| Improving over time (i.e. the child is likely to require less help in the future) |  |\n| Becoming worse over time (i.e. the child is likely to require more help in the future) |  |\n| Relatively stable (i.e. the child is likely to require the same level of help in the future) |  |\n| 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) |  |\n| Unsure |  |\n\nQuestion 2\n\nSettling down to sleep at night\n\n(e.g. repeated efforts needed to get the child to go to sleep at night\n\n| The child never has difficulty settling down to sleep at night |  |\n| -------------------------------------------------------------------------------------------------- | --- |\n| The child sometimes has difficulty settling down to sleep at night (e.g. one or two nights a week) |  |\n| The child often has difficulty settling down to sleep at night (e.g. more than two nights a week) |  |\n| The child always has difficulty settling down to sleep at night (e.g. every night) |  |\n\nQuestion 3\n\nDisrupted sleep at night\n\n(e.g. waking up many times during the night, awake for long periods during the night, or having nightmares)\n\n| The child never has disrupted sleep at night |  |\n| -------------------------------------------------------------------------------- | --- |\n| The child sometimes has disrupted sleep at night (e.g. one or two nights a week) |  |\n| The child often has disrupted sleep at night (e.g. more than two nights a week) |  |\n| The child always has disrupted sleep at night (e.g. every night) |  |\n\nQuestion 4\n\nIrritable behaviour\n\n(e.g. crying all the time, not able to be calmed down, or for an older child, continually agitated, prone to angry outbursts)\n\n| The child never has irritable behaviour |  |\n| ------------------------------------------------------------------------- | --- |\n| The child sometimes has irritable behaviour (e.g. one or two days a week) |  |\n| The child often has irritable behaviour (e.g. more than two days a week) |  |\n| The child always has irritable behaviour (e.g. every day) |  |\n\nQuestion 5\n\nSpeaking and Communicating\n\n(i.e. speaking and communicating everyday needs)\n\n| 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.) |  |\n| --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| 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) |  |\n| The child uses other ways to communicate (e.g. sign language, picture board, electronic communicator, gestures, pointing) |  |\n| The child cannot talk or communicate their needs effectively in any way |  |\n\nQuestion 6\n\nUnderstanding speech\n\n(i.e. the child understanding what you say to him or her)\n\n| The child is able to understand everything that I would expect for a child of this age |  |\n| -------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child sometimes needs me to speak more simply, repeat things or give reminders (e.g. once or twice a day) |  |\n| 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) |  |\n| 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?’) |  |\n\nQuestion 7\n\nPlaying and mixing with other children\n\n| The child plays and mixes with other children as expected for a child of their age |  |\n| -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child sometimes needs help to play and mix appropriately with other children (e.g. once or twice a week) |  |\n| The child often needs help to play and mix appropriately with other children (e.g. several times a week) |  |\n| 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) |  |\n\nQuestion 8\n\nIs the child aged under 3 years?\n\n| No |  | Go to next question |\n| --- | --- | ---------------------------- |\n| Yes |  | Go to question 20 (domain C) |\n\nDomain B – Behaviour 2\n\nQuestions 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.\n\nQuestion 9\n\nDoes the child have severe behaviour difficulties?\n\n| No |  | Go to question 20 (domain C) |\n| -------- | --- | ---------------------------- |\n| Yes |  | Go to next question |\n| Not sure |  | Go to next question |\n\nQuestion 10\n\n| The child wanders, escapes or runs away from home, school or community settings | |\n| ---------------------------------------------------------------------------------------------------------- | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (e.g. the child sometimes wanders or runs away but not every week) |  |\n| Often (e.g. the child would wander or run away at least once a week if not closely supervised) |  |\n| Always (e.g. the child continually wanders or runs away unless hand is held or doors and gates are locked) |  |\n\nQuestion 11\n\n| The child shouts, screams at, or threatens other people or makes so much noise that other people become alarmed. | |\n| ---------------------------------------------------------------------------------------------------------------- | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (The child sometimes has this behaviour, but not every week) |  |\n| Often (The child often has this behaviour e.g. at least once a week) |  |\n| Always (The child has this behaviour all the time e.g. every day) |  |\n\nQuestion 12\n\n| The child becomes physically aggressive and harms others by hitting, pushing, kicking, biting or throwing objects. | |\n| ------------------------------------------------------------------------------------------------------------------ | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (The child sometimes has this behaviour, but not every week) |  |\n| Often (The child often has this behaviour e.g. at least once a week) |  |\n| Always (The child has this behaviour all the time e.g. every day) |  |\n\nQuestion 13\n\n| 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). | |\n| ---------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (The child sometimes has this behaviour, but not every week) |  |\n| Often (The child often has this behaviour e.g. at least once a week) |  |\n| Always (The child has this behaviour all the time e.g. every day) |  |\n\nQuestion 14\n\n| The child gets extremely anxious, fearful or becomes emotionally withdrawn. | |\n| --------------------------------------------------------------------------- | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (The child sometimes has this behaviour, but not every week) |  |\n| Often (The child often has this behaviour e.g. at least once a week) |  |\n| Always (The child has this behaviour all the time e.g. every day) |  |\n\nQuestion 15\n\n| The child has very strange behaviours such as unusual routines, repetitive or obsessive behaviours, hearing voices or seeing things that are not there. | |\n| ------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (The child sometimes has this behaviour, but not every week) |  |\n| Often (The child often has this behaviour e.g. at least once a week) |  |\n| Always (The child has this behaviour all the time e.g. every day) |  |\n\nQuestion 16\n\n| 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. | |\n| ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (The child sometimes has this behaviour, but not every week) |  |\n| Often (The child often has this behaviour e.g. at least once a week) |  |\n| Always (The child has this behaviour all the time e.g. every day) |  |\n\nQuestion 17\n\n| The child behaves in ways that result in injury to themself. This may include head‑banging, hand‑biting or other self-harming behaviours. | |\n| ----------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (The child sometimes has this behaviour, but not every week) |  |\n| Often (The child often has this behaviour e.g. at least once a week) |  |\n| Always (The child has this behaviour all the time e.g. every day) |  |\n\nQuestion 18\n\n| The child has displayed suicidal behaviours (e.g. the child has suicidal thoughts and has planned or attempted suicide). | |\n| ----------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| Never (The child has never displayed suicidal thoughts or behaviours) |  |\n| Sometimes (The child has displayed suicidal behaviours once or twice in the past two years) |  |\n| Often (The child has displayed suicidal behaviours more than twice in the past two years) |  |\n| 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) |  |\n\nQuestion 19\n\n| The child does or says things that are sexually inappropriate. | |\n| ---------------------------------------------------------------------- | --- |\n| Never (The child never has this behaviour) |  |\n| Sometimes (The child sometimes has this behaviour, but not every week) |  |\n| Often (The child often has this behaviour e.g. at least once a week) |  |\n| Always (The child has this behaviour all the time e.g. every day) |  |\n\nDomain C – Functional Abilities\n\nQuestion 20\n\nDoes 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?\n\n| No |  | Go to question 37 (domain D) |\n| -------- | --- | ---------------------------- |\n| Yes |  | Go to next question |\n| Not sure |  | Go to next question |\n\nQuestion 21\n\nIs the child aged under 12 months?\n\n| No |  | Go to next question |\n| --- | --- | ---------------------------- |\n| Yes |  | Go to question 37 (domain D) |\n\nInstructions for domain C\n\nQuestions 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.\n\nFor 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.\n\nIf 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.\n\nThe child’s age will be taken into account when assessing your responses.\n\nDomain C – Functional abilities – subdomain 1\n\nQuestion 22\n\n| Does the child feed themself once food is prepared? | |\n| ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child feeds themself with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| 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.)) |  |\n\nQuestion 23\n\n| Does the child do everyday grooming tasks (e.g. brush teeth, brush/comb hair, wash and rinse hands and face)? | |\n| ------------------------------------------------------------------------------------------------------------- | --- |\n| The child grooms themself with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| The child is completely dependent on me to do their grooming |  |\n\nQuestion 24\n\n| Does the child wash themself from the neck down (except for their back) in the bath, shower or sponge/bed bath? | |\n| --------------------------------------------------------------------------------------------------------------- | --- |\n| The child washes themself with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| The child is completely dependent and needs me to wash them |  |\n\nQuestion 25\n\n| Does the child dress themself from the waist up (e.g. putting on singlets, t‑shirts, jumpers, jackets)? | |\n| ------------------------------------------------------------------------------------------------------- | --- |\n| The child dresses themself from the waist up with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| The child is completely dependent and needs me to dress them |  |\n\nDomain C – Functional abilities – everyday tasks\n\nQuestion 26\n\n| Does the child dress themself from the waist down (e.g. putting on underpants, skirts/pants/trousers, socks, shoes)? | |\n| -------------------------------------------------------------------------------------------------------------------- | --- |\n| The child dresses themself from the waist down with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| The child is completely dependent and needs me to dress them |  |\n\nQuestion 27\n\n| Does the child wipe themself and adjust their clothing before and after using the toilet? | |\n| ---------------------------------------------------------------------------------------------------- | --- |\n| The child uses the toilet with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| The child is completely dependent for toileting, or wears nappies or incontinence pads day and night |  |\n\nDomain C – Functional abilities – subdomain 2\n\nQuestion 28\n\n| Does the child have bladder accidents (i.e. wets their pants or nappy)? | |\n| -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child never has bladder accidents (e.g. the child is dry during the day and at night) |  |\n| 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) |  |\n| 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) |  |\n| 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) |  |\n\nQuestion 29\n\n| Does the child have bowel accidents (i.e. soils their pants or nappy)? | |\n| ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child never has bowel accidents |  |\n| The child sometimes has bowel accidents (e.g. the child occasionally soils their pants or nappy during the day or night) |  |\n| The child often has bowel accidents (e.g. the child soils their pants or nappy several times a week) |  |\n| 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) |  |\n\nDomain C – Functional abilities – subdomain 3\n\nQuestion 30\n\n| Does the child sit down and get up from the toilet or potty? | |\n| ----------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child sits down and gets up from the toilet or potty with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| 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) |  |\n\nQuestion 31\n\n| Does the child sit down and get up from a chair or wheelchair? | |\n| --------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child sits down and gets up from a chair with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| 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) |  |\n\nQuestion 32\n\n| Does the child get into or out of a bath or shower (whichever is used more often)? | |\n| ----------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child gets into and out of a bath or shower with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. prompting, reminding or a small amount of physical help) |  |\n| The child needs a lot of help (e.g. a lot of physical help) |  |\n| 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) |  |\n\nQuestion 33\n\n| How does the child move around? | |\n| ----------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| The child moves around by walking |  |\n| The child moves around using a wheelchair or other mobility aids (e.g. stroller, crutches, walking sticks, walking frame or other mobility equipment) |  |\n| The child moves around by crawling, rolling or bottom‑hitching (e.g. the child does not walk but can move around on the floor) |  |\n| The child is not able to move around by themself |  |\n\nQuestion 34\n\n| Does the child move around by themself indoors on an even surface? | |\n| --------------------------------------------------------------------------------------------- | --- |\n| The child moves around on an even surface with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. supervision or a small amount of physical help from me) |  |\n| The child needs a lot of help (e.g. a lot of physical help from me) |  |\n| The child is completely dependent (e.g. the child cannot move around indoors by themself) |  |\n\nQuestion 35\n\n| Does the child move around by themself outdoors on uneven surfaces? | |\n| ------------------------------------------------------------------------------------------------------ | --- |\n| The child moves around outdoors on uneven surfaces with no help (e.g. the child needs no help from me) |  |\n| The child needs a little help (e.g. supervision or a small amount of physical help from me) |  |\n| The child needs a lot of help (e.g. a lot of physical help from me) |  |\n| The child is completely dependent (e.g. the child cannot move around outdoors by themself) |  |\n\nQuestion 36\n\n| Does the child go up and down stairs? | |\n| ---------------------------------------------------------------------------------------------------------------------- | --- |\n| The child goes up and down a flight of stairs with no help from me |  |\n| The child goes up and down two or three steps with no help from me |  |\n| The child goes up and down a single step or kerb with no help from me |  |\n| 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 |  |\n\nDomain D – Special care needs\n\nInstructions for special care needs questions\n\nQuestions 37 to 53 ask you to indicate the child’s special care needs.\n\nIf the child has a condition that changes from day to day, please base your answers on the child’s usual and ongoing needs.\n\nDomain D – Special care needs – subdomain 1\n\nQuestion 37\n\nDoes the child use any of the following to help with breathing?\n\n| 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) |  |\n| -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| 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) |  |\n| Oxygen (The child is regularly given extra oxygen to breathe from an oxygen cylinder at home as directed by a medical practitioner) |  |\n| 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) |  |\n| NO ‑ Go to next question |  |\n\nQuestion 38\n\nDoes the child receive dialysis (due to a kidney condition)?\n\n(Dialysis is the assisted removal of waste products from the body for people with kidney failure.)\n\nQuestion 39\n\nDo you provide Total Parenteral Nutrition (TPN) for the child?\n\nTPN 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.\n\nQuestion 40\n\nDo you do postural drainage for the child?\n\nPostural 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.\n\n| No |  | Go to next question |\n| --- | --- | --------------------------------------------------------------------- |\n| Yes |  | Please indicate how often you provide postural drainage for the child |\n\nQuestion 41\n\nDo you clear the child’s airways through suctioning?\n\nSuctioning is the use of a tube connected to equipment to remove mucus or saliva from the child’s mouth, throat or airway.\n\n| No |  | Go to next question |\n| --- | --- | -------------------------------------------------------------- |\n| Yes |  | Please indicate how often you provide suctioning for the child |\n\nQuestion 42\n\nDo you physically assist or position the jaw of the child to help with chewing and/or swallowing?\n\n| No |  | Go to next question |\n| --- | --- | ------------------------------------------------------------------------------ |\n| Yes |  | Please indicate how often you physically assist with chewing and/or swallowing |\n\nQuestion 43\n\nDo you Percutaneous Endoscopic Gastrostomy (P.E.G.) feed or use a feeding tube to feed the child?\n\nWhen 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.\n\n| No |  | Go to next question |\n| --- | --- | --------------------------------------------------------------------------------------------------- |\n| Yes |  | Please indicate how often you P.E.G. feed or use a feeding tube for the child over a 24 hour period |\n\nQuestion 44\n\nDo you provide physical assistance to turn or position the child because they are unable to do so independently?\n\n| No |  | Go to next question |\n| --- | --- | -------------------------------------------------------------------------------------- |\n| Yes |  | Please indicate how often you physically assist the child to turn or position themself |\n\nQuestion 45\n\nDo you manage any wounds and/or dressings for the child?\n\n| No |  | Go to next question |\n| --- | --- | ---------------------------------------------------------------------------------- |\n| Yes |  | Please indicate how much time you spend managing wounds or dressings for the child |\n\n| Less than 30 minutes per day |  |\n| ---------------------------- | --- |\n| 30-60 minutes per day |  |\n| 1-2 hours per day |  |\n| More than 2 hours per day |  |\n\nQuestion 46\n\nDo you give emergency medication or first aid for poorly controlled seizures?\n\n| No |  | Go to next question |\n| --- | --- | --------------------------------------------------------------------------------------------------- |\n| Yes |  | Please indicate how often you give emergency medication or first aid for poorly controlled seizures |\n\n| Less than monthly |  |\n| --------------------------- | --- |\n| Once or twice a month |  |\n| Three or more times a month |  |\n\nQuestion 47\n\nDo you provide stoma care (e.g. colostomy, ileostomy) for the child?\n\nA 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.\n\n| No |  | Go to next question |\n| --- | --- | ------------------------------------------------------------------------------------ |\n| Yes |  | Please indicate how often you provide stoma care for the child over a 24 hour period |\n\nDomain D – Special care needs – subdomain 2\n\nQuestion 48\n\nDoes the child have an eating disorder that has been diagnosed by a medical practitioner (e.g. anorexia nervosa or bulimia)?\n\nQuestion 49\n\nIs the child receiving a course of chemotherapy or radiotherapy treatment?\n\nQuestion 50\n\nDo you prepare or administer medications related to the child’s medical condition?\n\n(Medications include tablets, other oral medicines, injections, puffers/inhalers, suppositories, enemas, ointments or creams prescribed by a medical practitioner)\n\n| No |  | Go to next question |\n| --- | --- | -------------------------------------------------------------------------------------------------------- |\n| Yes |  | Please indicate how many minutes PER DAY on average you spend preparing and/or administering medications |\n\n| minutes per day |\n| --------------- |\n\nQuestion 51\n\nDo you provide any of the following supports of treatments for the child?\n\n| Attending health care appointments related to the child’s disability or medical condition multiple times per month |  |\n| ----------------------------------------------------------------------------------------------------------------------------- | --- |\n| Exercises prescribed by a physiotherapist, speech therapist, occupational therapist or other specialist at least twice a week |  |\n| Applying daily splints, braces, special garments or mobility aids recommended by a health practitioner |  |\n| Behavioural program recommended by a psychologist, psychiatrist or other therapist |  |\n| Early childhood intervention activities recommended by a teacher, therapist or other disability specialist |  |\n| Sign language or hearing equipment where the child is deaf or has a severe hearing impairment |  |\n| Equipment or tactile aids or other assistance around the home where the child is blind or has a severe visual impairment |  |\n| Blood testing or urine testing performed by you at least three times a day |  |\n\nQuestion 52\n\nDo any of these other care needs apply to you and the child you care for?\n\n| I am unable to access general child care, after‑school hours care or vacation care programs due to this child’s special care needs |  |\n| ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | --- |\n| 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 |  |\n| 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 |  |\n| 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 |  |\n| 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 |  |\n| 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 |  |\n\nQuestion 53\n\nPlease describe any other care needs that the child has.\n\nQuestion 54\n\nPlease 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).\n\nQuestion 55\n\nIf there are any other comments about your situation that you feel are relevant, please write them in the space below.\n\n \n\nPart 2 Professional questionnaire\n\nFunctional domains – abilities\n\n- Please indicate the statement that describes the child’s usual ability.\n- If the child cannot do any of the skills listed in a question, tick the last box.\n- If the child’s ability is appropriate for the age of the child, tick the first box.\n- The child’s abilities include what they can do when using their aids, appliances or special equipment items.\n- 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.\n\n| | Question | Response Code |\n| --- | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------- |\n| 1 | Receptive language skills (listening, reading and understanding) | |\n| | Child’s ability is age appropriate | M‑1l |\n| | 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 |\n| | Child can read and interpret a paragraph from the front page of a daily newspaper | M-1i |\n| | 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 |\n| | Child understands and responds appropriately to simple questions such as ‘do you go to school?’ and ‘what is your favourite colour?’ | M‑1g |\n| | 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 |\n| | Child knows the difference between ‘big’ and ‘little’. Child can demonstrate what common objects are used for | M‑1e |\n| | Child recognises pictures of common objects, for example points appropriately when asked ‘where’s the dog?’ or ‘which one is the truck?’ | M‑1d |\n| | 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 |\n| | Child responds to sound. Child tracks noise‑making objects | M‑1b |\n| | Child looks momentarily at speaker’s face | M‑1a |\n| | Child cannot do any of the things listed above | M‑1k |\n| 2 | Expressive language skills (talking or signing) | |\n| | Child’s ability is age appropriate | M‑2l |\n| | Child has almost a full adult vocabulary. Child can discuss and debate complex issues such as politics or religion with an adult | M‑2j |\n| | Child can describe his or her experiences in detail using complex sentences | M‑2i |\n| | Child can tell a complex story involving several characters. Child can write a short story | M‑2h |\n| | 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 |\n| | 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 |\n| | Child can say sentences with 3 to 4 words. People other than family members can understand the child’s speech | M-2e |\n| | Child can clearly say or sign more than 20 words and can use 2 words in combination, for example ‘Daddy’s car’ | M-2d |\n| | Child can say or sign 3 or more simple words, for example ‘mum’, ‘dad’, ‘drink’, ‘bed’ | M-2c |\n| | Child smiles and babbles or makes purposeful sounds, for example to attract attention. Child demonstrates good eye contact | M-2b |\n| | Child makes a vocal sound other than crying | M-2a |\n| | Child cannot do any of the things listed above | M-2k |\n| 3 | Feeding and mealtime skills | |\n| | Child’s ability is age appropriate | M‑3l |\n| | Child can use all cooking equipment and kitchen appliances, for example, a microwave oven, electric frypan, or mixer, without assistance | M‑3j |\n| | Child can follow a recipe and prepare a simple meal | M‑3i |\n| | Child can cook a simple snack, for example, toast | M-3h |\n| | Child can prepare a simple uncooked snack, for example, a sandwich | M-3g |\n| | Child can use a fork and spoon at mealtimes | M-3f |\n| | Child can eat most solid foods if the food is cut up, for example, a raw apple | M-3e |\n| | Child uses spoon well | M-3d |\n| | Child can drink from a normal cup without help and can feed himself or herself with finger foods | M-3c |\n| | Child can drink from a modified cup when the cup is held by an adult | M-3b |\n| | Child can suck from a breast or baby’s feeding bottle | M-3a |\n| | Child cannot do any of the things listed above | M-3k |\n| 4 | Hygiene and grooming skills | |\n| | Child’s ability is age appropriate | M-4k |\n| | Child can style own hair and clean and cut own finger and toe nails without assistance | M-4i |\n| | Child can attend to basic hygiene, for example toileting, showering and brushing hair, without assistance | M-4h |\n| | Child manages basic hygiene, for example toileting, showering and brushing hair, with little assistance | M-4g |\n| | Child can wash hands and face and brush own teeth | M-4f |\n| | Child is reliably toilet trained during the day and can manage own toileting with minimal assistance | M-4e |\n| | Child can indicate toilet needs during the day but needs some assistance with clothing and wiping | M-4d |\n| | 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 |\n| | Child requires full assistance with toileting | M-4b |\n| | Child cries when nappy is soiled or wet | M-4a |\n| | Child cannot do any of the things listed above | M-4j |\n| 5 | Dressing skills | |\n| | Child’s ability is age appropriate | M-5l |\n| | Child can purchase and care for own clothing without assistance | M-5j |\n| | Child can wash and iron own clothing if required to with little assistance | M-5i |\n| | Child can choose own clothing appropriate to the weather and can dress and undress without any assistance | M-5h |\n| | Child can do up buckles and untie shoelaces | M-5g |\n| | Child can do up buttons and zippers | M-5f |\n| | Child dresses and undresses themself but needs assistance with buttons, laces or tight clothing | M-5e |\n| | Child can undress with little assistance | M-5d |\n| | Child tries to help with dressing | M-5c |\n| | Child lifts arms to be picked up | M-5b |\n| | Child snuggles in to an adult when cuddled | M-5a |\n| | Child cannot do any of the things listed above | M-5k |\n| 6 | Social and community skills | |\n| | Child’s ability is age appropriate | M-6l |\n| | 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 |\n| | Child is able to undertake basic activities in the community, for example shopping, with little supervision | M-6i |\n| | 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 |\n| | 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 |\n| | 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 |\n| | Child takes turns in conversations, for example speaks and then listens. Child knows whether they are a boy or a girl | M-6e |\n| | 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 |\n| | Child responds to affection from familiar people. Child recognises the difference between strangers and familiar people | M-6c |\n| | Child laughs and giggles when happy and cries when upset or angry. Child is interested in people and enjoys attention | M-6b |\n| | Child smiles. Child settles when picked up and cuddled | M-6a |\n| | Child cannot do any of the things listed above | M-6k |\n| 7 | Mobility – fine motor | |\n| | Child’s ability is age appropriate | M-7l |\n| | Child can use a variety of tools or hobby items with accuracy, for example for woodwork, sewing, painting or model building | M-7j |\n| | Child can write clearly | M-7i |\n| | Child can write all letters of the alphabet clearly | M-7h |\n| | 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 |\n| | 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 |\n| | Child can build a tower of 9 blocks. Child can copy a circle and a cross | M-7e |\n| | 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 |\n| | Child can make purposeful movements with objects, for example bang on a drum or clap hands | M-7c |\n| | Child grasps and releases objects such as rattle or feeding bottle | M-7b |\n| | Child can grasp an adult finger but may need assistance to release it | M-7a |\n| | Child cannot do any of the things listed above | M-7k |\n| 8 | Mobility – gross motor | |\n| | Child’s ability is age appropriate | M-8k |\n| | Child can hit a ball with a bat and can kick a ball with reasonable accuracy | M-8i |\n| | Child can catch a small ball, for example a tennis ball. Child skips well or rides a two wheel bike | M-8h |\n| | Child can jump and can hop on each leg. Child can bounce a ball and catch it | M-8g |\n| | Child can run fast. Child can balance on 1 leg for 3 seconds. Child can hop on 1 leg | M-8f |\n| | Child can balance briefly while standing on 1 leg. Child can pedal a tricycle | M-8e |\n| | Child can walk and can run a few steps. Child can walk up and down steps | M-8d |\n| | 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 |\n| | Child can independently move between prone and supine positions. Child can crawl or otherwise propel himself or herself along | M-8b |\n| | Child can lift head when in prone position. Child makes random movements with arms and legs | M-8a |\n| | Child cannot do any of the things listed above | M-8j |\n\nFunctional domains – behaviour and needs\n\nFor 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.\n\nNote The treating health professional may mark more than 1 statement for each domain.\n\n| | Question | Response Code |\n| --- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------ |\n| 9 | Behaviour | |\n| | Child is consistently uncooperative and disruptive during treatment or assessment episodes | M-9a |\n| | 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 |\n| | Child displays aggressive behaviour or violence towards other people or property in the treatment or assessment setting | M-9c |\n| | Child persistently attempts to leave or abscond from the treatment or assessment setting | M-9d |\n| | Child is extremely active and is unable to concentrate on a task for more than 30 seconds | M-9e |\n| | Child displays obsessional repetitive behaviours, for example obsession with particular objects or twirling or spinning objects for extended periods of time | M-9f |\n| 10 | Special care needs | |\n| | Child receives all food and fluids by nasogastric or gastrostomy tube or percutaneous enterogastric tube (PEG) | M‑10a |\n| | Child has a tracheostomyChild requires a ventilator to support respiration.Child requires regular oxygen therapy at home.Child requires a CPAP or BiPAP machine. | M‑10b1M‑10b2M‑10b3M‑10b4 |\n| | Child is aged over 4 years and is incontinent both day and night | M‑10c |\n| | Child is aged over 3 years and cannot stand without support | M‑10d |\n| | Child requires a wheelchair and requires assistance to propel the wheelchair | M‑10e |\n| | Child requires a wheelchair, quad sticks, prosthesis, crutches or walking frame but can move around with little assistance using the equipment | M‑10f |\n| | Child uses an electric wheelchair | M‑10g |\n| | Child requires urinary catheterisation several times each day | M‑10h |\n| | 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 |\n| | Child is over the age of 5 years and has persistent difficulties with memory, concentration, planning and organisation | M‑10j |\n| | 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 |\n| | Child is receiving a course of chemotherapy or radiotherapy treatment for cancer | M‑10l |\n| | The child has poorly controlled seizures which frequently require emergency medication or first aid? | M‑10m |\n| | 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 |\n| | Child has a severe eating disorder such as anorexia nervosa or bulimia. | M‑10o |\n\n \n\n","sortOrder":17},{"sectionNumber":"Sch 2","sectionType":"schedule","heading":"Rating Methods","content":"Schedule 2—Rating Methods\n\nPart 1 Scoring for ACL questionnaire\n\nStep 1 Terminal phase \\[Note: this Step 1 only relates to Carer Payment.\\]\n\nNo further steps need to be taken in the assessment of care load, if a medical practitioner has certified that:\n\n(a) a child has a terminal condition; and\n\n(b) the average life expectancy for a child with the same or similar condition is not substantially longer than 24 months.\n\nStep 2 Domain A score\n\n(1) Calculate a score for each question in domain A of the ACL questionnaire as follows:\n\n(a) locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;\n\n(2) Calculate the total score for domain A by adding the scores in column 4 of the table.\n\nDomain A – Behaviour\n\n| Question number | Answer code | Value | Score |\n| --------------- | ----------- | -------- | ----- |\n| 1 | a | No score | |\n| | b | No score | |\n| | c | No score | |\n| | d | No score | |\n| | e | No score | |\n| 2 | a | 0 | |\n| | c | 2 | |\n| | d | 5 | |\n| 3 | a | 0 | |\n| | c | 3 | |\n| | d | 6 | |\n| 4 | a | 0 | |\n| | d | 8 | |\n| 5 | a | 0 | |\n| | b | 2 | |\n| 6 | a | 0 | |\n| 7 | a | 0 | |\n| | b | 2 | |\n| | c | 4 | |\n\nStep 3 Care load score for domain A\n\nCalculate the care load for domain A as follows:\n\n(a) locate the score range in column 1 of the following table into which the total score for domain A fits;\n\n(b) the care load score is the corresponding conversion score in column 2 of the table.\n\n

Score range

Conversion score

Care load score

0 to 4

0

5 to 16

10

17 to 30

20

31 or more

40

\n```\n\nStep 4 Score for domain B\n\n(1) Calculate a score for each question in domain B of the ACL questionnaire as follows:\n\n(a) locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;\n\n(2) Calculate the total score for domain B by adding the scores in column 4 of the table.\n\nDomain B – Behaviour 2\n\n| Question number | Answer code | Value | Score |\n| --------------- | ----------- | ----- | ----- |\n| 10 | a | 0 | |\n| | d | 15 | |\n| 11 | a | 0 | |\n| | c | 6 | |\n| 12 | a | 0 | |\n| | c | 12 | |\n| 13 | a | 0 | |\n| 14 | a | 0 | |\n| 15 | a | 0 | |\n| 16 | a | 0 | |\n| | c | 4 | |\n| 17 | a | 0 | |\n| 18 | a | 0 | |\n| 19 | a | 0 | |\n\nStep 5 Care load score for domain B\n\nCalculate the care load score for domain B as follows:\n\n(a) locate the score range in column 1 of the table into which the total score for domain B fits;\n\n(b) the care load score is the corresponding conversion score in column 2 of the table.\n\n

Score range

Conversion score

Care load score

0 to 9

0

10 to 19

15

20 to 29

30

30 or more

85

\n```\n\nStep 6 Score for subdomain C (1)\n\n(1) Calculate a score for each question in subdomain C (1) as follows:\n\n(a) locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;\n\n(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;\n\n(3) Calculate the total score for subdomain C (1) by adding the age‑adjusted scores in column 6.\n\nNote 1 The age‑adjusted score can never be less than zero.\n\nNote 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.\n\nDomain C – Functional abilities – self care subdomain C (1)\n\n| 22 | a | 4 | | | |\n| 23 | a | 4 | | | |\n| 24 | a | 4 | | | |\n| 25 | a | 4 | | | |\n| 26 | a | 4 | | | |\n| 27 | a | 4 | | | |\n\nStep 7 Adjusted score for subdomain C (1)\n\nCalculate the adjusted score for subdomain C (1) as follows:\n\n(a) locate the score range in column 1 of the following table into which the total score for subdomain C (1) fits;\n\n

Score range

Conversion score

Care load score

0 to 2.20

40

2.21 to 4.04

20

4.05 to 100

0

\n```\n\nStep 8 Score for subdomain C (2)\n\n(1) Calculate a score for each question in subdomain C (2) as follows:\n\n(a) locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;\n\n(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;\n\n(3) Calculate the total score for subdomain C (2) by adding the age‑adjusted scores in column 6.\n\nDomain C – Functional abilities – self care subdomain C (2)\n\n| 28 | a | 4 | | | |\n| 29 | a | 4 | | | |\n\nStep 9 Adjusted score for subdomain C (2)\n\nCalculate the adjusted score for subdomain C (2) as follows:\n\n(a) locate the score range in column 1 of the following table into which the total score for subdomain C (2) fits;\n\n

Score range

Conversion score

Care load score

0 to 0.73

60

0.74 to 1.34

40

1.35 to 100

0

\n```\n\nStep 10 Score for subdomain C (3)\n\n(1) Calculate a score for each question in subdomain C (3) as follows:\n\n(a) locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;\n\n(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;\n\n(3) Calculate the total score for subdomain C (3) by adding the age‑adjusted scores in column 6.\n\nDomain C – Functional abilities – mobility subdomain C (3)\n\n| 30 | a | 4 | | | |\n| 31 | a | 4 | | | |\n| 32 | a | 4 | | | |\n| 33 | a | No score | | | |\n| | b | No score | | | |\n| | c | No score | | | |\n| | d | No score | | | |\n| 34 | a | 4 | | | |\n| 35 | a | 4 | | | |\n| 36 | a | 4 | | | |\n\nStep 11 Adjusted score for subdomain C (3)\n\nCalculate the adjusted score for subdomain C (3) as follows:\n\n(a) locate the score range in column 1 of the following table into which the total score for subdomain C (3) fits;\n\n

Score range

Conversion score

Care load score

0 to 2.20

30

2.21 to 4.04

15

4.05 to 100

0

\n```\n\nStep 12 Total score for domain C\n\nCalculate the total score for domain C by adding the adjusted scores for subdomains C (1), (2) and (3).\n\nStep 13 Care load score for domain C\n\nCalculate the care load score for domain C as follows:\n\n(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;\n\n(b) the care load score is the corresponding conversion score in column 2 of the table;\n\n(c) if the total score for domain C is 0, the care load score is 0.\n\n

Score range

Conversion score

Care load score

1 to 20

20

30 to 55

40

60 to 75

60

80 to 130

85

\n```\n\nAge adjustment table\n\n| Age | 1 | 1 | 1 | 1 | 2 | 2 | 2 | 2 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 5 | 5 | 5 | 5 | 6 | 6 | 6 | 6 | 7 |\n| ----------------------------------------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ---------- | ------ |\n| Age grouping in Months | 12 to < 15 | 15 to < 18 | 18 to < 21 | 21 to < 24 | 24 to < 27 | 27 to < 30 | 30 to < 33 | 33 to < 36 | 36 to < 39 | 39 to < 42 | 42 to < 45 | 45 to < 48 | 48 to < 51 | 51 to < 54 | 54 to < 57 | 57 to < 60 | 60 to < 63 | 63 to < 66 | 66 to < 69 | 69 to < 72 | 72 to < 75 | 75 to < 78 | 78 to < 81 | 81 to < 84 | > = 84 |\n| Q22 ‑ Eating | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 |\n| Q23 ‑ Grooming | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 |\n| Q24 ‑ Bathing | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 2 | 2 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 |\n| Q25 ‑ Dressing ‑ upper | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 |\n| Q26 ‑ Dressing ‑ lower | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 |\n| Q27 ‑ Toileting | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 |\n| Q28 ‑ Bladder | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 4 |\n| Q29 ‑ Bowel | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |\n| Q30 ‑ Mobility Toilet | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |\n| Q31 ‑ Mobility Chair/ Wheelchair | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |\n| Q32 ‑ Mobility Bath/Shower | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 |\n| Q34 ‑ Mobility Walk/Wheelchair (indoors) | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |\n| Q35 ‑ Mobility Walk/Wheelchair (outdoors) | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 2 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |\n| Q36 ‑ Mobility Stairs | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 2 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 3 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 | 4 |\n\nNote Questions 20, 21 and 33 are excluded from this table as they are non‑scoring questions.\n\nStep 14 Total score for subdomain D (1)\n\n(1) Calculate a score for each question in subdomain D (1) as follows:\n\n(a) locate the value in column 3 of the following table that corresponds to the answer code for the question in column 2;\n\n(2) Calculate the total score for subdomain D (1) by adding the scores in column 4.\n\nSubdomain D (1) – Special care needs – interventions\n\n

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

\n```\n\nStep 15 Total score for subdomain D (2)\n\n(1) Calculate the score for question 53 in subdomain D (2) as follows:\n\n(a) copy the number of hours into column 3 of the following table;\n\n(b) locate the range of hours in column 4 of the table into which the number of hours fits;\n\n(c) the score is the corresponding final score in column 5 of the table.\n\n(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.\n\n(3) Calculate the total score for subdomain D (2) by adding the final scores for the questions.\n\nSubdomain D (2) – Special care needs – time\n\n

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

\n```\n\nStep 16 Total score for domain D\n\nCalculate the total score for domain D by adding the total scores for subdomains D (1) and (2).\n\nStep 17 Care load score for domain D\n\nThe care load score for domain D is the total score for domain D.\n\nStep 18 ACL grand total\n\nCalculate the ACL grand total by adding the care load scores for domains A, B, C and D.\n\nStep 19 Additional points for score of ACL if Secretary is not satisfied\n\nIf 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.\n\nStep 20 ACL adjusted grand total\n\nCalculate the ACL adjusted grand total by adding any extra points from the Secretary to the ACL grand total.\n\nPart 2 Scoring for professional questionnaire\n\nStep 1 Chronological age\n\nCalculate the child’s chronological age at the date of completion of the questionnaire.\n\nStep 2 Scores for functional domains 1, 2, 3, 5, 6 and 7\n\n(1) Calculate the child’s scores for functional domains 1, 2, 3, 5, 6 and 7 from the following table based on:\n\n(b) the child’s functional age, based on the responses marked in functional domains 1, 2, 3, 5, 6 and 7 in the questionnaire.\n\n(2) Record the scores in column 2 of the table in step 6.\n\n

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

0

+1

+2

+3

+4

+5

4 years to <6 years (response f)

‑5

‑4

‑3

‑2

‑1

0

+1

+2

+3

+4

6 years to <9 years (response g)

‑6

‑5

‑4

‑3

‑2

‑1

0

+1

+2

+3

9 years to <12 years (response h)

‑7

‑6

‑5

‑4

‑3

‑2

‑1

0

+1

+2

12 years to <15 years (response i)

‑8

‑7

‑6

‑5

‑4

‑3

‑2

‑1

0

+1

15 years or older (response j)

‑9

‑8

‑7

‑6

‑5

‑4

‑3

‑2

‑1

0

No skills demonstrated (response k)

+1

+2

+3

+4

+5

+6

+7

+8

+9

+10

Age appropriate (response l)

0

0

0

0

0

0

0

0

0

0

\n```\n\nStep 3 Score for functional domain 4\n\n(1) Calculate the child’s score for functional domain 4 from the following table based on:\n\n(b) the child’s functional age, based on the response marked in functional domain 4.\n\n(2) Record the score in column 2 of the table in step 6.\n\n

Chronological age

Functional age

Birth 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 <1 year (response a)

0

+1

+2

+3

+4

+5

+6

+7

+8

1 year to <2 years (response b)

‑1

0

+1

+2

+3

+4

+5

+6

+7

2 years to <3 years (response c)

‑2

‑1

0

+1

+2

+3

+4

+5

+6

3 years to <4 years (response d)

‑3

‑2

‑1

0

+1

+2

+3

+4

+5

4 years to <6 years (response e)

‑4

‑3

‑2

‑1

0

+1

+2

+3

+4

6 years to <9 years (response f)

‑5

‑4

‑3

‑2

‑1

0

+1

+2

+3

9 years to <12 years (response g)

‑6

‑5

‑4

‑3

‑2

‑1

0

+1

+2

12 years to <15 years (response h)

‑7

‑6

‑5

‑4

‑3

‑2

‑1

0

+1

15 years or older
(response i)

‑8

‑7

‑6

‑5

‑4

‑3

‑2

‑1

0

No skills demonstrated (response j)

+1

+2

+3

+4

+5

+6

+7

+8

+9

Age appropriate (response k)

0

0

0

0

0

0

0

0

0

\n```\n\nStep 4 Score for Score for functional domain 8\n\n(1) Calculate the child’s score for functional domain 8 from the following table based on:\n\n(b) the child’s functional age, based on the response marked in functional domain 8.\n\n(2) Record the score in column 2 of the table in step 6.\n\n

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 or older

Birth to <6 months (response a)

0

+1

+2

+3

+4

+5

+6

+7

+8

6 months to <1 year (response b)

‑1

0

+1

+2

+3

+4

+5

+6

+7

1 year to <2 years (response c)

‑2

‑1

0

+1

+2

+3

+4

+5

+6

2 years to <3 years (response d)

‑3

‑2

‑1

0

+1

+2

+3

+4

+5

3 years to <4 years (response e)

‑4

‑3

‑2

‑1

0

+1

+2

+3

+4

4 years to <6 years (response f)

‑5

‑4

‑3

‑2

‑1

0

+1

+2

+3

6 years to <9 years (response g)

‑6

‑5

‑4

‑3

‑2

‑1

0

+1

+2

9 years to <12 years (response h)

‑7

‑6

‑5

‑4

‑3

‑2

‑1

0

+1

12 years or older (response i)

‑8

‑7

‑6

‑5

‑4

‑3

‑2

‑1

0

No skills demonstrated (response j)

+1

+2

+3

+4

+5

+6

+7

+8

+9

Age appropriate (response k)

0

0

0

0

0

0

0

0

0

\n```\n\nStep 5 Score for functional domains 9 and 10\n\n(1) Calculate the child’s scores for functional domains 9 and 10 by:\n\n(a) copying the responses for each functional domain in the questionnaire into the following table; and\n\n(b) allocating a score of +2 for each response marked M 10k and M 10l; and\n\n(c) allocating a score of +1 for all other responses marked; and\n\n(d) adding up the score for each functional domain.\n\n(2) Copy the scores into column 2 of the table in step 6.\n\n| Functional domain | | Score(allocate a score of 1 for each response marked) |\n| -------------------- | --- | ----------------------------------------------------- |\n| Functional domain 9 | | |\n| M‑9a | | |\n| M‑9b | | |\n| M‑9c | | |\n| M‑9d | | |\n| M‑9e | | |\n| M‑9f | | |\n| Total: | | |\n| Functional domain 10 | | |\n| M‑10a | | |\n| M‑10b | | |\n| M‑10c | | |\n| M‑10d | | |\n| M‑10e | | |\n| M‑10f | | |\n| M‑10g | | |\n| M‑10h | | |\n| M‑10i | | |\n| M‑10j | | |\n| M‑10k | | |\n| M‑10l | | |\n| M‑10m | | |\n| M‑10n | | |\n| M‑10o | | |\n| Total: | | |\n\nStep 6 Interim treating health professional questionnaire score\n\n(1) Calculate the questionnaire weighting in column 3 of the following table by dividing each score in column 2 by 2.\n\n(2) Calculate the milestone weighted scores in column 4 for functional domains 1, 2, 3, 5, 6 and 7 by multiplying the score for each domain in column 3 by 10 and then dividing the result by 10.\n\n(3) Calculate the milestone weighted scores for functional domains 4 and 8 by multiplying the score for each domain in column 3 by 10 and then dividing the result by 9.\n\n(4) Calculate the self care score in column 5 by adding the scores in column 4 for functional domains 3, 4 and 5, and dividing the result by 3.\n\n(5) The raw scores in column 6 are the following:\n\n(a) the scores in column 4 for functional domains 1 and 2;\n\n(b) the self care skills score in column 5;\n\n(c) the scores in column 4 for functional domains 6, 7 and 8;\n\n(d) the scores in column 3 for domains 9 and 10.\n\n(6) Calculate the functional weighting in column 7 by multiplying the score in column 6 for functional domain 1 by 1.2, and multiplying the score in column 6 for functional domain 10 by 2.\n\n(7) The total scores in column 8 are as follows:\n\n(a) the scores in column 7 for functional domains 1 and 10;\n\n(b) the scores in column 6 for the remaining functional domains.\n\n(8) Calculate the interim treating health professional questionnaire score by adding the total weighted scores in column 8 together.\n\n

Functional domain

Scores in steps 2 to 5

Questionnaire weighting

Milestone weighting

Self care skills score

Raw score for each domain

Functional weighting

Total weighted score

1

2

3

4

5

6

7

8

9

10

Interim treating health professional score

\n```\n\nStep 7 Age amended treating health professional score\n\nIf the child is 12 years or older, calculate an age amended treating health professional score by completing the following steps.\n\n| Treating health professional score | Score |\n| ------------------------------------------------------------------------------------------------------------------------ | ----- |\n| Interim treating health professional questionnaire total score from step 6: | |\n| If child is aged 12 years but less than 15 years, take 1 away from the interim treating health professional total score: | |\n| OR | |\n| If the child is aged 15 years or over, take 1.5 away from the interim treating health professional total score: | |\n| Age amended treating health professional total score: | |\n\nStep 8 Age amended treating health professional total score\n\n(1) Calculate an age amended score using the following tables if:\n\n(a) the age amended treating health professional total score mentioned in the table in step 7 is less than or equal to 0; and\n\n(b) the child is between:\n\n(i) 5 years, 9 months of age and 6 years of age; or\n\n(ii) 8 years, 9 months of age and 9 years of age; or\n\n(iii) 11 years, 9 months of age and 12 years of age; or\n\n(iv) 14 years, 9 months of age and 15 years of age.\n\n(2) Copy the scores obtained from steps 2 to 4 into column 2 of the following table.\n\n(3) Calculate the new scores in column 3 of the table as follows:\n\n(a) if a score in column 2 is less than or equal to 0, calculate the corresponding score in column 3 by adding 1 to the score in column 2;\n\n(b) if a score in column 2 is greater than 0, copy the score into column 3.\n\n(4) Using the scores in column 3, repeat steps 6 and 7, and calculate the new age amended treating health professional total score.\n\n| Functional domain | Original scores from steps 2 to 4 | Calculation of new score | Recalculation of age amended treating health professional total score |\n| ----------------- | --------------------------------- | ------------------------ | --------------------------------------------------------------------- |\n| 1 | | | |\n| 2 | | | |\n| 3 | | | |\n| 4 | | | |\n| 5 | | | |\n| 6 | | | |\n| 7 | | | |\n| 8 | | | |\n\nStep 9 Qualifying rating\n\nTo contribute to the qualifying rating, the age amended treating health professional total score must be greater than 0.\n\n \n\n","sortOrder":18},{"sectionNumber":"Sch 3","sectionType":"schedule","heading":"List of Recognised Disabilities","content":"Schedule 3—List of Recognised Disabilities\n\n(section 7)\n\nPart 1 Recognised Disabilities\n\n(1) Moderate to severe multiple disability or moderate to severe physical disability (including neurological disability) where the child is, or is likely to be, dependent for mobility indoors and outdoors from the age of 3 onwards.\n\nExample:\n\nA child who has cerebral palsy, lower limb deficiencies or spina bifida and is dependent on a stroller, wheelchair, crutches or walking frame.\n\n(2) Severe multiple or physical disability (including uncontrolled seizures) requiring constant care and attention where the child is less than 6 months of age.\n\n(3) Epilepsy (uncontrolled while on medication).\n\n(4) Chromosomal or syndromic conditions that are not specified elsewhere in this Part and where there is moderate or severe intellectual disability and/or multiple, major and permanent physical abnormalities as diagnosed by a paediatrician, paediatric subspecialist or clinical geneticist.\n\n(5) Neurometabolic degenerative conditions including lysosomal storage disorders where there is moderate or severe intellectual and/or moderate or severe physical disability and where the condition is diagnosed by a paediatrician, paediatric sub‑specialist or clinical geneticist.\n\n(6) Neurodegenerative disorders where there is moderate or severe intellectual and/or moderate or severe physical disability and where the condition is diagnosed by a paediatrician, paediatric sub‑specialist or clinical geneticist.\n\n(7) Any of the following neuromuscular conditions:\n\n(a) Duchenne (or Becker) muscular dystrophy;\n\n(b) Autosomal recessive muscular dystrophy;\n\n(c) Spinal muscular atrophy conditions (e.g. Werdnig‑Hoffman);\n\n(d) Friedreich’s ataxia.\n\n(8) Moderate, severe, or profound intellectual disability where IQ is less than 55, (including a child with a known syndrome).\n\n(9) The following conditions:\n\n(a) Autism Spectrum Disorder when diagnosed by a psychiatrist, developmental paediatrician, or a registered psychologist experienced in the assessment of Pervasive Developmental Disorders and using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5);\n\n(b) Autistic Disorder or Asperger’s Disorder (not including Pervasive Developmental Disorder not otherwise specified) when diagnosed by a psychiatrist, developmental paediatrician, or a registered psychologist experienced in the assessment of Pervasive Development Disorders and using the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).\n\n(10) The following conditions:\n\n(a) Childhood Disintegrative Disorder diagnosed by a psychiatrist using DSM-IV;\n\n(b) Major depression of childhood diagnosed by a psychiatrist using DSM‑IV or DSM-5;\n\n(c) Childhood schizophrenia diagnosed by a psychiatrist using DSM-IV or DSM-5.\n\n(11) Any of the following sensory impairments:\n\n(a) Bilateral blindness where:\n\n(i) visual acuity is less than or equal to 6/60 with corrected vision; or\n\n(ii) visual fields are reduced to a measured arc of less than 10 degrees;\n\n(b) Hearing loss ‑ a 45 decibels or greater hearing impairment in the better ear, based on a 4 frequency pure tone average (using 500, 1000, 2000 and 4000Hz);\n\n(c) Deaf‑blindness ‑ diagnosed by a specialist multidisciplinary team, including a professional audiological and ophthalmological evaluation.\n\n(12) The following dermatological conditions:\n\n(a) Epidermolysis Bullosa Dystrophica;\n\n(b) The following types of Ectodermal Dysplasias:\n\n(i) Hypohidrotic ectodermal dysplasia (synonym: anhidrotic ectodermal dysplasia);\n\n(ii) Hay Wells syndrome (synonym: ankyloblepharon, ectodermal dysplasia and clefting \\[AEC\\] syndrome);\n\nNote: These are specific terms and do not apply to other ectodermal dysplasia which may have some degree of reduced sweating.\n\n(c) The following severe congenital ichthyoses:\n\n(i) Lamellar ichthyosis;\n\n(ii) Harlequin ichthyosis;\n\n(iii) Sjogren Larsson syndrome;\n\n(iv) Netherton syndrome;\n\n(v) Severe congenital ichthyosiform erythroderma;\n\n(vi) Generalised bullous ichthyosis (synonym: bullous ichthyosiform erythroderma, epidermolytic hyperkeratosis).\n\n(13) Phenylketonuria (PKU).\n\n(14) Other inborn errors of metabolism not specified elsewhere in this Part that are treated by medically prescribed diet to prevent neurological disability and/or severe organ damage.\n\n(15) Cystic Fibrosis.\n\n(16) Moderate to severe Osteogenesis Imperfecta with two or more fractures per year and/or significant pain that significantly limits activities of daily living.\n\n(17) Down syndrome.\n\n(18) Fragile X syndrome.\n\nPart 2 Medical Conditions\n\n(1) Chronic or end stage organ failure where the child is receiving organ specific treatment and/or awaiting transplant.\n\n(2) HIV/AIDS where the child is symptomatic (in addition to having lymphadenopathy) and requires treatment with a 3 or more drug antiviral regimen.\n\n(3) Immunodeficiency where the child requires regular immunoglobin infusions.\n\n(4) The following Haematological/Oncological Conditions:\n\n(a) Leukaemia, Haemophagocytic Lymphohistiocytosis and other childhood malignancies where the child is undergoing chemotherapy, radiotherapy or palliative care;\n\n(b) Haemophilia with Factor VIII or Factor IX deficiency (less than 10%);\n\n(c) Thalassaemia or Haemoglobinopathy requiring chelation therapy;\n\n(d) Chronic Transfusion Dependent Anaemia requiring chelation therapy;\n\n(e) Langerhan Cell Histiocytosis: disseminated (multi‑organ) disease requiring chemotherapy for longer than 6 months;\n\n(f) Severe congenital Neutropenia (Kostman’s variant, dependent on Filgrastin).\n\n(5) The following Chronic Respiratory Conditions:\n\n(a) Chronic Respiratory Disease requiring home oxygen;\n\n(b) A condition where the child is dependent for his or her health on an external apparatus/machine called a ventilator to assist with breathing, either on a continuous or intermittent basis;\n\n(c) Long term tracheostomy where the child is cared for at home.\n\n(6) Severe atopic dermatitis which involves at least 75% of the body surface and which has required two or more hospitalisations of at least 5 days duration in the previous calendar year, and/or the use of immunosuppressive therapy.\n\n(7) Significant burn where more than 30% of body surface area is affected, or a lesser burn where there is significant impairment of function of the hands or feet or assistance is required with feeding or toileting to a greater degree than is age appropriate for the child.\n\n(8) Gastroenterological condition or other medical condition requiring total parenteral nutrition for an extended period, with medical treatment and medical supervision required for at least 12 months.\n\n(9) Final stage of Ulcerative Colitis where the condition is no longer responding to medical treatment and where a sub‑total colectomy and ileo‑rectal anastomosis with formation of a J‑pouch is required.\n\n(10) Polyarticular course Juvenile Arthritis requiring regular multi‑disciplinary therapy, including immunosuppressive medication.\n\n(11) Diabetes Mellitus Type 1.\n\n \n\n","sortOrder":19},{"sectionNumber":"Sch 4","sectionType":"schedule","heading":"Repeals","content":"Schedule 4—Repeals\n\nDisability Care Load Assessment (Child) Determination 2010\n\n","sortOrder":20},{"sectionNumber":"1","sectionType":"section","heading":"The whole of the instrument","content":"1 The whole of the instrument\n\nRepeal the instrument.\n\nSocial Security (Treating Health Professionals) Determination 2010\n\n2 The whole of the instrument\n\nRepeal the instrument.\n\nEndnotes\n\n> Note: Endnote 1—About the endnotes\n\nThe endnotes provide information about this compilation and the compiled law.\n\nThe following endnotes are included in every compilation:\n\nEndnote 1—About the endnotes\n\nEndnote 2—Abbreviation key\n\nEndnote 3—Legislation history\n\nEndnote 4—Amendment history\n\nAbbreviation key—Endnote 2\n\nThe abbreviation key sets out abbreviations that may be used in the endnotes.\n\nLegislation history and amendment history—Endnotes 3 and 4\n\nAmending laws are annotated in the legislation history and amendment history.\n\nThe legislation history in endnote 3 provides information about each law that has amended (or will amend) the compiled law. The information includes commencement details for amending laws and details of any application, saving or transitional provisions that are not included in this compilation.\n\nThe amendment history in endnote 4 provides information about amendments at the provision (generally section or equivalent) level. It also includes information about any provision of the compiled law that has been repealed in accordance with a provision of the law.\n\nMisdescribed amendments\n\nA misdescribed amendment is an amendment that does not accurately describe the amendment to be made. If, despite the misdescription, the amendment can be given effect as intended, the amendment is incorporated into the compiled law and the abbreviation “(md)” added to the details of the amendment included in the amendment history.\n\nIf a misdescribed amendment cannot be given effect as intended, the abbreviation “(md not incorp)” is added to the details of the amendment included in the amendment history.\n\n> Note: Endnote 2—Abbreviation key\n\n| | o = order(s) |\n| ---------------------------------------------- | ----------------------------------- |\n| ad = added or inserted | Ord = Ordinance |\n| am = amended | orig = original |\n| amdt = amendment | par = paragraph(s)/subparagraph(s) |\n| c = clause(s) | /sub‑subparagraph(s) |\n| C[x] = Compilation No. x | pres = present |\n| Ch = Chapter(s) | prev = previous |\n| def = definition(s) | (prev…) = previously |\n| Dict = Dictionary | Pt = Part(s) |\n| disallowed = disallowed by Parliament | r = regulation(s)/rule(s) |\n| Div = Division(s) | |\n| exp = expires/expired or ceases/ceased to have | reloc = relocated |\n| effect | renum = renumbered |\n| F = Federal Register of Legislation | rep = repealed |\n| gaz = gazette | rs = repealed and substituted |\n| LA = Legislation Act 2003 | s = section(s)/subsection(s) |\n| LIA = Legislative Instruments Act 2003 | Sch = Schedule(s) |\n| (md) = misdescribed amendment can be given | Sdiv = Subdivision(s) |\n| effect | SLI = Select Legislative Instrument |\n| (md not incorp) = misdescribed amendment | SR = Statutory Rules |\n| cannot be given effect | Sub‑Ch = Sub‑Chapter(s) |\n| mod = modified/modification | SubPt = Subpart(s) |\n| No. = Number(s) | underlining = whole or part not |\n| | commenced or to be commenced |\n\n> Note: Endnote 3—Legislation history\n\n| Name | Registration | Commencement | Application, saving and transitional provisions |\n| ------------------------------------------------------------------------------------------- | ------------------------------ | -------------- | ----------------------------------------------- |\n| Disability Care Load Assessment (Child) Amendment (Age Adjustment Table) Determination 2020 | 14 September 2020(F2020L01163) | 18 August 2020 | — |\n| | | | |\n\n> Note: Endnote 4—Amendment history\n\n| Provision affected | How affected |\n| ------------------------- | -------------- |\n| Schedule 2Step 13, Part 1 | rs F2020L01163 |\n| | |\n| | |","sortOrder":21}],"analysis":{"kimi_summary":{"_metrics":{"completionTokens":690},"content_quality":"ok","complexity_score":9,"scope_assessment":{"changed":false,"description":"This is a consolidated remake of the 2010 Determination with the 2020 Age Adjustment Table amendment incorporated. The scope remains tightly focused on assessment methodology for child disability care load — it does not expand beyond this purpose. The instrument repeals and replaces the 2010 version and the Treating Health Professionals Determination 2010, but this is consolidation rather than scope expansion."},"complexity_factors":["Multi-layered scoring system with 4 domains and 3 subdomains in the ACL questionnaire","Age-adjusted calculations requiring division of raw scores by age-specific denominators (Schedule 2, Part 1, Step 13)","Multiple conversion tables that transform raw scores into care load scores through non-linear thresholds","Professional questionnaire involves 10 functional domains with weighted scoring and milestone-based adjustments","Complex conditional logic for combining scores across multiple children (max 4 contributing questionnaires for Carer Payment, max 2 for Carer Allowance)","Cross-references to the Social Security Act 1991 and Adult Disability Assessment Tool","Secretary has discretionary power to amend scores, creating administrative discretion within a technical framework","Terminal illness exemption creates a parallel assessment pathway","Recognised disabilities list in Schedule 3 contains 18 categories with specific diagnostic requirements","Repeals and replaces two previous instruments, requiring transitional understanding"],"plain_english_summary":"This law sets how the Australian Government decides eligibility for Carer Payment and Carer Allowance for carers of children under 16 with disabilities or serious medical conditions. It relies on two questionnaires (carer and health professional) and age‑adjusted scoring to measure a child’s extra care needs; some recognised conditions automatically qualify.\n\nIt matters because it determines access to financial support for parents and carers whose caregiving limits their ability to work, with scope for the Secretary to adjust scores if needed."},"flash_summary":{"complexity_score":9,"scope_assessment":{"changed":false,"description":"This instrument replaces and consolidates the 2010 determinations (Schedule 4) and implements detailed scoring rules to operationalise eligibility tests already present in the Social Security Act. The 2020 amendment noted in the endnotes changed the Age Adjustment Table (numerical recalibration) but did not broaden the categories of persons captured or add new payment types. In short, the instrument refines and consolidates assessment mechanics rather than materially expanding the statutory scope of who may qualify."},"complexity_factors":["Length and structure: 3 Parts plus 4 Schedules with multiple lengthy tables and questionnaires (Schedules 1–3 extensive).","Many defined terms and cross‑references: definitions in s4 and repeated reliance on terms defined in the Social Security Act (e.g. disabled child, Secretary, Adult Disability Assessment Tool).","Two separate, interlocking scoring systems: ACL (claimant) scoring with multi‑step domain conversions and age adjustments (Schedule 2, Part 1, Steps 2–18) and professional questionnaire scoring with milestone/weighting, age amendments and possible recalculation (Schedule 2, Part 2, Steps 1–9).","Age adjustment table: large matrix (many cells) used to convert raw question scores into age‑adjusted scores (Schedule 2, Step 13) — numerical and highly conditional.","Many conditional branches and exceptions: terminal‑phase shortcut (Step 1, Schedule 2); minimums for contributing ACLs (20) and caps on contributing questionnaires (s14(3), s15(5), s17(2)); different rules for single child, multiple children and mixed adult/child caring (Parts 2–3).","Numerical thresholds and rounding rules: rounding to 2 decimal places in professional scoring (s12(2)); multiple conversion thresholds (e.g. ACL 85 cut‑off).","Secretary discretion points: Secretary can amend or add points and request replacement professional questionnaires (ss 11–12), introducing non‑algorithmic decision steps.","Lengthy questionnaires: ACL contains 55+ numbered questions across 4 domains (Schedule 1), and the professional questionnaire has many milestone responses that map to numeric codes.","Multiple repeal and consolidation elements: repeals earlier 2010 instruments and incorporates an amendment (Age Adjustment Table) — administrative history increases interpretive complexity (Schedules and endnotes)."],"plain_english_summary":"**What this instrument does (mechanics first)\n\n- Sets the tests and scoring method used to decide whether a carer of a child qualifies for the Commonwealth's child carer payments (Carer Payment and Carer Allowance) under the Social Security Act 1991. (See sections 6, 10–17.)\n\n- Requires two forms of evidence for most claims:\n - an \"ACL questionnaire\" (Assessment of Care Load) completed by the person claiming the carer payment/allowance about the child’s behaviour, functional ability and special care needs (Schedule 1, Part 1; section 9(1)–(2)); and\n - a \"professional questionnaire\" completed by an approved treating health professional about the same matters (Schedule 1, Part 2; section 9(3)–(4)).\n\n- Converts questionnaire answers into numeric scores by domain (Behaviour A & B, Functional Abilities, Special Care Needs) and then into a single ACL grand total using multi-step tables and age‑adjustment factors (Schedule 2, Part 1, Steps 2–18).\n\n- Scores the professional questionnaire using a separate staged weighting and milestone method (Schedule 2, Part 2, Steps 1–6), including age adjustments and a final condition that the resulting treating‑health‑professional total score must be greater than zero to \"contribute\".\n\n- Declares the threshold for an \"intense\" (qualifying) rating that a carer must meet to be eligible for payment:\n - Normally, an ACL grand total of 85 or more and a professional questionnaire score > 0 (for single‑child claims) (see sections 13(3), 16(2)).\n - For carers of multiple children or carers who also care for an adult with a lower ADAT score, the Determination sets how many questionnaires can contribute, minimum per‑child ACLs to count, and how the scores combine (sections 14 and 15). Examples:\n - No more than 4 contributing child ACLs and 4 professional questionnaires for some multi‑child Carer Payment assessments (s14(3)).\n - An individual ACL only contributes if it scores at least 20 (s14(5), s15(6), s17(4)).\n\n- Lists which medical/health practitioners may act as a treating health professional for these questionnaires (section 8), and gives a list of recognised disabilities and medical conditions relevant to the scheme (Schedule 3).\n\n- Gives the Secretary of the Department (the official who administers these payments) powers to adjust questionnaire scores if they are not satisfied an ACL is accurate or to request a replacement professional questionnaire (sections 11(5)–(7) and 12(4)–(5)).\n\n- Repeals earlier 2010 instruments and consolidates the assessment rules (Schedule 4).\n\nWho is affected\n\n- Primary: people applying for Carer Payment or Carer Allowance for the care of a child under 16 (defined as \"child\") — they must complete the ACL questionnaire and obtain a treating health professional to complete the professional questionnaire (sections 9, 11–12, 13–17).\n\n- Secondary: the treating health professionals listed in section 8 (doctors, nurses, psychologists, occupational therapists, physiotherapists, speech pathologists and certain Aboriginal and Torres Strait Islander health workers). They must complete the professional questionnaire using the instrument's scoring rules.\n\n- The Commonwealth (Department administering social security) runs the system and decides final scores and eligibility (the Secretary has explicit powers to amend or request replacements — sections 11(5)–(7), 12(4)–(5)).\n\nWhy it matters (claimed purpose, then practical consequences)\n\n- The instrument claims to provide a consistent, objective method to measure the carer workload associated with caring for a child with disability or medical conditions and to determine eligibility for means of financial support (see sections 6, 10 and Schedule 3). That is, it translates clinical/functional descriptions into numeric thresholds (e.g. ACL ≥ 85 + professional > 0).\n\n- Practical trade‑offs and costs:\n - Administrative and compliance burden: claimants must fill a lengthy ACL (many questions across four domains) and secure a treating health professional able to complete the professional questionnaire (sections 9, Schedule 1). That takes time for families and clinicians.\n - Implementation complexity and error risk: multi‑stage calculations, age‑adjustments and conversion tables (Schedule 2) create many places for input error or inconsistent application. The Secretary’s power to amend or request replacement questionnaires (sections 11–12) creates a safety valve but also increases decision‑maker discretion and administrative workload.\n - Incentives for behaviour: the test gives claimants a reason to document frequent or specialised care needs and to seek assessment from listed professionals. It also sets minimum per‑child ACLs (20) and caps on contributing questionnaires (s14(3), s14(5), s15(5)–(6), s17(2)–(4)), which shape how families with multiple care recipients assemble evidence.\n - Reliance on particular professionals and diagnoses: some recognised disabilities or diagnoses in Schedule 3 must be made by specific specialists (e.g. paediatrician, psychiatrist), so access to those specialists affects the ability to obtain the professional questionnaire.\n - Budgetary effect: the Determination operationalises eligibility rules that determine who receives Carer Payment / Carer Allowance; the fiscal cost flows to the Commonwealth from approved claims.\n\nWho pays, who decides, and what behaviour changes\n\n- Who pays: the Commonwealth (via social security payments) funds Carer Payment and Carer Allowance when eligibility under the Act is met; this instrument only defines the assessment method (sections 6, 13–17).\n\n- Who decides: the Secretary (Department officer under the Act) implements the instrument, accepts or amends ACL scores and may request replacement professional questionnaires (sections 11(5)–(7), 12(4)–(5)). Treating health professionals provide the professional questionnaire input (s8, s9(3)).\n\n- Behaviour changes induced: families will be required to provide detailed, function‑and‑care oriented information and to obtain assessments from specified health professionals. Clinicians will need to familiarise themselves with the scoring rules. The scoring thresholds and per‑child minimums influence whether families pursue claims for single versus combined care recipients.\n\nKey legal thresholds and constraints (quick reference)\n\n- ACL threshold for \"intense\" qualifying rating: ACL grand total (after adjustments) of 85 or more (sections 13(3)(a), 16(2)(a), 14(4)(a), 15(3)(a), 17(3)(a)).\n- Professional questionnaire: must score greater than 0 (sections 13(3)(b), 16(2)(b), 14(4)(b), 15(3)(b), 17(3)(b)).\n- Contributing ACL minimum and caps for aggregation: an ACL must be at least 20 to be \"contributing\" (s14(5), s15(6), s17(4)); caps on number of contributing questionnaires differ by context (e.g. s14(3) caps at 4; s15(5) caps at 2; s17(2) caps at 2).\n- Secretary discretion: can amend ACL scores if not satisfied they accurately reflect the child’s needs and can add points for unaccounted care load (s11(5)–(7)); can order a different treating professional to complete the professional questionnaire (s12(5)).\n\nImplementation risks and operational notes\n\n- The scoring method is detailed and technical (age‑adjustment tables, many domain conversion tables — Schedule 2). Small data entry or interpretation differences can change whether a claimant reaches the 85‑point threshold.\n- Access to the required treating health professional, and to specialists named in Schedule 3 where a condition must be diagnosed by a specific specialist, is a gate to getting a professional questionnaire that \"counts\".\n- The Secretary’s amendment powers reduce purely automatic decision‑making but increase reliance on administrative discretion; the Determination provides limited procedural safeguards in the text (e.g. requirement to be \"satisfied\") but does not set an internal review process here.\n\nPrimary operative provisions cited: sections 9, 10, 11, 12, 13–17 and Schedules 1–3. Authority: made under ss 38E and 38F of the Social Security Act 1991 (section 3)."},"flash_summary_failed":{"failed":true,"reason":"A positive credit balance is required for all requests, including BYOK, so fallback providers remain available. Add credits at https://vercel.com/d?to=%2F%5Bteam%5D%2F%7E%2Fai%3Fmodal%3Dtop-up to continue.","source":"analysis-cron"}},"importantCases":[],"_links":{"self":"/api/acts/disability-care-load-assessment-child-determination-2020","history":"/api/acts/disability-care-load-assessment-child-determination-2020/history","analysis":"/api/acts/disability-care-load-assessment-child-determination-2020/analysis","conflicts":"/api/acts/disability-care-load-assessment-child-determination-2020/conflicts","importantCases":"/api/acts/disability-care-load-assessment-child-determination-2020/important-cases","documents":"/api/acts/disability-care-load-assessment-child-determination-2020/documents"}}