Table 1 Clinical assessment method and definitions of impairment

Moderate/severe vision impairment

SCREEN

0–2

Fix and follow

Unable to fix and follow

3–4

Counting fingers (child copies number of fingers shown at 6 m both eyes together)

Unable to count finger at 6 m (approx. Equivalent to Visual Acuity (VA) < 6/60).

≥ 5

Visual acuity test using tumbling E-chart

Presenting VA <6/60 in better eye.

EXAM

Eye exam with direct ophthalmoscope and retinoscope by ophthalmic clinical officer

Moderate/severe hearing impairment

SCREEN

6 m-4

Otoacoustic Emissions (OAE) tests.

Fails OAE both ears.

≥ 5

Ages ≥ 5 years: Pure Tone Audiometry (PTA)^a

> 35 dBHL in both ears^a

EXAM

Ear exam by ENT clinical officer using an otoscope

Moderate/severe physical impairment

Standardised observation of activities (ability to hold and change position, mobility, and hand function) and physical examination by orthopaedic clinical officer to determine severity and cause

Moderate/severe physical impairment lasting more than one month/from birth) affecting functioning based on observation of activities and physical examination.

Epilepsy

Eight screening questions about type and frequency of epilepsy episodes in the past year

Paediatric clinical officer/nurse confirmed epilepsy based on responses to screening questions.

SCREEN

0–2

Paediatric clinical officer/Nurse judgement

Intellectual impairment

≥ 5

12 age-relevant questions on behaviour, communication, comprehension, concentration, relationships and learning ^b

Scores positive on at least 3 questions and/or presence of Down’s Syndrome, microcephaly or hydrocephaly.