Are children correctly classified in expertises concerning their need for care?

This project deals with assessment directives issued by the leading statuto ry care insurance companies to define the need for care of children at cert ain ages in coping with the activities of daily life specified by the Germa n Social Legislation. The ages in question relate to healthy, normally developed children. They a re used as a measure of comparison for the assessment of diseased children. Besides, they have a decisive significance in defining the need for care. Only if a child is not able to perform a certain activity, although it is m eant to be able to do so at that age, can we define the need for help and a ssistance, i.e. care. The project is divided into two sections. 1. Comparison of age mentioned in the assessment directives far each of the daily life activities of healthy and normally developed children aged 1 to 12 years with the age mentioned in technical literature. 2. Comparison of age mentioned in the assessment directives for each ot the daily life activities of healthy and normally developed children at the ag e of 1 to 12 years with those mentioned in retrospective interviews with th e same group of children. In the first part of the project, an analysis of the literature dealing wit h the subject was done. The literature included the stock of technical lite rature in the German language. Studying the literature, ages for children c ould be isolated, that could be classed with the activities of daily life m entioned in the German Social Code. These ages were compared with those in the assessment directives. In a second part of the project, 81 mothers and fathers of healthy, normall y developed children aged 1 to 12 years were asked via a questionnaire. The y were asked to estimate retrospectively from what age on their child had b een able to perform certain activities of daily life without any help. The comparison of ages mentioned in the assessment directives with those of the analysis of literature conformed only regarding daily life activity. R egarding the other activities of daily life the age for children was set hi gher in the assessment directives than in the literature. Comparing the age of children in the assessment directives with the results of the questionn aires the age was also set higher in the directives than shown by the resul ts of the questionnaires. The results of the literature analysis and the inquiry by questionnaires sh ow that the ages mentioned in the assessment directives for an independent performance of daily life activities do not correspond to the development a ccording to the age of healthy normally developed children aged 1 to 12 yea rs. As a result of this project it seems to be justified to be doubtful abo ut an adequate assessment of children who are in the need of care. Due to t his reason it would be desirable to reexamine the data of the assessment di rectives by means of a new representative prospective study.