ABS approach to collecting disability data and relationship to the ICF

ABS measures of disability Disability survey The main source of population measures of disability in the Australian population is the Survey of Disability, Ageing and Carers (SDAC): First run in 1981 Next run in 2003, with 6 yearly rotation 45 minute interview on average Computer assisted interviews Interviewer enumerated, personal interview survey Sample covers both households and cared accommodation Originally based on the ICIDH, now the ICF

ABS measures of disability (continued) Disability module The ABS also uses a disability module to identify the disability population in a range of other social surveys, such as education and household expenditure surveys Census module Disability questions were included in the 1976 census, but deemed not of sufficient quality to repeat. Development and testing for the 1996 and 2001 surveys failed to produce quality census disability questions

ABS approach to measurement of disability All three question sets identify the disability population using a set of screening questions. The range of items able to be included in the screen questions differs between the three question sets because of the operational constraints on the three types of collection involved

Screening questions used in the disability module I WOULD NOW LIKE TO ASK ABOUT ANY CONDITIONS YOU MAY HAVE, THAT HAVE LASTED, OR ARE LIKELY TO LAST, FOR SIX MONTHS OR MORE. DO YOU HAVE ANY OF THESE CONDITIONS? WHICH ONES? Sight problems not corrected by glasses or contact lenses Hearing problems Speech problems Blackouts, fits or loss of consciousness Difficulty learning or understanding things Limited use of arms or fingers Difficulty gripping things Limited use of legs or feet Any condition that restricts physical activity or physical work (e.g. back problems, migraines) Any disfigurement or deformity Any mental illness for which help or supervision is required

STILL THINKING OF CONDITIONS LASTING 6 MONTHS OR MORE, ARE YOU RESTRICTED IN EVERYDAY ACTIVITIES BY ANY OF THESE? WHICH ONES? Shortness of breath, or difficulty breathing Chronic or recurring pain A nervous or emotional condition Long term effects as a result of a head injury, stroke or other brain damage Any other long term condition that requires treatment or medication Any other long term condition such as arthritis, asthma, heart disease, Alzheimer's disease, dementia etc. Screening questions used in the disability module (continued)

Comparison of the methods and mapping summary Disability Survey Screen using impairment of body function and some activity limitations and environmental factors Separate responses obtained for each impairment/activity/environment Identifies underlying cause in terms of ICD for each impairment/activity/environment area questioned Includes a range of activity/participation and environment items Need for assistance, difficulty with activities and use of aids is used to derive levels of severity of restriction. Specific restrictions covered are mobility, self- care, communication, and employment and school restrictions

Disability module similar screen to the disability survey, but compressed onto prompt card - impairment of body function and some activity limitations and environmental factors grouped responses only no underlying conditions collected obtains activity limitation and need for assistance in the areas of self-care, mobility, communication and restricted participation in education and employment only Comparison of the methods and mapping summary (continued)

Census module two questions first asking whether have "difficulty" with seven listed activities - ( a combination of 'activity' and 'impairment' using a scaled response of 'none', 'a little' and 'a lot') second asking cause of difficulty, with long-term health condition, disability and old age comprising the disability population Comparison of the methods and mapping summary (continued)

Mapping the ABS disability survey and module to the ICF The ABS and the AIHW have jointly mapped a number of disability surveys/questions to the ICF The mapping is useful to identify dimensions and domains covered in screening questions in the survey However, it is a summary measure only, and does not give the full picture of the approach to the measurement of disability Also, some domains and dimensions are covered as part of the screen questions to identify the disability population, while others are asked of all persons and are output items in their own right

Body FunctionSurveyModuleCensusBody StructuresSurveyModuleCensus 1 Mental Functionsyyn1 Structures of the nervous systemyyn 2 Sensory functions and painyyy2 The eye, ear and related structuresy, indirectnn 3 Voice and speech functionsyyn3 Structures involved in voice and speech y, indirectnn 4 Functions of the cardiovascular, haematological, immunological and respiratory systems yyn4 Structures of the cardiovascular, immunological and respiratory systems y, indirectnn 5 Functions of the digestive, metabolic and endocrine systems ynn5 Structures related to the digestive, metabolic and endocrine systems y, indirectnn 6 Genitourinary and reproductive functions with abovenn6 Structures related to the genitourinary and reproductive systems y, indirectnn 7 Neuromusculoskeletal and movement-related functions yyn7 Structures related to movement y, indirectnn 8 Functions of the skin and related structures indirectnn 8 Skin and related structuresy, indirectn Mapping Survey Module and Census to ICF Body Function and Structures

Activities and ParticipationSurveyModuleCensusEnvironmental FactorsSurveyModuleCensus 1 Learning and applying knowledgeyyy1 Products and technologyyyn 2 General tasks and demandsyyy2 Natural environment and human-made changes to environment nnn 3 Communicationyyy3 Support and relationshipsyyn may in future 4 Mobilityyyy4 Attitudesnnn 5 Self-careyyy5 Services, systems and policiesynn 6 Domestic lifeyny 7 Interpersonal interactionsynn 8 Major life areasynn 9 Community, social and civic lifeynn Mapping Survey Module and Census to ICF Activities and Participation and Environmental Factors