A model for the assessment and management of children with multiple disabilities

Children with multiple disabilities present complex management problems, bo th for their families and for the professionals involved in their care. For any one child, the list of functional and medical problems that need to be addressed is frequently reflected in an even longer list of involved profe ssionals, leading to conflicting advice and problems in cc-ordination of ca re. A hierarchical model for assessment and management is proposed, which h ighlights the interdependency of apparently different areas of functioning. The model aims to assist both parents and professionals in determining pri orities, to improve interdisciplinary working, and to underpin staff traini ng. Illustrative case studies indicate the importance of resolving issues i n areas such as visual functioning, positioning and nutrition before integr ated functions such as communication skills can be addressed successfully.