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DLA Form – A Step by Step Guide

Welcome to the very best guide to filling In your child's Disability Living Allowance (DLA) form

DLA Form

The DLA claim form is huge and it can seem daunting at first glance. But don't panic. Take your time, use this guide and  you should be able to complete it without too much trouble.

We know that its tempting, when you receive the form to just put it to one side for a while, but don't! If you can avoid this temptation you'll have time to do it bit by bit and not feel rushed.

Now put the kettle on, get some biscuits and lets begin...

Top Tips

  • Read through it first before putting pen to paper so you have an idea of what’s needed.
  • If possible get specialist advice from a welfare benefits adviser or someone else who is familiar with completing the form. This will increase the likelihood of your child being awarded the right level of DLA.
  • Keep a diary for a week before tackling the form. Include details of the amounts and types of care your child needs during the day and night. This will be useful when you fill in the form and can be used as evidence. It will also be a useful aid in helping you think about all the extra help your child needs.
  • Give as much information as possible. You can write outside of the boxes and attach extra sheets if you run out of space.
  • Don‘t play down your child‘s condition. Although it‘s hard, try not to overplay details of your child’s abilities and achievements. Include the bad days, as these will give the decision makers an insight into the full extent of your child’s needs.
  • If your child has a fluctuating condition use the terms ‘bad days‘ and ‘better days‘ to describe the changes in their condition. Using terms like ‘good days’ or ‘normal days’ can imply your child needs no extra help on these days. Say how often your child needs help, rather than how often they get help.
  • Remember that your aim in filling in the form is to give as clear a picture as possible of your child’s difficulties. Much of the form consists of tick boxes with a few lines for you to describe their problems more clearly. However, you do not have to be constricted by this structure and can carry on writing below the lines if necessary, or even attach an extra piece of paper.
  • Show how your child‘s needs are different to those of other children of the same age. Is your child’s level of competence age-appropriate for different tasks? If you have older children compare their needs at the same age or compare your child’s needs with those of a friend or family member’s child.
  • Ask yourself – have you included enough detail to convince someone who hasn‘t met your child? The application will be assessed by someone who hasn’t met your child and who may not be familiar with your child’s condition. If they have a rare condition, you may have information about it you can include to help the decision maker understand more.
  • Include supporting evidence with the form if you have it. This can be medical reports, speech and language assessments, psychological reports, and a statement of special educational needs – 6+anything that supports what you’ve said in the form.
    But don’t delay making a claim if you haven’t got these reports yet, as
  • DLA can’t be backdated and you could lose out. If you write on the form that you‘ll be sending further information the decision makers should accept it.

Terminology

Personal Budgets

To assess what rate of DLA should be paid, some of the words they will be looking for in the rules have a specific meaning...

'Bodily functions'
Includes anything to do with how the body works, like breathing, eating, drinking, hearing, seeing, walking, sitting, dressing, undressing, washing, bathing, toileting and sleeping.

If the help can be done in another room, away from the child, it is unlikely to count unless it is closely connected to something personal, for example changing bedding after a child has wet the bed.

'Supervision'
Someone present to prevent any accidents or harm to your child or others.

'Substantial danger'
there must be a realistic possibility that without supervision your child could seriously risk harming themselves or others. This situation may arise infrequently or be a one-off.

'Night'
Starts from when the whole household goes to bed and ends when everyone gets up. Night-time needs means that during the night your child requires either:

  • ‘prolonged’ help with their personal care. (This means for at least 20 minutes)
  • ‘repeated’ help with personal care during the night (This means at least twice)
  • to avoid danger to themselves, or others, another person needs to be awake and watching over them for either a ‘prolonged’ period or at ‘frequent intervals’ (this means more than twice).

Filling in the DLA Form

DLA Form

A Step-by-Step Guide to Filling in your DLA Form

The first parts of the claim form (parts 1 – 24) are fairly straight forward they are asking for basic information about your child and the people involved in their care. Parts 25-36 are the mobility questions, and parts 37-55 are the care questions.

You will see that on the DLA Form, the basic format of these pages is similar, with a series of tick box questions followed by some space to expand on your answers. In this guide we go through these questions one by one.

This guide is designed so that you can dip in and out of it as necessary and just refer to the parts you need. Equally, you can work through it page by page as it reflects the arrangement of the new DLA child claim form. In either case, read through these introductory notes before you start.

How to Complete Your Child’s DLA Claim Form

respite care for children with special needs

Disability Living Allowance - Mobility (physical difficulties)

DLA Q.25 - Can they physically walk?

If the child cannot physically walk at all then tick no under question 25 of your DLA claim pack and continue to question 36 – you do not need to fill out any of the other sections in between. Tick yes if the child can physically walk and continue onto question 26.

DLA Q.26 - Do they have physical difficulties walking?

If the child has difficulties walking which affects their speed, health, the way they walk, how long it takes them, how far the can walk or they require a considerable amount of effort to walk then tick yes under question 26 of your DLA claim pack then move onto the following questions. Tick no if the child doesn’t have any physical difficulties walking, and move onto question 32 (behavioural difficulties walking).

Some children with learning disabilities or autism spectrum disorders can qualify for higher rate mobility because of severe behavioural problems from age three.

Think about why your child needs more guidance or supervision than children the same age.

• does your child have behavioural problems which could lead to danger?
• do they have a learning or communication problem which means they could get lost or are
• more vulnerable to danger?
• does your child have a visual or hearing impairment and need extra help with following directions and avoiding obstacles?
• does your child’s hearing impairment mean they can’t hear dangers coming from behind?
• are they likely to stumble or fall without someone’s help?

Virtual inability to walk due to refusal episodes

Some children, because of their condition, regularly refuse to walk. If these episodes are regular and unpredictable enough then you may be able to claim the higher rate as they can be said to render your child ‘virtually unable to walk’.

However, the refusals must be as a result of the child having a physical disability. Some conditions, such as autism and Down Syndrome have been considered physical by DLA case law as they stem from the brain which is a physical organ of the body. Other conditions may not be considered in this way, and certainly higher functioning children with conditions such as Asperger’s Syndrome, Dyspraxia, ADHD etc will be very unlikely to qualify under the criteria in this appendix.

If your child has severe behavioural problems and a severe mental impairment, or regularly refuses to walk due to a neurological condition, please tick yes to question 26 and use the following guide to complete questions 27-36.;- ( refer to the notes on mental health below these questions).

DLA Q.27

Don’t tick any of the boxes! Write in the space between the suggestions and the tick boxes something to the effect of ‘Regularly and unpredictably refuses to walk’.

DLA Q.28

As for question 27, don’t tick any boxes and just write ‘regularly and unpredictably refuses to walk’.
DLA Q.29. Again, don’t tick any boxes but you can use the small text box at the bottom to say that your child regularly and unpredictable refuses to walk.

DLA Q.30

Tick ‘no’ (unless they have a co-morbid condition that means that it does).

DLA Q.31

This is where you need to describe the refusal episodes. Start by saying that they are caused by your child’s condition; that they happen regularly and unpredictably; that they are not just naughty behaviour (suggest what causes them, e.g. inflexibility of thinking, sensory overload etc); that they cannot just be overcome by punishment or reward; what happens if you try to move your child (eg hits you, smashes their head on the ground etc); how long they last for; how difficult/impossible it is to make any further progress; and, finally, how you consider your child to be ‘virtually unable to walk’ as a result.

Anything else you want to tell them? (use the suggestions below to help fill in the additional information box at the bottom of the claim form);-

• Child may have breathing problems that are exacerbated by walking
• May have a heart condition that makes the effort of walking dangerous
• May be prone to dizziness or epileptic absences that restrict the distance they can walk
• Hypermobility may cause joint pain and restrict walking distance
• If your child walks with a limp/on their toes/with feet turned inwards etc, explain what causes this.

High Rate DLA

disabled sports, disabled clubs

Severe Mental Impairment and Severe Behavioural Problems

Some children can be entitled to the higher rate mobility component under this category.

Severe mental impairment is not a nice thing to have to say about your child but remember it’s just benefits terminology. It is a technical and complex regulation, and they have to satisfy a five point test:

1. They must be entitled to the higher rate of the care component.
If this is a new claim you will not know what award of care component they will have, but if they have care needs day and night then you will just have to assume that they will. Don’t wait for the award of the care component first and then try to claim under this route later.

2. They suffer from ‘a state of arrested or incomplete physical development of the brain which results in severe impairment of intelligence and social functioning’
Again, some conditions are considered as fulfilling this criteria and others are not, as described earlier. You still have to show that your child has a severe impairment of intelligence and social functioning. For some children this is easy and can be related to their IQ, however some children can be reasonably intelligent but unable to use that intelligence (eg non-verbal children) and so could still qualify. Impairment of social functioning relates to how your child interacts with others, how they are able or unable to cope in society. Generally, children who attend mainstream school would not pass this part of the test, although this is not always the case.

3. They exhibit disruptive behaviour which is ‘extreme’
This relates to your child’s behaviour outside of the home, whilst trying to get about. Extreme means wholly out of the ordinary, things like running off and shouting are not enough.

4. They must regularly need another person to intervene and physically restrain them to prevent them causing physical injury to themselves or others or damage to property
This is fairly self-explanatory, and demonstrates the extremity of behaviour that is required to be shown to achieve higher rate mobility by this route. However, physical restraint can just be a hand on the arm, rather than literally pinning your child down.

5. Their behaviour must be so unpredictable that they require another person to watch over them whenever they are awake.
In other words, your child can never be left alone due to the severity of their behaviour. This will include demonstrating that they need this level of supervision at school as well as at home.

So, if you’ve decided that your child may qualify via this route you need to show that on the claim form! This is a suggestion of how you might complete questions 26-31 for the severe mental impairment and severe behavioural problems route:

DLA Q.32 - Do they need guidance or supervision most of the time when they walk outdoors?

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Read through the examples and explanations below and if you decide your child needs extra supervision or guidance when outdoors then tick 'yes' at the top of the page for question 32.

Only tick ‘no’ to question 32 if you have looked at the examples below and decided you don’t have such problems, and then move to question 33.

Answer ‘no’ if they cannot...

  • Find their way around places they know; In familiar places the child would get lost and if on their own they would not be able to find their way without any assistance.
  • Ask for and follow directions; The child cannot communicate clearly enough to ask for directions, or understand what is being said to them. If lost they could not follow directions to find their way.
  • Walk safely next to a busy road ; The child doesn’t know how to behave next to a busy road at all times; they may run off or get distracted by things.
  • Cross a road safely; Don’t know how to check for traffic and use pedestrian crossings on their own in all contexts and situations.
  • Understand common dangers outdoors ; Cannot behave safely around traffic, ponds etc. Child is unaware of stranger danger. Child is not able to read and understand warning signs and signals.

Phrasing of the question has now changed!  Answer 'yes' if they regularly...

  • Become anxious, confused or disorientated; Worry about things that would not normally bother other children, not know where they are or what they are doing.
  • Display unpredictable behaviour; May have tantrums, run off, invade another person’s space, get very upset, and be aggressive or verbally abusive.
  • Need physical restraint; In order to protect the child or others they may need to be strapped into a buggy, on reins, or have someone holding onto them.

Refuse to walk

  • The child will not walk due to behavioural issues, they throw themselves on the floor and have a tantrum, changes to routine or anxieties result in the child refusing to walk.
  • They need lots of encouragement to walk.
  • Need supervision to ensure they don’t use too much energy or hurt themselves.
  • Need to be supervised as they have seizures, you have to monitor them, keep them safe during and help with recovery afterwards.
  • Have a visual or hearing impairment and need someone to help guide or supervise them.
  • Cannot judge speeds or distance and need help crossing roads.
  • Child is easily distracted and has a lack of danger awareness e.g. if they saw someone on the other side of the road they would run without looking.
  • Have episodes of incontinence, need guiding to the nearest toilet, and/or help with toileting needs.
  • Child is scared to go outside alone due to fears and anxieties related to their condition.
  • Inappropriate behaviour such as shouting, kicking, being destructive etc.
  • Can be compulsive and want to count things, touch things smell things etc. before walking on
  • Have panic attacks and need someone to watch for them and help calm them down.
  • Sensory overload e.g. loud sounds, strong smells etc. can distress the child resulting in refusal episodes.
  • A rigid routine has to be enforced when outdoors and the environment controlled as much as possible to prevent meltdowns and refusals.

Balance problems mean the child falls over frequently

  • Any bumps or bruises can have a serious affect to their health.
  • Need supervision to watch for signs of tantrums and/or attempts to run off.
  • They can become confrontational, aggressive and abusive towards strangers.

Only tick no to question 32 if you have looked at the examples below and decided you don’t have such problems, and then move to question 33.

DLA Q33 - Do they fall due to their disability?

If your child often trips and falls due to their condition then tick yes and record the number of falls each month. If they do not fall due to their condition continue onto section 34.

Answer yes if they...

Can get up without help; They get up on their own and don’t need someone to physically help them get up, or give them encouragement.

DLA Q.34 - If you want to tell them why you have ticked the boxes, how their needs vary or anything else you think they should know, then record it here

For example… Has your child had injuries needing hospital treatment? The child has had a trip or fall that is directly related to their condition and as a result has needed to have treatment in a hospital e.g. stitches, casts, brain  scans etc.

DLA Q.35 - Extra information about mobility

Use this box to put down any additional information that you couldn’t fit in boxes 31 or 34, use the previous section of the guide to help with this.

DLA Q.36 - When did the child’s mobility needs you have told us about start?

The age at which you first noticed your child’s mobility difficulties e.g. the child not meeting developmental milestones, experiencing pain, refusing to walk or severe behavioural problems.

 

DLA Q.37 - Getting into or out of or settling in bed during the day

Disability Living Allowance Stairs

Do they need encouragement, prompting or physical help to get into or out of or settling in bed during the day?

If your child gets any extra help or encouragement waking up, lifting their legs into or out of bed, sitting up or settling in bed please tick yes at the top of the page under question 37 .

Only tick 'no' if you have read the boxes and examples on the form and have looked at the examples and decided your child doesn’t have such problems.

During the day includes putting the child to bed at bedtime and waking them in the morning plus any sleeps during the day but does NOT include any awakenings during the night (when the rest of the household is in bed) – this will be dealt in section 53.

How often each day and how long for? (use this column to decide how often each day and how long each time the child needs help with each task);

Fill in timings if they need encouragement, prompting or physical help to...

Wake up

  • Include waking the child up in the morning and from any daytime sleeps.
  • The time it takes from first trying to wake the child until they are fully awake and conscious
  • How often each day; How long each time (mins)?

Get out of bed

  • Include physically helping the child out of bed, and encouraging/prompting the child to get out of bed.
  • The amount of time it takes from deciding it is time to get the child up until  the child is out of bed (including following a routine or refusals).
  • How often each day; How long each time (mins)?

Get into bed

  • Include physically helping the child into bed and encouraging/prompting the child to get into bed, both at bedtime and for any daytime sleeps.
  • The amount of time it takes from deciding it is time for the child to go to bed (after any care needs such as bathing or toileting) until the child is in bed (include following a routine or refusals).
  • How often each day; How long each time (mins)?

Settle into bed

  • Include settling the child at bedtime and for any sleeps during the day.
  • The amount of time it takes from when the child is first in bed until they are settled and starting to fall asleep.
  • How often each day; How long each time (mins)?

Anything  else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form.

  • Need physical help waking, getting up, going to bed and settling.
  • A lengthy/rigid routine has to be put in place.
  • The child needs watching over as they can be a danger to themselves or others.
  • They are too tired to get up due to night time awakenings.
  • Lack of motivation to get up.
  • They experience physical pain and/or exhaustion making it difficult to get up.
  • Emotional distress/worry makes the child reluctant to get up.
  • Effects of medication (e.g. drowsiness).
  • Need help with covers and pillows.
  • Transferring the child from a wheelchair or using hoists.
  • Persuading and reassuring the child due to behavioural, sensory or medical issues.
  • They are still wide awake and active at bedtime.
  • They get out of bed and disrupt the rest of the household.

DLA Q.38 – Toilet needs during the day

Do they need encouragement, prompting or physical help to go to or use the toilet during the day?

If your child gets any extra help going to the toilet, managing clothes, getting on or off and using the toilet, cleaning themselves and coping with continence care please tick yes at the top of the page under question 38. Only tick ‘no’ if you have read the boxes and examples on the form and have decided your child doesn’t have such problems.

(Do NOT include any issues with toileting that occur during the night, such as bed wetting - this will be dealt with in section 53.)

Tick the box if they need encouraging, prompting or physical help...

Going to the toilet - To go to the toilet during the day, including reminding the child to go to the toilet, guiding them to the toilet or supervising them while going to the toilet.

Manage clothes -When dressing or undressing when going to the toilet, including when managing nappies, pads, catheters, stomas etc. Or changing/cleaning clothes after accidents.

Get on and off the toilet -When getting on and off the toilet, including supervision and transferring from a wheelchair onto/off the toilet (incl. hoists.), and supervision whilst using the toilet.

Wipe themselves-Help the child to wipe themselves after going to the toilet, include supervising and checking that they have wiped themselves properly.

Wash and dry their hands - Help the child to wash and dry their hands, including supervising (eg. making sure child does not burn themselves on hot water, eat soap etc.), and physically helping the child to reach taps.

Manage a catheter, ostomy or stoma - Help the child to manage any continence aids, include emptying, cleaning, checking etc. Instructing/explaining to the child how to use them and/or what they are for.

Manage nappies or pads - Help the child with nappies and pads, include physically changing nappies (including cleaning the child), and helping/supervising a child with pads.

Anything else you think you should tell them? This can include things like…

  • Needs supervising when using the toilet for safety reasons and/or because they are easily distracted.
  • Cleaning the toilet area after the child.
  • Help with trousers, underwear, buttons and fastenings, checking clothing and appearance after going to the toilet.
  • Dealing with episodes of incontinence.
  • Need help knowing when their bladder or bowels need emptying.
  • Painful/frequent bowel movements or urination.
  • Comforting the child if they experience pain or distress when using the toilet.
  • Help with personal hygiene (including needing to bath/shower after going to the toilet)
  • Assisting with medication and creams relating to toileting.
  • Suffer from frequent constipation or loose bowels.
  • Dealing with smearing, eating or playing with faeces.
  • Child goes to the toilet in other places around the home.
  • Miss the toilet when urinating.
  • Calming and reassuring a child who finds toileting distressing or gets anxious.
  • Taking samples for monitoring/medical purposes.

DLA Q.39 – Moving around indoors during the day

Disability Living Allowance Stairs

Do they need encouragement, prompting or physical help to move around indoors, using stairs or getting in or out of a chair?

If your child gets any extra help to move from one place to another when indoors please tick yes at the top of the page under question. Only tick no if you have read the examples on the form and decided your child doesn’t have such problems.

Tick the box if they need encouragement, prompting or physical help...

Go up and down one step -While moving up and down one step to ensure their safety, help with movement and co-ordination, to enable them to get from one place to another and/or to use any aids.

Examples and Explanations to decide whether to select yes or no in the tick boxes…..

Go upstairs - While moving up a flight of stairs to ensure their safety, help with movement and co-ordination and to enable them to get from one place to another and/or to use any aids.

Go downstairs - While moving down a flight of stairs to ensure their safety, help with movement and co-ordination and to enable them to get from one place to another and/or to use any aids.

Move around safely - While moving around indoors to ensure their safety, trying to prevent falls and accidents, guiding the child and making sure they know where they are going and making them aware of their surroundings.

Get into or out of a chair - To get into or out of a chair as they may be unable to do it alone, to ensure their safety and/or because it takes them a long time.

Sit in a chair - To sit safely in a chair, including the use of specialised seating or postural support equipment, regularly moving the child because sitting for prolonged periods may cause pain or stiffness.

Anything else you want to tell them? This can include things like…

  • Child is physically unable to walk or move without help.
  • Child may suffer pain, stiffness or flaccidity when they move.
  • Child has limited movements/control.
  • Child can’t stand for long periods of time, may cause pain, fatigue etc.
  • Child suffers from uncontrollable spasms and movements.
  • Child has poor balance, spatial awareness or motor skills.
  • Child becomes exhausted easily.
  • They need hand rails or have to hold on to things very tightly to pull themselves up. Child moves very slowly.
  • Child is unable to manipulate objects, such as opening and closing doors.
  • Child needs objects and aids to steady themselves, such as walkers or canes.
  • Child has to use certain techniques when indoors, such as going on their bottom to go up and down stairs, or rolling off chairs onto knees.
  • Getting up from sitting is painful or potentially damaging to the child’s health.
  • Need a lot more encouragement or help to learn skills such as sitting, crawling, standing, walking, running.

DLA Q.40 – Washing, bathing, showering and checking appearance during the day

OCD

Do they need encouragement, prompting or physical help to wash, bath, shower and check their appearance during the day?

If your child gets any extra help getting in or out of a bath or shower, washing or drying themselves, brushing their teeth and checking their appearance please tick yes at the top of the page under question 40. Only tick no if you have read the examples on the form and have and decided your child doesn’t have such problems.

How often each day and how long for, use this column to decide how often each day and how long each time the child needs help with each task. Fill in timings if they need encouragement, prompting or physical help to...

Have a wash

  • All times during the day that the child has a wash, including washing in the morning and/or at bedtime and washing before/after certain activities.
  • The time it takes from the start of a wash (including any prior prompting and encouragement) until the child is washed and dried (including following a routine or refusals).
  • How often each day and how long each time (mins)?

Clean their teeth

  • All times during the day that the child cleans their teeth or needs physical help or prompting to do so. The time it takes from the start of teeth cleaning (including any prior prompting and encouragement) until the child’s teeth are cleaned (including following a routine or refusals).
  • How often each day and how long each time (mins)?

Wash their hair

  • All times during the day that the child washes their hair or needs physical help or prompting to do so.
  • The time it takes from the start of washing their hair (including any prior prompting and encouragement) until the child’s hair is washed (including following a routine or refusals).
  • How often each day and how long each time (mins)?

Get in or out of the bath

  • All times during the day that the child gets in or out of the bath and needs physical help or prompting to do so.
  • The time it takes to get in and/or out of the bath (including any prior prompting and encouragement) until the child is safely/comfortably in or out of the bath (including following a routine or refusals).
  • How often each day and how long each time (mins)?

Get in or out of the shower

  • All times during the day that the child gets in or out of the shower and needs physical help or prompting to do so.
  • The time it takes to get in and/or out of the shower (including any prior prompting and encouragement) until the child is safely/comfortably in or out of the shower (including following a routine or refusals).
  • How often each day and how long each time (mins)?

 

Clean themselves - in the bath or shower

  • All times during the day that the child cleans themselves in the bath or shower and needs physical help or prompting to do so.
  • The time it takes the child to clean themselves in the bath or shower (including any prior prompting and encouragement) until the child is adequately cleaned (including following a routine or refusals).
  • How often each day and how long each time (mins)?

Dry themselves after a bath or shower

  • All times during the day that the child dries themselves after a bath or shower and needs physical help or prompting to do so.
  • The time it takes the child to dry themselves after a bath or shower (including any prior prompting and encouragement) until the child is adequately dried (including following a routine or refusals).
  • How often each day and how long each time (mins)?

Check their appearance

  • All the times that the child needs to check their appearance during the day including brushing hair, shaving, applying cosmetics etc.
  • The time it takes the child to check their appearance from start to finish (including any prior prompting and encouragement) and including following a routine or refusals.
  • How often each day and how long each time (mins)?

 

Anything  else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

Child is physically unable to cope with any aspects of washing, bathing, showering and checking appearance.

  • Has to follow a very lengthy and rigid routine. Have pain associated with getting to and from the bathroom, getting into or out of the bath, while in the bath or shower or while washing.
  • Child is resistant to washing, can be aggressive.
  • Have problems because they have areas that have to be kept dry, such as dressings, a line into a vein or a stoma appliance etc.
  • No danger awareness so needs supervising whilst washing to ensure their safety, for example they might leave taps running, eat soap, scald themselves etc.
  • Have to wash more often than other children.
  • Need someone to check that they have washed properly.

DLA Q.41 – Dressing and undressing during the day

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Do they need encouragement, prompting or physical help to dress and undress during the day?

If your child gets any extra help with any form of dressing or undressing (except when using the toilet) please tick yes at the top of the page under question 41. Only tick ‘no’ if you have read the boxes and examples on the form and have decided you don’t have such problems.

How often each day and how long for (use this column to decide how often each day and how long each time the child needs help with each task) Fill in timings if they need encouragement, prompting or physical help to...

Dress

  • All times during the day that the child gets dressed, including in the morning, at bedtime, for any activities such as sports and swimming, redressing if a child continues to take clothes off during the day, and changing any soiled clothes.
  • The time it takes from the start of dressing the child (including any prior prompting and encouragement) until the child is fully dressed (including following a routine or refusals).
  • How often each day and how long each time (mins)?

Undress

  • All times during the day that the child gets undressed, including in the morning, at bedtime, for any activities such as sports and swimming, and changing any soiled clothes.
  • The time it takes from the start of undressing the child (including any prior prompting and encouragement) until the child is fully undressed (including following a routine or refusals).
  • How often each day and how long each time (mins)?

 

Manage - zips, buttons or other fastenings      

  • All times during the day that the child needs help with zips, buttons or other fastenings, including shoe laces.
  • The time it takes to help the child with zips, buttons or other fastenings (including any prior prompting and encouragement), including following a routine or refusals.
  • How often each day and how long each time (mins)?

Choose appropriate clothes

  • All times during the day that the child needs help choosing appropriate clothing including in the morning, at night, for any activities such as sports and swimming, and changing any soiled clothes.
  • The time it takes to choose appropriate clothing for the child.
  • How often each day and how long each time (mins)?

 

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • Child physically cannot dress or undress themselves.
  • Child experiences pain and discomfort when trying to dress or undress.
  • Child has fine motor skills problems.
  • Need to follow a lengthy or rigid routine.
  • Clothes have to be laid out or put on in a specific order.
  • Sensory issues with clothing means clothes have to be carefully chosen, for example, labels have to be taken out, specific materials, colours etc.
  • Need to check that clothes are put on properly, right way round etc.
  • They are easily distracted and dressing and undressing can be a very long process.
  • Need special clothing that is easy to get on or off, is medically adapted etc.
  • Find dressing and undressing a distressing experience and need reassurance and support.
  • The child likes to get undressed at inappropriate times and places.
  • Child can be very resistant to getting dressed or undressed, may get aggressive.

DLA Q.42 – Eating and drinking during the day

Disability Living Allowance Eating

Do they need encouragement, prompting or physical help to eat and drink during the day?

If your child gets any extra help getting food into their mouth, chewing and swallowing, using cutlery, cutting up food, holding a cup and drinking please tick yes at the top of the page under question 42. Only tick ‘no’ if you have read the boxes and examples on the form and have decided you don’t have such problems.

How often each day and how long for (use this column to decide how often each day and how long each time the child needs help with each task) Fill in timings if they need encouragement, prompting or physical help to...

Eat

  • All times during the day that the child eats, including meals and snacks.
  • The time it takes from beginning the meal or snack (including any prior prompting and encouragement) until the child has finished (including following a routine or refusals).
  • How often each day and how long each time (mins)?

Use a spoon

  • All times during the day that the child has help to use a spoon during the day, including snacks.
  • The time it takes the child to use a spoon with encouragement, help and prompting (including refusals, pauses and breaks).
  • How often each day and how long each time (mins)?

Cut up food on their plate

  • All times during the day that the child has help cutting up their food, including cutting up food in the preparation stages.
  • The time it takes for the child to cut up food on their plate, any help they may need, or cutting food up for the child.
  • How often each day and how long each time (mins)?

Drink using a cup

  • All times during the day that the child has help to drink using a cup.
  • The time it takes for the child to drink using a cup, including and additional help needed.
  • How often each day and how long each time (mins)?

Be tube or pump fed

  • All times during the day that the child needs to be tube or pump fed (each individual feeding).
  • The time it takes from the beginning of the process until the end, including preparing, cleaning and setting up equipment.
  • How often each day and how long each time (mins)?

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • Child has problems chewing, swallowing and sucking, which makes it more difficult, time consuming and/or hazardous.
  • Child experiences pain and/or discomfort when eating and drinking, and needs comforting, prompting, reassuring etc.
  • Additional preparation is required due to specific dietary needs and/or eating difficulties.
  • Child is unable or finds it difficult and painful to manipulate objects such as cutlery and cups.
  • Child has a special dietary requirement which means avoiding certain foods, precise measuring and monitoring etc.
  • Eating and drinking is a very lengthy process due to pain, difficulties, special requirements, child is easily distracted, behavioural problems etc.
  • Does medication impact on eating and drinking e.g. affect appetite, types of food that can be eaten, meal timings etc.
  • Eating patterns are different from a child of the same age.
  • Child has to have constant supervision otherwise they may eat dangerous/inedible things.
  • Child will only eat certain foods, presented in a particular way, will only eat from a certain plate, may be brand specific etc.
  • They eat in socially unacceptable ways e.g. very noisily or messily, they will only use their fingers etc.
  • Child needs to be reminded or prompted to eat and drink during the day.

DLA Q.43 – Taking medication or having therapy during the day

DLA health

Do they need encouragement, prompting or physical help to take medication or have therapy during the day?

If your child gets any extra help to take their medication, be reminded of when, how and the quantity to take or have their therapy please tick yes at the top of the page under question 43. Only tick no if you have read the boxes and examples on the form and have decided you don’t have such problems.

How often each day and how long for, use this to decide how often each day and how long each time the child needs help with each task). Fill in timings if they need encouragement, prompting or physical help to...

Take the correct medicine

  • All times during the day that the child needs help to take the correct medicine, including physical help, preparation, supervision, encouragement etc.
  • The time it takes for the child to take the correct medicine (including any prior prompting and encouragement) until the child has taken it (including any refusal episodes).
  • How often each day and how long each time (mins)?

Know when to take their medicine

  • All times during the day that the child needs help to know when to take their medicine, including reminding and reassuring.
  • The time it takes for the child to know when to take their medicine including any prior prompting and encouragement.
  • How often each day and how long each time (mins)?

Do their therapy

  • All the times during the day that the child needs help to do their therapy, including physical help, preparation, supervision, encouragement etc.
  • The time it takes from the child starting their therapy (including any prior prompting and encouragement) until the child has completed it (including any refusal episodes).
  • How often each day and how long each time (mins)?

Know when to do their therapy

  • All times during the day that the child needs help to know when to do their therapy, including reminding and reassuring.
  • The time it takes for the child to know when to do their therapy including any prior prompting and encouragement.
  • How often each day and how long each time (mins)?

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • Child may not like taking medication; get upset and angry, refuse to take it, have a tantrum etc. and need comforting and reassuring.
  • Child may need physical help administering medicine e.g. injections, eye drops etc. and using other pieces of medical equipment.
  • Cleaning wounds, changing dressings etc.
  • Preparing medication and making it more palatable.
  • Reminding the child to take medication as they may forget.
  • Monitoring for warning signs that medication needs to be taken e.g. temperatures, difficulty breathing, blood sugar levels etc.
  • Refusal episodes, as the child experiences pain/discomfort from the medication.
  • Calculating timings for medication or therapy.
  • Reminding the child to do their therapy and supervising to make sure it is done properly.
  • Physically helping the child with therapy, before, during and after.
  • Encouraging, reassuring and comforting the child during their therapy.

DLA Q.44 – Seeing

Disability Living Allowance Seeing

Do they have difficulty seeing?

If your child has difficulty seeing when using their aids like glasses or contact lenses then tick yes at the top of the page under question 44. Only tick ‘no’ if your child does not have a Certificate of Vision Impairment and any difficulties they do have are corrected perfectly by aids such as glasses.

Are they certified sight impaired or severely sight impaired?

Certified severely sight impaired

An examiner would have certified your child sight impaired or severely sight impaired, you would have been made aware of this and given a Certificate of Vision Impairment (CVI). If your child has a severe sight impairment then tick the box and move onto the next question. If your child is certified sight impaired (not severely) tick the box and mark the boxes that apply.

Remember to tell them if you want the copy of your CVI, returned to you – write this anywhere on the page.

Certified sight impaired

Only tick ‘yes’ to these boxes if the child can see each thing clearly and does not need, support guidance or any extra help with their vision…

  • Computer keyboard keys or large print in a book
  • TV and follow the actions to a story
  • The shape of furniture in a room
  • Someone’s face across a room
  • Someone across a street

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • Vision is made worse in poorly lit places.
  • Vision is made worse due to sensitivity to light.
  • The child experiences headaches etc. due to poor vision.
  • The child needs lots of extra help and support due to difficulty seeing to prevent them from coming to harm and to ensure their needs are met.
  • Child gets very anxious and upset due to their sight impairment.
  • They can’t take part in certain activities due to their vision.
  • Eye treatments such as drops, an eye patch etc. have to be monitored and administered.
  • Child uses Braille, has a guide or uses other aids and adaptions.

DLA Q.45 – Hearing

Disability Living Allowance Hearing

Do they have difficulty hearing?

If your child has difficulty hearing sound or someone speaking when using their hearing aids then tick yes at the top of the page under question 45. If your child has not been issued hearing aids but still has problems hearing after any other aid or adaption they have then also tick yes e.g. the child may have grommets or a cochlear implant but still has difficulty hearing. Only tick ‘no’ if you have read the boxes and examples on the form and have decided you don’t have such problems.

Have they had an audiology test in the last 6 months?

If they have had an audiology test due to a difficulty in hearing please tick yes. If you have any reports confirming the child’s difficulty in hearing then attach a copy if you can.

Remember to tell them if you want the copy of your audiology report returned – write this anywhere on the page.

Answer ‘yes’ if they can hear...

  • A whisper in a quiet room
  • A normal voice in a quiet room
  • A loud voice in a quiet room
  • A TV, radio or CD but only at a very loud volume
  • A school bell or a car horn

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • The child cannot hear things if there is a lot of background noise.
  • Hearing is made worse by sensitivity to noise.
  • The child has frequent medical issues e.g. ear aches due to hearing difficulties.
  • The child needs lots of extra help and support due to difficulty hearing to prevent them from coming to harm and to ensure their needs are met.
  • Child gets very anxious and upset due to their hearing.
  • They can’t take part in certain activities due to their hearing.
  • Ear treatments such as drops etc. have to be monitored and administered.
  • The child uses sign language, has a guide or uses other aids and adaptions.

DLA Q.46 – Speaking

Do they have difficulty speaking?

If your child has difficulty saying words out loud and talking clearly then tick yes at the top of the page under question 46. Only tick no if you have read the boxes and examples on the form and have decided you don’t have such problems.

Answer ‘yes’ if they can…

  • Speak clearly in sentences - Child can speak in clear sentences that have meaning and are relevant to the situation.
  • Put words together to make simple sentences - Child can put a few words together to make a meaningful sentence such as ‘I want banana’.
  • Speak single words - Child can speak single words ‘dog’, ‘ball’ etc. but cannot build them into sentences.

Answer ‘yes’ if they can communicate using speech…

  • With someone they know - The child can effectively communicate with someone who is familiar to them using speech. They may use simple sentences or single words but these can easily be understood by someone who knows them.
  • With someone they don’t know – Child’s speech is clear and complex enough to effectively communicate with a stranger. They can talk out loud, clearly and be easily understood by someone who does not know them.

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • Child has a physical impairment which means they cannot speak or their speech is difficult to understand.
  • They copy and echo sounds rather than use speech to communicate.
  • They have the vocabulary/speech of a much younger child.
  • Child is receiving speech and language therapy.
  • They get angry and distressed if people do not understand what they are saying.
  • They are embarrassed, self-conscious about speaking so withdraw from speech, or will only talk to people they are familiar with.

DLA Q.47 - Communicating.

Disability Living Allowance Communicating

Do they have difficulty and need extra help communicating?

If your child has difficulty and needs extra help passing on information, asking and answering questions, telling people how they feel and giving and following instructions please tick yes at the top of the page under question 47. Only tick no if you have read the boxes and have decided you don’t have such problems.

Answer yes if to communicate they use...

  • Writing - Child may sometimes need to write or have things written down in order for them to communicate effectively.
  • BSL (British Sign Language) - Use sign language and have difficulty understanding and making themselves understood in spoken language.
  • Lip-reading - Child communicates by reading lips.
  • Using hand movements, facial expressions and body language - Child uses a series of movements, expressions, gestures etc. to communicate (not Makaton or BSL), these may be specific to an individual, family, group of people or area.
  • Makaton - Communicating using more basic signs and symbols.
  • Other forms of communication - Touch pad or computer screen, Picture Exchange Communication System (PECS), use an interpreter or other specially designed communication aid.

Answer ‘yes’ if they can communicate...

  • With someone they know -The child can effectively communicate their thoughts, needs and feelings with someone who is familiar to them. They may have their own specific way of communicating using sounds, signs and expressions that only certain people understand. Or they may need someone to communicate in a certain way so they can understand
  • g. slowly and clearly. The child may be shy, withdrawn, and anxious and only communicate with people they know.
  • With someone they don’t know -The child can effectively communicate their thoughts, needs and feelings with people they don’t know. They do not need help with interpretation (including parents), and can be understood by others. Child is not withdrawn or shy and does not need to be familiar with someone in order to communicate.

 

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • They find it difficult to understand long complex sentences and need people to communicate slowly, clearly, and not to obstruct their face.
  • Often need things repeated and to be explained in several different ways.
  • They need time to process what is being said.
  • Child becomes confused by figures of speech, sarcasm, humour etc.
  • They struggle to understand non-verbal communication such as facial expressions, gestures and body language.
  • You have to get and hold the child’s attention when talking to them as they are easily distracted, avoid eye contact etc.
  • Become very nervous, anxious or self-conscious when talking to others due to physical, emotional and social issues, they need reassurance and help building self-confidence.
  • Child shouts, talks very fast, changes conversation too quickly or cannot keep up with conversation.
  • Child talks at you rather than with you, and may talk repeatedly or obsessively about certain topics.
  • Use inappropriate language, gestures and body language e.g. they may invade personal space or say things that people may take offence to.
  • They find it easier to talk to adults rather than children of their own age.
  • Child is shy and often withdraws from social situations and needs lots of encouragement and reassurance when communicating otherwise will become isolated.
  • Child gets very upset, anxious and aggressive when communicating and needs a lot of support and reassurances.

DLA Q.48 – Fits, blackouts, seizures or similar

Do they have fits, blackouts, seizures or something similar?

If your child has fits, blackouts, seizures or similar, including epileptic, non-epileptic or febrile fits, faints, absences, loss of consciousness and hypoglycaemic attacks tick yes at the top of the page under question 48 (you have more space below to explain what happens). Only tick no if you have read the boxes and examples on the form and have decided you don’t have such problems.

Tell us what type they have and what happens? For instance are they absences or tonic clonic seizures? Give a brief description of what happens e.g child collapses, is unaware of their surroundings etc

Answer ‘yes’ if they...

  • Can recognise a warning and tell an adult - Warning signs are clear and reliable; the child can recognise a warning and have enough time to let an adult know.
  • Can recognise a warning and take appropriate action -Warning signs are clear and reliable; the child can recognise a warning and have enough time to make themselves safe etc.
  • Have no warning -They have no warnings or warnings are unreliable.
  • Have had a serious injury in the last 6 months because of a fit, blackout, or seizure? A serious injury may be concussion, a cut, they may have bitten themselves, bad bruising or been hospitalised.
  • Display dangerous behaviour after a fit, blackout or seizure.
  • The child may be confused, upset, exhausted, dizzy, sick, and aggressive after a seizure and need time to recover. This could be 1 hour or 1 day.

You will also need to tell them...

  • The number of days affected each month; -When putting in numbers try to work out an average. If you have a child who on a good day/night fits once but on a bad day/night fits 10 times put down around 5 times.
  • How many fits they have on these days
  • The number of nights affected each month
  • How many fits they have on these nights
  • Have they had an episode of status epilepticus in the past 12 months?
  • Persistent epileptic activity for more than 30 minutes or continued seizures without regaining consciousness.

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • Is there a particular time of day the child has them?
  • The child loses consciousness, has convulsions or becomes incontinent.
  • They need monitoring e.g. how long they are fitting for each time.
  • Child may be very anxious about having a fit, blackout, seizure and need lots of support and reassurance.
  • You may have to make the environment safe before, during and after the child has a seizure, fit etc.
  • Child needs looking after and to be made comfortable after an attack.
  • Do they need watching over during the day/night in case of a fit, blackout, seizure?
  • Medication has to be administered.
  • Clothes may need to be changed afterwards.

DLA Q.49 – Supervision

carers allowance

Do they need to be supervised during the day to keep safe?

If your child needs supervising because of how they feel or behave, or how they react to people, changing situations and things around them please tick ‘yes’ at the top of the page under question 49. Only tick no if you have read the boxes and examples on the form and have decided you don’t have such problems.

Answer ‘no’ if they cannot...

  • Recognise and react to common dangers - Cannot behave safely around cookers, knives etc. Child is unable to read and understand warning signs and signals.
  • Cope with planned changes to daily routine - Even if given notice of changes in routine child reacts badly, routines cannot be changed easily with prior notice.
  • Cope with unplanned changes to daily routine - Any changes to routine cannot be coped with, it is hard to make changes to routine without serious consequences, distress, anger etc.

Please note phrasing of question has now changed. Answer ‘yes’ if they regularly...

  • Feel anxious or panicky - Worry about things that would not normally bother other children.
  • Become upset or frustrated - Get upset and frustrated over things other children wouldn’t. Struggle to understand things or get their point across.
  • Try to harm themselves or others - Banging head against things, biting, pinching, scratching, hitting themselves etc.
  • Feel someone may harm them - A fear of being alone with and meeting different people, paranoia, attachment disorders.
  • Become verbally, physically aggressive or destructive - Shouting and swearing. Hitting, kicking, pulling hair, punching and biting. Throwing and hitting with the use of objects.
  • Act impulsively - Running off, unpredictable behaviour.
  • Have tantrums - Get very angry, refuse to listen to what is being said, ignoring instructions, are uncooperative, and cry/scream uncontrollably for prolonged periods of time.

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • Journeys may have to be rearranged or avoided due to planned and unplanned changes to routine.
  • They may over exert themselves which could have serious consequences.
  • Have a physical disability and need supervision to ensure safety and enable certain activities.
  • They may behave dangerously/aggressively towards other children and adults. Has a lack of danger awareness e.g. no fear of heights, hot things, sharp things.
  • Child may be a danger to themselves and others around them.
  • Any falls cuts or bumps could have serious consequences.
  • They self-harm, for example banging their head against a wall or pulling their hair out.
  • You have to offer comfort, support or reassurance when they are upset or frustrated.
  • Child may express withdrawn behaviour and/or become isolated.
  • Child’s basic needs would not be met.
  • Child may become emotionally distressed.
  • Child needs continual supervision, a substantial amount more than a typically developing child of the same age.

DLA Q.50 –Development

Disability Living Allowance Development

Do they need extra help with their development?

If your child gets any extra help they need to improve their understanding of people and their surroundings please tick yes at the top of the page under question 50. Only tick no if you have read the boxes and examples on the form and have decided you don’t have such problems.

Answer ‘yes’ if they need help to...

  • Understand the world around them - Explain things in a variety of ways, need to provide lots of support and encouragements as the child regularly feels confused or does not take an interest in the world around them.
  • Recognise their surroundings - Need assistance and prompting as they are often confused and disorientated, they struggle to remember places or notice things around them.
  • Follow instructions - Need things to be explained in short clear sentences. Spend time explaining things in different ways.
  • Play with others - Need help and encouragement to interact with others physically, socially and communicatively. Assist with rules and monitor behaviour.
  • Play on their own - They need encouragement to play in a more varied and stimulating way. Help them to use play equipment and explain play activities in a variety of ways.
  • Join in activities with others - Need help interacting with others, for example playing games and -group learning exercises.
  • Behave appropriately - Need help to understand social situations, they often act inappropriately e.g. invade personal space, try and touch people, have tantrums and melt downs, can be verbally aggressive/inappropriate.
  • Understand other people’s behaviour - Need help to interpret what others mean or want, often get mixed messages, take things the wrong way or are left out due to a lack of understanding.

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • Physical/sensory/learning/social/play skills are delayed.
  • Have difficulty manipulating objects e.g. holding, kicking or throwing things.
  • Need help learning to read write or do simple maths, may need extra help with school work.
  • Play obsessively and repetitively.
  • Play games that are for much younger children.
  • Dominate others, play wildly and dangerously.
  • Child does not understand how to play e.g. rules and turn taking.
  • Have a lack of danger awareness e.g. no fear of heights, traffic safety.
  • They need extra help to learn and practice new skills.
  • Need encouragement to play in a more varied and stimulating way.
  • Someone to help facilitate play, explain rules and help the child engage and interact with others.
  • The child has to learn different skills such as signing instead of speaking.
  • Without additional support they would develop much more slowly and not be able to take part in things.
  • Child would become emotionally distressed.
  • Would be physically unable to practice new skills.
  • Would find it difficult to learn new skills.
  • Might be bullied or become isolated.
  • Prefers to be alone, cannot socialise with others.

DLA Q.51 – At school or nursery

EHCP

If your child needs encouragement, prompting or physical help at school or nursery tick ‘yes’ at the top of the page under question 51. Only tick no if you have read the boxes and examples on the form and have decided you don’t have such problems.

Answer ‘yes’ if they need encouragement, prompting or physical help to...

  • Go to and use the toilet - The child needs help with toileting needs, including physical help, preparation, supervision, encouragement. Help managing clothes, reminding them to go, checking they have cleaned themselves etc.
  • Safely move between lessons - Need assistance to find their way as they get confused and disorientated, physical help to move around, supervision and encouragement to ensure they do not get hurt or distracted.
  • Change into different clothes for PE and other school activities - They cannot change on their own and need help with buttons, zips, laces etc. Changing can take a long time and they need prompting and encouraging. They need reassuring as they get anxious and upset about getting changed.
  • Eat meals - They need to be encouraged to eat, monitoring for special dietary requirements or to make sure they eat the right things, help manipulating cutlery and cutting food up.
  • Take medicine or do therapy - The child needs help with medicine/therapy e.g knowing when and how to take/do it, applying creams, changing dressing etc. including physical help, preparation, supervision, encouragement.
  • Communicate - The child has difficulty and needs extra help passing on information, asking and answering questions, telling people how they feel and giving and following instructions.
  • What extra help do they need with learning? - They need help with reading, writing and simple maths. They have difficulty concentrating and staying on task. Things need to be written down, in pictures or another adapted format. They are put into smaller groups, instructions are simple and repeated.
  • What is their behaviour like at school or nursery? -They get upset and frustrated. They don’t have many friends and are lonely/isolated. They have to follow a very strict and rigid routine. They get angry and aggressive, they have been excluded or have to be removed from classes.
  • How do they usually get to and from school or nursery? - You walk with them, take them in the car, they go on a school bus, walk with siblings/friends etc.

Anything  else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • What type of school are they at?
  • They have one to one support from a teacher or teaching assistant.
  • They have a buddy at school to help them move around.
  • They have an IEP, Statement, EHCP or are on School Action, School Action Plus or a form of specialised curriculum.
  • They have social communication lessons/support at school.
  • They do certain lessons in a special unit or area e.g. a resource unit.
  • A safe space they can go to if they need to.
  • Help expressing themselves or communicating so they can learn more efficiently.
  • Aids and adaptions such as specialised glasses, laptops, pens etc. so they can learn more easily.
  • They attend special after school clubs.
  • Additional support is provided in exams and for homework.

DLA Q.52 – Hobbies and Activities

Disability Living Allowance Hobbies

Do they need encouragement, prompting or physical help to take part in hobbies, social or religious activities?

If your child gets any extra help with hobbies and activities please tick ‘yes’ at the top of the page under question 52. These can be hobbies and activities that they are already doing, or things they would like to do if they had the help they needed.  tick no if you have read the boxes and examples on the form and have decided you don’t have such problems.

Activity examples - Help needed, use this column to decide how often each day and how long each time the child needs help with tasks on the left.

At home

Painting, drawing, arts and crafts, playing with toys, playing in the garden, riding a bike, cooking and baking, messy play, imaginary play, playing board games, interacting with other children, watching films or cartoons. Encouragement to use equipment, help getting equipment set up, motivation to keep interested, facilitation of play, help explaining and understanding games and rules, supervision for safety reasons, help or encouragement to clean up after themselves, help doing the activity e.g. using scissors or lifting things.

  • Is this something they do or would do every day if they had the help?
  • If not, how many times a week would they like to be able to do this activity.
  • How often each day and how long each time (mins)?

When they go out

Dance classes, the play park, go to the cinema, soft play areas, swimming, after school clubs, drama clubs, visiting friends, day trips, church, holidays, shopping for pleasure, playing outdoors, going to the library, brownies, cubs, scouts etc.

A lot of the help needed will be the same as above, however also think about Help getting to the activity or hobby, supervision and help with care needs when out e.g. reminding them to go to the toilet, help them with eating etc. staying with them during the activity, simple instruction or one to one support in clubs and classes, help with communication.

Remember to include time needed for encouragement, accompanying them there, and refusal episodes or tantrums.

How often each day and how long each time (mins)?

DLA Q.53 – Help and supervision during the night

Disability Living Allowance Sleeping

Do they wake and need help at night, or need someone to be awake and watch over them at night?

If your child gets any extra help and supervision at night please tick yes at the top of the page under question 53. Only tick no if you have read the boxes and examples on the form and have decided you don’t have such problems.

During the night, when everyone in the house is in bed e.g. once the carer has gone to bed…

How often each day and how long for (use this column to decide how often each day and how long each time the child needs help with each task)

Fill in timings if they need encouragement, prompting or physical help to...

  • Get into, get out of or turn in bed - Include physically helping the child turning, get into or out of bed, and encouraging/prompting the child to turn, get into or out of bed.
  • The amount of time it takes from deciding it is time to get the child into, out of or turn them until it has been done (including following a routine or refusals).
  • How often each night and ow long each time (mins)?

 

Get to and use the toilet, manage nappies or pads

  • All the times during the night that the child needs help with toileting needs, including physical help, preparation, supervision, encouragement, changing bed sheets and clothing etc.
  • The time it takes from the child first identifying a toileting need (including checking, any prior prompting and encouragement) until the child’s needs are complete (including any refusal episodes).
  • How often each night day and how long each time (mins)?

Have treatment

  • All times during the night that the child needs help with treatment e.g. medication, creams changing dressing, therapy etc. including physical help, preparation, supervision, encouragement.
  • The time it takes for the child to have treatment including any prior prompting and encouragement) until the child has taken it (including any refusal episodes).
  • How often each night and how long each time (mins)?

Settle or re- settle

  • Settle the child during the night, do not include when you first settle them in bed as this is included in question 35.
  • The amount of time it takes from when the child is put back in bed until they are settled and starting to fall asleep.
  • How often each night and how long each time (mins)?

Fill in the timings if they need watching over because they...

  • Are unaware of danger and may harm themselves or others - Child is unaware of dangers such as water hazards, sharp objects, heights, plugs etc. They may put themselves or others in harm’s way if not supervised.
  • How often each night and how long each time (mins)?

May wander about

  • During the night the child does not stay in bed. They wander around the house, upstairs and downstairs they may try to get outside. They need to be supervised to ensure this doesn’t happen.
  • How often each night and how long each time (mins)?

Have behavioural problems

  • The child gets upset, aggressive, destructive, has tantrums, shouts, becomes anxious during the night and needs someone to watch over them. (Include comforting and reassuring the child)
  • How often each night and how long each time (mins)?

 

Anything else you want to tell them? Use the suggestions below to help fill in the additional information box at the bottom of the claim form…

  • The child does not go to sleep until very late and needs watching over.
  • The child wakes up very early in the morning before everyone else is awake and needs supervision or help.
  • The child has problems sleeping/sleep disorders such as sleep walking, night terrors, sleep apnoea, nightmares, intermittent sleep etc.
  • The child needs turning to avoid bed sores.
  • Need to be moved or have bed sheets adjusted as they cannot do it themselves.
  • The child cannot move around, get into or out of bed without help.
  • They suffer pain and discomfort at night time.
  • Temperature needs to be monitored as they can’t do this themselves e.g. they may not remove covers even though  they are very hot.
  • They have episodes of incontinence or have to be helped with toileting needs during the night.
  • The child regularly has accidents and bed clothes and sheets need changing or cleaning.
  • The child has therapy during the night.
  • The child has to have medication or food given to them during the night (include tube feeding).
  • Need watching over because of medical reasons, fits etc.
  • They get upset; have lots of anxiety at night time and need lots of comforting and reassurance.
  • The child wakes throughout the night and cannot resettle themselves.
  • Need constant supervision when not asleep as they may harm themselves or someone else.
  • The child would be unable to sleep without help, supervision and encouragement.
  • The child needs to be monitored/supervised because of the danger of epileptic seizures.

DLA Q.54 - Q.71

Most of these questions are just simple yes or no answers, so we have just listed a few here, with a few hints and tips where needed…

Q.54

If you want to tell us anything else about their care needs, use the box below – If there is anything you haven’t had room to explain in questions 37-53 it’s important that you use this box to do so, and reference your comments back to the relevant question.

Q.55

When did the child’s care needs you have told us about start? – The date when you first noticed that your child had care needs greatly in excess of typically developing children of their own age. This may be from birth in some cases, later in others.

Q.70

Extra information – This can be used as a continuation box for anything you couldn’t fit in to questions 35 or 54, or to tell the DWP anything else you think is relevant to the claim that hasn’t been covered in the rest of the form. You can continue on a separate piece of paper. Remember though that they won’t have time to read large amounts so it’s best to be as brief but specific as possible.

DLA Q.71 – Declaration. Don’t forget to sign and date the form before you send it in!

Once completed….

Read through the form before you send it.

  • Have you included enough information?
  • Have you answered all the relevant questions?
  • Are your contact details correct?
  • Have you missed anything?
  • Is the professionals’ evidence complete?

Keep a copy of the form and any supporting evidence for your records. You might need it if you are unhappy with your award and wish to challenge the decision. It will also help you when the claim is due for renewal or if you want to apply for a different rate later on.

Reward yourself when the form is finished. Filling in the DLA form can be time consuming, and because you’re concentrating on the things your child can’t do, stressful and demoralising. But if you get the DLA it will be worth it in the end.

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