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Core-activity limitation

Four levels of core-activity limitation are determined based on whether a person needs help, has difficulty, or uses aids or equipment with any of the core activities (communication, mobility or self care). A person's overall level of core-activity limitation is determined by their highest level of limitation in these activities.

The four levels of limitation are:

• profound: the person is unable to do, or always needs help with, a core-activity task
• severe: the person
  • sometimes needs help with a core-activity task
  • has difficulty understanding or being understood by family or friends
  • can communicate more easily using sign language or other non-spoken forms of communication.
• moderate: the person needs no help but has difficulty with a core-activity task
• mild: the person needs no help and has no difficulty with any of the core-activity tasks, but
  • uses aids and equipment
  • cannot easily walk 200 metres
  • cannot walk up and down stairs without a handrail
  • cannot easily bend to pick up an object from the floor
  • cannot use public transport
  • can use public transport but needs help or supervision
  • needs no help or supervision but has difficulty using public transport.

This interview was conducted as part of the Child and Adolescent Component of the National Survey of Mental Health and Well-Being. (The Mental Health Branch of the then Commonwealth Department of Health and Aged Care commissioned the University of Adelaide to undertake the survey.) Parents of children and adolescents aged 6-17 years were administered the Diagnostic Interview Schedule for Children (Version IV) (Shaffer et al., 2000) to identify the prevalence of::- depressive disorder; conduct disorder; and Attention-Deficit/Hyperactivity Disorder (ADHD). The Diagnostic Interview Schedule uses the criteria described in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, to identify these disorders (American Psychiatric Association, 1994).

It should be noted that the use of the Diagnostic Interview Schedule for parents to identify the three mental disorders may have influenced the prevalence estimates in two ways. First, because parents may not always recognise subjective distress experienced by children and adolescents, it is possible that a higher prevalence of depressive disorder may have been identified if interviews had been conducted with the young people themselves. Second, it is possible that some children or adolescents identified as having ADHD may have been more appropriately diagnosed with another disorder not included in the survey. It should also be noted that few children and adolescents were identified with dysthymic disorder. For that reason, dysthymic disorder and major depressive disorder have been combined in the presentation of results.

For a description of the three disorders covered in the Diagnostic Interview Schedule for Children (Version IV) and for further information regarding the Diagnostic Interview Schedule for Children (Version IV) as collected in the Child and Adolescent Component of the National Survey of Mental Health and Well-being, please refer to the following text:

• Sawyer et al 2000. The mental health of young people in Australia, Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care, Canberra.

Disabilities can be broadly grouped depending on whether they relate to functioning of the mind or the senses, or to anatomy or physiology. Each disability group may refer to a single disability or be composed of a number of broadly similar disabilities. The SDAC module relating to disability groups was designed to identify four separate groups based on the particular type of disability identified.

These groups are:

Sensory

• Loss of sight (not corrected by glasses or contact lenses)
• Loss of hearing where communication is restricted, or an aid used
• Speech difficulties, including loss.

• Difficulty learning or understanding things

• Shortness of breath or breathing difficulties that restrict everyday activities
• Blackouts, fits or loss of consciousness
• Chronic or recurrent pain or discomfort that restricts everyday activities
• Incomplete use of arms or fingers
• Difficulty gripping or holding things
• Incomplete use of feet or legs
• Restriction in physical activities or in doing physical work
• Disfigurement or deformity.

• Nervous or emotional condition that restricts everyday activities
• Mental illness or condition requiring help or supervision
• Head injury, stroke or other brain damage, with long-term effects that restrict everyday activities.

• Receiving treatment or medication for any other long-term conditions or ailments and still restricted in everyday activities
• Any other long-term conditions resulting in a restriction in everyday activities.

Disabilities which resulted from head injury, stroke or other brain damage were classified to the appropriate group. For example, a person reporting speech loss as a result of stroke would be classified to the sensory disability group. However, a person who reported having had a head injury, stroke or other brain damage was also classified to a separate disability category of this name (ABS 2004).

Mental Health problems assessed by the Child Behaviour Checklist (CBCL)

The Child Behaviour Checklist was administered as part of the Child and Adolescent Component of the National Survey of Mental Health and Well-Being. (The Mental Health Branch of the then Commonwealth Department of Health and Aged Care commissioned the University of Adelaide to undertake the survey.) The prevalence of mental health problems was based on scores obtained from the scales of the CBCL which was completed by parents. The CBCL scales identify mental health problems in three general areas and eight specific areas.

The three general areas are:

Internalising Problems Scale: inhibited or over-controlled behaviour (e.g., anxiety or depression).
Externalising Problems Scale: antisocial or under-controlled behaviour (e.g., delinquency or aggression).
Total Problems Scale: all mental health problems reported by parents or adolescents.

Somatic Complaints Scale: chronic physical complaints without known cause or medically verified basis.
Delinquent Behaviour Scale: breaking rules and norms set by parents and communities (e.g., lying, swearing, stealing or truancy).
Attention Problems Scale: difficulty concentrating and sitting still, and impaired school performance.
Aggressive Behaviour Scale: bullying, teasing, temper tantrums and fighting.
Social Problems Scale: impaired peer relationships.
Withdrawn Scale: shyness and social isolation.
Anxiety/Depression Scale: feelings of loneliness, sadness, being unloved, worthlessness, anxiety and general fears.
Social Problems Scale: strange behaviour or ideas, obsessions (Sawyer et al 2000).

• Sawyer et al 2000. The mental health of young people in Australia, Mental Health and Special Programs Branch, Commonwealth Department of Health and Aged Care, Canberra.

Comprises:

• Aboriginal health worker (n.e.c.)
• Accredited counsellor
• Acupuncturist
• Alcohol and other drug worker (n.e.c.)
• Audiologist/audiometrist
• Chemist (for advice)
• Chiropodist/podiatrist
• Chiropractor
• Dietitian/nutritionist
• Herbalist
• Hypnotherapist
• Naturopath
• Nurse
• Occupational therapist
• Optician/optometrist
• Osteopath
• Physiotherapist/hydrotherapist
• Psychologist
• Social worker/welfare officer
• Speech therapist/pathologist

A recent injury event is an event meeting the following criteria:

• the event was an accident, harmful incident, exposure to harmful factors or other incident
• occurred in the four weeks prior to interview
• resulted in an injury
• resulted in one or more of the following actions being taken:
  • consulting a health professional
  • seeking medical advice
  • receiving medical treatment
  • reducing usual activities
  • other treatment of injury such as taking medications, or using a bandage or band aid or heat or ice pack.