to me / does not apply. If the needs / functioning fall within a shaded box, explain why: child’s III-8. Medical Needs Chronicity (PAST 30 DAYS) – Child is expected to fully Child is expected to fully Child is expected to fully medical condition is Child’s recover from his / her recover from his / her recover from his / her expected to continue condition within the next 6 condition after at least 6 condition but not within the throughout his / her lifetime. months or this information is months but less than 2 next 2 years. unknown to me / does not years. apply. If the needs / functioning fall within a shaded box, explain why: child’s C. PHYSICAL / PERSONAL CARE CHARACTERISTICS (Ages Birth to 5) (Continued) III-9. Medical Needs Diagnostic Complexity (PAST 30 DAYS) – medical diagnoses Some evidence exists to say There is substantial concern It is currently not possible to Child’s are clear and correct or this that the symptoms about the accuracy of the accurately diagnose the child’s information is unknown to are complex and the medical diagnoses medical conditions. child’s child’s me / does not apply. diagnosis may not be due to the complexity of entirely accurate. symptoms. If the needs / functioning fall within a shaded box, explain why: child’s III-10. Medical Needs Emotional Response (PAST 30 DAYS) – Child is coping well with his / Child is experiencing some emotional response Child is having severe Child’s her medical condition or this emotions related to the to his / her condition is emotional response to his / information is unknown to medical condition, but these interfering with treatment her condition that is me / does not apply. are not affecting other areas and other areas of life. interfering with treatment of life. and functioning. If the needs / functioning fall within a shaded box, explain why: child’s III-11. Medical Needs Impairment in Functioning (PAST 30 DAYS) – medical condition is medical condition is medical condition is medical condition Child’s Child’s Child’s Child’s
to me / does not apply. If the child’s needs / functioning fall within a shaded box, explain why: III-8. Medical Needs – Chronicity (PAST 30 DAYS) Child is expected to fully recover from his / her condition within the next 6 months or this information is unknown to me / does not apply. Child is expected to fully recover from his / her condition after at least 6 months but less than 2 years. Child is expected to fully recover from his / her condition but not within the next 2 years. Child’s medical condition is expected to continue throughout his / her lifetime. If the child’s needs / functioning fall within a shaded box, explain why: C. PHYSICAL / PERSONAL CARE CHARACTERISTICS (Ages Birth to 5) (Continued) III-9. Medical Needs – Diagnostic Complexity (PAST 30 DAYS) Child’s medical diagnoses are clear and correct or this information is unknown to me / does not apply. Some evidence exists to say that the child’s symptoms are complex and the diagnosis may not be entirely accurate. There is substantial concern about the accuracy of the child’s medical diagnoses due to the complexity of symptoms. It is currently not possible to accurately diagnose the child’s medical conditions. If the child’s needs / functioning fall within a shaded box, explain why: III-10. Medical Needs – Emotional Response (PAST 30 DAYS) Child is coping well with his / her medical condition or this information is unknown to me / does not apply. Child is experiencing some emotions related to the medical condition, but these are not affecting other areas of life. Child’s emotional response to his / her condition is interfering with treatment and other areas of life. Child is having severe emotional response to his / her condition that is interfering with treatment and functioning. If the child’s needs / functioning fall within a shaded box, explain why: III-11. Medical Needs – Impairment in Functioning (PAST 30 DAYS) Child’s medical condition is Child’s medical condition is Child’s medical condition is Child’s medical condition
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