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Indigenous Australians and the National Disability Insurance Scheme

Appendix 2: How Indigenous persons with a disability were identified in the NATSISS, Census and SDAC

National Aboriginal or Torres Strait Islander Social Survey 2008

Data for the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) were collected from Indigenous persons aged 15 years+ who were asked about the presence of disabilities or long-term health conditions which limited, restricted or impaired everyday activities, and lasted, or were expected to last for six months. People with a condition or long-term health condition in non-remote areas were identified using a broad set of criteria which included sensory, physical and learning difficulties, disfigurements and deformities, conditions which restrict physical activity or physical work, and mental illness for which supervision is required. More than one response could be provided. People residing in remote areas were also identified using these criteria. However, this measure did not include mental illness. People who reported at least one condition which lasted or was expected to last six months or more were also asked to nominate from a provided list of categories which restrictions they have experienced as a result of the reported condition(s). Data were also collected on assistance or supervision required for personal needs, moving around and talking with people. The wording of questions differed slightly between non-remote and remote areas, although this did not affect the underlying purpose of the questions being asked.

Responses provided data on what type of conditions, whether the conditions restricted everyday activities, and whether assistance or supervision were required to complete tasks are used to categorise respondents’ into three levels of Disability Status: profound or severe core-activity limitation, unspecified limitation or restriction, or no disability or long-term health condition. The severity of restriction is also measured for those categorised as having profound or severe core-activity limitation.

Disability Type is categorised according to responses on the following type of conditions and whether they restricted everyday activities:

  • • sight, hearing, speech
  • • physical
  • • intellectual
  • • psychological
  • • type not specified, or
  • • no disability or long-term health condition.

Disability Type categories are the same for non-remote and remote areas, although in non-remote areas where respondents reported mental illness, they were included in the psychological category. Responses provided on the types of conditions and whether the conditions restricted everyday activities are used to categorise individuals into the following Types of Restrictions (ABS 2010a):

  • • sight problems
  • • 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
  • • any disfigurement of deformity
  • • shortness of breath or difficulty breathing
  • • chronic or recurring pain
  • • a nervous or emotional condition
  • • long-term effects as a result of 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., or
  • • no disability or long term health condition.

Census 2006

The 2006 Census collected one data variable relating to disability, which measured the number of people with a profound or severe disability. For the purpose of the Census, profound or severe disability was defined as the need for help or assistance in one or more of three core activity areas of self-care, mobility and communication, because of a disability, long-term health condition (lasting six months or more), or old age.

Questions 20–22 of the 2006 Census measured whether or not a person needed assistance in any of these three core activity areas:

  • • Question 20: Does the person ever need someone to help with, or be with them, for self-care activities?
  • • Question 21: Does the person ever need someone to help with, or be with them, for body movement activities?
  • • Question 22: Does the person ever need someone to help with, or be with them, for communication activities?

To determine if a person’s need for assistance as reported in Questions 20–22 is due to severe or profound disability, Question 23 asks: ‘What are the reasons for the need for assistance or supervision shown in questions 20, 21 and 22?’. The person is coded as ‘Does not have need for assistance with core activities’ if the response to question 23 is one or more of the following:

  • • no need for help or supervision
  • • short-term health condition (lasting less than six months)
  • • difficulty with English language
  • • other cause.

A person is coded as ‘Has need for assistance with core activities’ if the response to Question 23 is either one of the following:

  • • long-term health condition (lasting six months or more)
  • • disability (lasting six months or more).

If the response is ‘old or young age’ and the person is over 40 years old, then they are also categorised as having a need for assistance with core activities.

If the responses do not meet the requirements for needing or not needing assistance with core activities, the response can be coded as ‘Not stated.’ (ABS 2006).

Survey of Disability, Ageing and Carers 2009

For the purposes of the Survey of Disability, Ageing and Carers (SDAC), disability is defined as any limitation, restriction or impairment which restricts everyday activities and has lasted or is likely to last for at least six months. It includes difficulties with sight, hearing, speech and breathing. Chronic or recurrent pain, blackouts, fits, and learning difficulties are also included, as well as emotional or nervous conditions, physical conditions, disfigurement or deformity, mental illness, head injury, stroke and brain damage.

A series of screening questions are used to establish whether or not any members of a household may experience a disability. Where a member of a household meets the SDAC definition of disability, seven criteria are used to determine the severity of the disability, with the use of prompt cards describing everyday activities. The seven criteria are:

  • • if the person has a condition, impairment, limitation or restriction
  • • if the person always needs help or supervision with tasks
  • • if the person ever needs help or supervision
  • • if the person ever has difficulty with tasks
  • • if the person uses aids to assist with tasks
  • • if the person is 5–20 years of age and has an education restriction (the age range may vary according to the scope of the collection)
  • • if the person is aged less than 65 years and has an employment restriction.

Severity of disability is classified using seven base-level categories to determine Disability Status (ABS 2010b):

  • • profound core activity limitation
  • • severe core activity limitation
  • • moderate core activity limitation
  • • mild core activity limitation
  • • education/employment restriction only
  • • no specific limitation or restriction
  • • no disability or long-term health condition.

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.

Intellectual

  • • difficulty learning or understanding things.

Physical

  • • 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.

Psychological

  • • 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 activity.

To identify whether a person has a particular type of limitation or restriction, the SDAC collects information on need for assistance, difficulty experienced, or use of aids or equipment to perform selected tasks. The tasks associated with each type of limitation and restriction are given in Table A2.1 (ABS 2010a).

Table A2.1 Tasks associated with limitation typing, SDAC

Limitation or restriction

Activity

Tasks

Specific limitation or restriction

Core-activity limitations

Communication

Understanding family or friends

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Being understood by family or friends

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Understanding strangers

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Being understood by strangers

Mobility

Getting into or out of a bed or chair

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Moving about usual place of residence

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Moving about a place away from usual residence

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Walking 200 metres

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Walking up and down stairs without a handrail

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Bending and picking up an object from the floor

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Using public transport

Self care

Showering or bathing

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Dressing

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Eating

Description: http://www.abs.gov.au/icons/ecblank.gif

Toileting

Description: http://www.abs.gov.au/icons/ecblank.gif

Bladder or bowel control

Limitation or restriction

Activity

Tasks

Specific limitation or restriction

Schooling or employment restrictions

Schooling

Unable to attend school

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Attends a special school

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Attends special classes at an ordinary school

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Needs at least one day a week off school on average

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Has difficulty at school

Employment

Permanently unable to work

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Restricted in the type of work they can or could do

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Need, or would need, at least one day a week off work on average

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Restricted in the number of hours they can, or could, work

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Requires special equipment or modified work environment

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Needs ongoing assistance or supervision

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Would find it difficult to change jobs or get a preferred job

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Needs assistance from a disability job placement program or agency

Without specific limitation or restriction

Other activities

Health care

Foot care

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Taking medications or administering injections

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Dressing wounds

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Using medical machinery

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Manipulating muscles or limbs

Paperwork

Reading or writing tasks such as:

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Checking bills or bank statements

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Writing letters

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Filling in forms

Transport

Going to places away from the usual place of residence

Housework

Household chores such as:

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Washing

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Vacuuming

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Dusting

Property maintenance

Changing light bulbs, taps, washers or car registration stickers

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Making minor home repairs

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Mowing lawns, watering, pruning shrubs, light weeding or planting

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Removing rubbish

Meal preparation

Preparing ingredients

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Cooking food

Cognition or emotion

Making friendships, interacting with others or maintaining relationships

Description: http://www.abs.gov.au/icons/ecblank.gif

Coping with feelings or emotions

Description: http://www.abs.gov.au/icons/ecblank.gif

Decision making or thinking through problems

Source: ABS (2010a)


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