Eligibility requirements for the Supplement for Handicapped Children

When presenting the 2024–2025 budget, the Gouvernement du Québec announced changes to the eligibility requirements for the financial assistance programs for handicapped children. The new eligibility requirements will apply to applications sent as of 1 July 2024. For more information, consult the Minister of Finance's budget This link will open in a new window..

Our Web pages will be updated as soon as the announced changes are implemented, that is, by 1 July 2024, at the latest.

To receive the Supplement for Handicapped Children, you must be eligible for Family Allowance.

Here are the specific eligibility requirements for each type of handicap and the documents you must enclose with your application.

Nutrition and digestion

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations in carrying out life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as factors in the child's environment that facilitate or inhibit the accomplishment of life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. the child is fed by naso-gastric hyperalimentation;
  2. the child has a gluten-free diet;
  3. the child has a colostomy or ileostomy;
  4. the child has congenital anal imperforation and is 2 years of age or less;
  5. one of the cases in A and one of the cases in B below both apply to the child:
A Cases
A.1the child has a malformation or disease of the digestive tract.
A.2 the child has oropharyngeal dyspraxia.
A.3 the child has an inflammatory intestinal disease.
B Cases
B.1the child's diet imposes substantial constraints on the child's family.
B.2deglutition and mastication functions are such that the child requires the services of an occupational or speech therapist.
B.3the child's illness is not controlled by medication and he has digestive problems, a deteriorated general condition or symptomatic anemia that restricts the activities of daily living for more than 3 months a year.
B.4the total period of hospitalization because of the inflammatory intestinal disease and its complications is more than 1 month a year.
B.5the child must go to a health care facility or a doctor more that 10 times a year because of decompensation due to the inflammatory intestinal disease, extradigestive manifestations, endoscopy, biological tests or therapeutic adjustments.

The following documents are required for a child with an impairment related to nutrition or digestion:

Documents to be provided by the parent

Metabolic or hereditary abnormalities

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. the child has a hemoglobinopathy of type SC, SS OR Sß thalassemia with sickle cell anemia and is less than 7 years old
  2. the child has a phenylalanine-reduced diet due to phenylketonuria and is less than 7 years old
  3. the child has mucopolysaccharidosis of the Hunter or Hurler type, the child has Gaucher's disease, galactosemia, tyrosinemia, classic severe maple sugar urine disease, lactic acidosis
  4. the child has cystic fibrosis and pulmonary and digestive complications and is under continuous treatment with enzymes
  5. the child is a hemophiliac with Factor VIII or IX activity of less than 1%
  6. the child receives daily insulin therapy
  7. one of the cases in A and one of the cases in B below both apply to the child:
A Cases
A.1the child has a metabolic illness resulting in an essential metabolite deficiency.
A.2 the child has a metabolic illness resulting in an accumulation of toxic metabolites.
A.3 the child has a metabolic illness resulting in an insufficient energy production.
B Cases
B.1the child could experience severe decompensation after fasting for a few hours, with a fever or benign infection, a condition which requires specific care under medical supervision.
B.2the child must consume proteins, lipids or glucides of a specific type or in closely supervised portions, which prevents him from consuming the same food as the child's family;
B.3the child requires at least every month a medical or paramedical follow-up because of the illness, decompensations or to prevent the child's development from being affected;
B.4the child's fatigability restricts the activities of daily living.

The following documents are required for a child with an impairment related to metabolic or hereditary abnormalities.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • For cases of cystic fibrosis: a detailed list of all medications that have been prescribed by a physician (including prescription renewals). The prescriptions must have been filled at a pharmacy.
  • Medical follow-up from the previous year, obtained from a clinic specialized in cystic fibrosis or respiratory medecine, and copies of documents related to visits to the emergency room or any hospitalization summary sheets.

Immune system abnormalities and neoplasia

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. the child is receiving chemotherapy or radiation therapy for leukemia or cancer;
  2. the child has AIDS and the condition imposes significant restrictions on his family;
  3. the child is undergoing immunosuppressive treatment for an autoimmune disease or following an organ transplant;
  4. the child has multiple food allergies to at least 3 different food groups consumed daily and the severity of the allergic reactions requires that emergency treatment be constantly available.

The following documents are required for a child with an impairment related to immune system abnormalities. If the child has cancer, only parts 1 and 2 of the application form are required.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • a detailed list of all medications that have been prescribed by a physician (including prescription renewals). The prescriptions must have been filled at a pharmacy.
  • Immune-allergy follow-up reports from the last 2 years, including the allergy tests carried out during that period and the specialist's interpretation
  • Medical follow-up in rheumatology for the last 12 months and any recent laboratory tests if the child has an autoimmune disease

Nervous system abnormalities

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. the child has Lennox-Gastaut syndrome;
  2. one of the cases in A and one of the cases in B below both apply to the child:
A Cases
A.1the child has epilepsy and has been undergoing anticonvulsive therapy for more than 6 months.
A.2 the child has Tourette's disorder.
A.3 the child has suffered a craniocerebral injury resulting in a coma.
B Cases
B.1in spite of medication, the child has more than 1 partial seizure a week.
B.2in spite of medication, the child has more than 1 episode of generalized seizures every 2 months.
B.3 in spite of medication, the child has persistent tics that significantly affect activities of daily living.
B.4the side effects of the medication significantly affect activities of daily living.
B.5 the child cannot attend a day care centre or school without being accompanied.

The following documents are required for a child with an impairment related to nervous system abnormalities.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • School Achievement Report (page 7 of the form) to be filled out by a school or daycare official
  • A detailed list of all medications that have been prescribed by a physician (including prescription renewals). The prescriptions must have been filled at a pharmacy.
  • Results of the initial assessment in neurology, if any
  • Results of the initial assessment in psychology, if any
  • Results of the initial assessment in child psychiatry, if any
  • Medical follow-up for the last 12 months.

Musculoskeletal system

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. the child has a total paralysis of the brachial plexus;
  2. the child is 2 years of age or less and requires several surgical procedures for clubfoot;
  3. the child is more than 3 years of age and requires a wheelchair or a walker because of limited motor skills;
  4. the child is achondroplastic and his height is less than the 3rd percentile;
  5. one of the cases in A and one of the cases in B below both apply to the child:
A Cases
A.1the child has a deformity or agenesis affecting the musculoskeletal system.
A.2 the child has a type of dwarfism.
A.3 the child has a neuromuscular disease.
A.4the child has cerebral palsy.
A.5the child has myopathy.
A.5the child has anrthropathy.
A.7the child has sequelae of disease or trauma that limits his motor skills.
B Cases
B.1the child is less than 5 years of age and his ability to maintain sitting and standing positions, handle objects and move about is less than that of the average healthy child half his age.
B.2the child is 2 years of age or older and has an upper limb impairment resulting in inefficient prehension in one hand or hindering the activities of daily living that require both hands.
B.3

the child is 5 years of age or older and is unable to walk about in places to which the child would normally go, to walk there or use public transportation to get there; the abnormalities and limitations described in the expert's report imply that the child requires the assistance of another person, special apparatus or devices, adapted transportation or an adapted learning environment.

B.4the child is 5 years of age or older and prehension and coordination skills are such that the child cannot feed or dress or requires an inordinate amount of time to do so, thus requiring another person's help or a special apparatus or device.
B.5the child must undergo several specialized therapeutic interventions because of the limited skills, thus entailing more than 2 specific care treatments per month outside the home.

The following documents are required for a child with an impairment related to the musculoskeletal system.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • Results of a recent assessment in occupational therapy (if the child has been assessed)
  • Results of a recent assessment in physical therapy (if the child has been assessed)
  • Results of a recent assessment in psychology, if any
  • In cases of arthritis: copy of progress notes from the last 12 months.

Hearing

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped within the meaning of section 1020.8.61.19R1 in the following cases:

  1. the average threshold in air conduction tests before fitting is more than 70 dB for the better ear;
  2. the child is less than 6 years of age and the average threshold in air conduction tests before fitting is more than 40 dB for the better ear;
  3. one of the cases in A and one of the cases in B below both apply to the child:
A Cases
A.1the child is less than 6 years of age and the average threshold in air conduction tests before fitting is 25 dB or more for the better ear.
A.2 the child is 6 years of age or older and the average threshold in air conduction tests before fitting is 40 dB or more for the better ear.
B Cases
B.1in spite of an appropriate fitting, the child's delayed language development is comparable to the cases on language disorders.
B.2the child's hearing impairment requires specialized services outside the school more than twice a month; specialized services are audiologic, medical or speech therapy follow-ups and visits to a hearing-aid acoustician.

The following documents are required for a child with an impairment related to hearing.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • Results of an assessment in audiology carried out in the last 12 months, as well as the audiogram and case history
  • Results of a speech-language assessment (if the child has been assessed)
  • School Achievement Report (page 7 of the form) to be filled out by a school or daycare official

Cardiovascular function

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed handicapped in the following cases:

  1. the child is 3 years of age or less, has a heart disease and requires digitalis;
  2. from birth to the end of 2 full years following surgery, if the child was born with hypoplastic left heart syndrome, transposition of the great vessels, pulmonary atresia or a tetralogy;
  3. the child has a valvular disease and is taking anticoagulants;
  4. the child has a pacemaker, and complications related to the implant site require 2 or more surgical procedures during the year;
  5. one of the cases in A and one of the cases in B below both apply to the child:
A Cases
A.1the child has a surgically uncorrected malformation of the heart.
A.2the child has a malformation of the heart surgically corrected with a palliative procedure.
A.3the child has arrythmia.
A.4the child has cardiac insufficiency.
B Cases
B.1the child, in spite of medication, has symptoms at rest or with low effort that hinder the activities of daily living.
B.2the child has seriously retarded growth: weight or height less than the 3rd percentile or persistent weight or height loss of more than 15 percentiles.
B.3the progressive deterioration of the child's cardiovascular function requires surgery and the activities of daily living are affected, or the care required imposes significant restrictions on the child's family.
B.4the child requires medical follow-up at least once a month to adjust medication according to the child's response to treatment and variations in weight.

The following documents are required for a child with an impairment related to cardiovascular function.

Documents to be provided by the parent

Renal and urinary functions

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. the child has a chronic renal insufficiency and is undergoing dialysis;
  2. the child uses a urinary catheter daily;
  3. the child has had a vesicostomy or a urethrostomy;
  4. the child is 5 years of age or older and diurnal incontinence requires daily care and sanitary products.

The following documents are required for a child with an impairment related to renal and urinary functions.

Documents to be provided by the parent

Respiratory function

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. the child receives daily oxygen therapy at home;
  2. the child has bronchopulmonary dysplasia requiring the daily use of a bronchodilator;
  3. the child has a deformity of the thorax or a restrictive syndrome that reduces vital capacity by 50% or more compared to the normal vital capacity for the child's size; vital capacity must be measured when the child's condition is stable, in the absence of any acute infection or decompensation;
  4. one of the cases in A and one of the cases in B below both apply to the child:
A Cases
A.1the child is less than 2 years of age and has been treated for at least the past 3 months as recommended by the Asthma Committee of the Canadian Thoracic Society.
A.2the child is 2 years of age or older and has been treated for asthma for at least the past 6 months as recommended by the Asthma Committee of the Canadian Thoracic Society.
B Cases
B.1the child is less than 2 years of age and receives daily medication 6 months a year or more administered by wet nebulization, where a metered-dose inhaler is medically contraindicated.
B.2in spite of adequate preventive treatment, the child has had at least 3 severe decompensation episodes in the last 12 months, requiring treatment in hospital for more than 48 hours or oral corticosteroids treatment for more than 7 days.
B.3in spite of inhaled beclomethasone in doses of 1,000 g/day or 20 g/kg/day with a metered-dose inhaler or its equivalent, the child's asthma cannot be controlled and the child has symptoms, at least 6 months a year, that limit the child's activities, or a condition that requires a higher dose of inhaled steroids or the addition of another medication the potential side effects of which require close medical supervision.

The following documents are required for a child with an impairment related to respiratory function.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • A detailed list of all medications that have been prescribed by a physician (including prescription renewals). The prescriptions must have been filled at a pharmacy.
  • Medical follow-up from the last year for the child's respiratory condition, including the consultations in respiratory medicine, and copies of documents related to visits to the emergency room or any hospitalization summary sheets.

Congenital malformations and chromosomal abnormalities

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. until the child is 2 years of age, if born with complete unilateral or bilateral cleft lip palate;
  2. the child has a trisomy involving the autosomes without mosaicism;
  3. the child has a monosomy involving the autosomes without mosaicism.

The following documents are required for a child with an impairment related to nervous system abnormalities.

Documents to be provided by the parent

Sight

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Regulation respecting the Taxation Act:

A child is presumed to be handicapped in the following cases:

  1. the child is less than 4 years of age and wears contact lenses because of bilateral aphakia;
  2. the child has a visual acuity of 6/60 or less;
  3. child's field of vision for both eyes is less than 30 degrees at the widest diameter, measured when focusing on a central point;
  4. one of the cases in A and one of the cases in B below both apply to the child:
A Cases
A.1the child has a visual acuity of 6/21 or less.
A.2the child's field of vision for both eyes is less than 60 degrees at the widest diameter, measured when focusing on a central point.
A.3the child has a loss of sight of 30% or more, calculated in accordance with the method and tables of the American Medical Association and taking into account loss of central vision, field of vision and eye motility.
B Cases
B.1special services are required to stimulate and maximize the child's visual potential.
B.2assistance is required to move about in an unfamiliar environment or to go to school or move about there.
B.3adapted learning tools are required, particularly special school books, audio recordings, magnifying devices or documents in braille.

The following documents are required for a child with an impairment related to sight.

Documents to be provided by the parent

Intellectual impairment 

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Ministère des Finances' Information Bulletin 2016-9 This link will open in a new window.:

A child is presumed to be handicapped in the following cases:

  1. The child is at least 6 years of age and has an IQ of 50 or less, for a confidence interval of 95%
  2. The child is at least 6 years of age and meets the following criteria:
    1. his or her global IQ is in the 2nd percentile or below, for a confidence interval of 95%,
    2. the assessment of his or her adaptive behaviour shows that the score on one of the three components assessed among the conceptual, social and practical components, or the overall score for these three components, is in the 2nd percentile or below, for a confidence interval of 95%, in at least two of the child's living environments.

Assessment parameters

Assessments must be conducted by a member of a professional order, through recognized standardized tests and in accordance with the applicable standards of practice, when the child is at least 6 years of age.

The professional's assessment report must describe the child's abilities and disabilities, present the professional's observations and enable Retraite Québec to rule on the validity of the results obtained.

Exclusion

A child who was not exposed on a sustained basis, for a period of at least 2 years, to the language used in the assessment tests is not presumed to be handicapped due to an intellectual impairment. In this respect, a child will be considered to be exposed on a sustained basis to the language used in a test if, for at least 40% of his or her waking hours, the child interacts with a person who is proficient in that language.

The following documents are required for a child with an intellectual impairment.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • Results of the adaptive skills assessment, if any
  • School Achievement Report (page 7 of the Parent's part of the form) to be filled out by a school or daycare official
  • Most recent individual education plan
  • Most recent report card.

Global developmental delay

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Ministère des Finances' Information Bulletin 2016-9 This link will open in a new window.:

A child is presumed to be handicapped:

if the child is at least 2 years of age and less than 6 years of age, and meets at least 2 of the following criteria:

  1. the child's global IQ or the score on a scale assessing his or her level of cognitive development is in the 2nd percentile or below, for a confidence interval of 95%;
  2. the overall result on a test of the child's gross and fine motor skills is in the 2nd percentile or below;
  3. the score on a receptive vocabulary test standardized for child's population group, is in the 2nd percentile or below.

Assessment parameters

Assessments must be conducted by a member of a professional order, through recognized standardized tests and in accordance with the applicable standards of practice, when the child is at least 2 years of age and less than 6 years of age.

The professional's assessment report must describe the child's abilities and disabilities, present the professional's observations and enable Retraite Québec to rule on the validity of the results obtained.

Exclusion

A child who was not exposed on a sustained basis, for a period of at least 2 years, to the language used in the assessment tests is not presumed to be handicapped due to a global developmental delay. In this respect, a child will be considered to be exposed on a sustained basis to the language used in a test if, for at least 40% of his or her waking hours, the child interacts with a person who is proficient in that language.

The following documents are required for a child with an impairment related to global developmental.

Documents to be provided by the parent

Serious behavioural disorders

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Ministère des Finances' Information Bulletin 2016-9 This link will open in a new window.:

A child is presumed to be handicapped if the following criteria are met:

  1. the child is at least 4 years of age and displays at least 2 of the following behaviours:
    • physical aggression toward himself or herself, or others,
    • defiance of authority through an obstinate refusal to follow instructions and the rules in effect in a given environment,
    • temper tantrums that significantly exceed the norm for the child's stage of development,
    • deliberate engagement in vandalism;
  1. despite the implementation of therapeutic measures recommended by members of a professional order, displays of these behaviours present all of the following characteristics:
    • high level of intensity,
    • high frequency,
    • consistency, that is, the behaviours exist in the child's various living environments.

Assessment parameters

The behavioural disorder must be confirmed in an assessment report by a member of a professional order. The professional's assessment report must describe the nature and seriousness of the disorder and its consequences from a school, family and social standpoint, as well as the child's abilities and disabilities and the professional's observations.

Exclusions

A child who presents with an attention deficit disorder with or without hyperactivity and whose symptoms are controlled through medication is not presumed to be handicapped due to a serious behavioural disorder.

The following documents are required for a child with an impairment related to behavioural disorders.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • School Achievement Report (page 7 of the Parent's part of the form) to be filled out by a school or daycare official
  • A detailed list of all medications that have been prescribed by a physician (including prescription renewals). The prescriptions must have been filled at a pharmacy.
  • Results of the most recent assessment in neuropsychology, child psychiatry, psychology or psychoeducation, if the child has been assessed
  • Copy of medical follow-up notes in the last 12 months concerning the behavioural disorders.

Autism spectrum disorder (ASD)

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Ministère des Finances' Information Bulletin 2016-9 This link will open in a new window.:

A child is presumed to be handicapped in the following cases:

  1. the child is at least 2 years of age, has been diagnosed with autism spectrum disorder and presents with at least 4 of the following characteristics:
    • does not use gestures to communicate,
    • does not show interest in others,
    • does not respond to social smiles, even with people he or she knows,
    • does not have fun with others, even with people he or she knows,
    • does not share interests with others by showing or bringing objects,
    • does not pay attention to an object pointed to by another person,
    • does not respond verbally or non-verbally to verbal messages,
    • does not imitate the behaviour of others
    • does not engage in functional play;
  2. the child is at least 3 years of age, has been diagnosed with autism spectrum disorder and is non-verbal;
  3. the child is at least 3 years of age and less than 6 years of age, has been diagnosed with autism spectrum disorder and meets at least 2 of the following criteria:
    • his or her global IQ or the score on a scale assessing the child's level of cognitive development is at least 1.5 standard deviations below average,
    • the global result on a test of the child's gross and fine motor skills is at least 1.5 standard deviations below average,
    • the scores on all receptive language tests are at least 1.5 standard deviations below average;
  4. the child is at least 5 years of age, has been diagnosed with autism spectrum disorder and his or her global IQ is in the 5th percentile or below, for a confidence interval of 95%;
  5. the child is at least 4 years of age, has been diagnosed with autism spectrum disorder and, despite the implementation of therapeutic measures recommended by members of a professional order:
    • has temper tantrums in his or her various living environments, the frequency, duration and intensity of which are high and significantly exceed the norm for the child's stage of development, or
    • displays physical aggression toward himself or herself, or others, in his or her various living environments, the frequency and intensity of which are high and significantly exceed the norm for the child's stage of development.

Assessment parameters

An assessment that results in a diagnosis of autism spectrum disorder must be conducted when the child is at least 2 years of age. The disorder must be confirmed in an assessment report by a member of a professional order.

The professional's assessment report must describe the child's abilities and disabilities, present the professional's observations and, where applicable, enable Retraite Québec to rule on the validity of the results obtained.

For the purpose of analysis of a case set forth in paragraph (a), information on communication and social interaction must be corroborated by more than one source, such as by observations of the parents and childcare workers or school social workers presented in the professionals' assessment reports, and by those of professionals during their interactions with the child.

For the purpose of analysis of a case set forth in paragraph (c), assessments must be conducted by a member of a professional order, through recognized standardized tests and in accordance with applicable standards of practice, when the child is at least 3 years of age and less than 6 years of age, and the professional's assessment report must enable Retraite Québec to rule on the validity of the results obtained.

For the purpose of analysis of a case set forth in paragraph (d), an assessment must be conducted by a member of a professional order, through recognized standardized tests and in accordance with applicable standards of practice, when the child is at least 5 years of age, and the professional's assessment report must enable Retraite Québec to rule on the validity of the results obtained.

For the purpose of analysis of a case set forth in paragraph (e), information on the nature, intensity, duration and frequency of the disruptive behaviour must be corroborated by more than one source, such as by observations of the parents and childcare workers or school social workers presented in the professionals' assessment reports and progress notes, and by intervention plans at a daycare, school or rehabilitation centre.

Exclusion

In the cases set forth in paragraphs (c) and (d), a child who was not exposed on a sustained basis, for a period of at least 2 years, to the language used in the assessment tests is not presumed to be handicapped due to autism spectrum disorder. In this respect, a child will be considered to be exposed on a sustained basis to the language used in a test if, for at least 40% of his or her waking hours, the child interacts with a person who is proficient in that language.

The following documents are required for a child with an autism spectrum disorder.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • School Achievement Report (page 7 of the Parent's part of the form) to be filled out by a school or daycare official
  • Complete assessment report that led to the diagnosis of an autism spectrum disorder
  • Depending on the specialists seen, the most recent results of an assessment by a psychologist, neuropsychologist , child psychiatrist, speech therapist, occupational therapist or physiotherapist.

Language disorders

A child whose condition corresponds to cases indicated below is considered handicapped. If the child's condition does not correspond to cases indicated below, his or her eligibility is determined on the basis of the severity of his or her limitations with regard to life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the factors in the child's environment that facilitate or inhibit the child when accomplishing life habits.

Excerpt from the Ministère des Finances' Information Bulletin 2016-9 This link will open in a new window.:

A child is presumed to be handicapped in the following cases:

  1. the child is at least 2 years of age and does not have at least 4 of the following pre-language skills:
    • joint attention,
    • motor imitation,
    • verbal imitation,
    • use of gestures to communicate,
    • turn-taking in conversation;
  2. the child is at least 3 years of age and, in various situations, expresses himself or herself using isolated words, and it has been shown that the child does not understand simple questions like "who," "what" and "where" in relation to familiar objects or persons present in the immediate environment;
  3. the child is at least 3 years of age and presents with a persistent inability to pronounce words of 2 different syllables;
  4. the child is at least 4 years of age and less than 6 years of age, the scores on formal assessment tests are corroborated by a qualitative analysis of his or her day-to-day language skills and:
    • with respect to receptive language, the child obtains scores equal to or below the 5th percentile on at least 3 tests standardized for the child's population group, and obtains no scores above the 5th percentile on any other test; or
    • with respect to expressive language, at least two of the following language components are impaired:
      • regarding vocabulary, the child obtains scores equal to or below the 5th percentile on at least one test standardized for the child's population group,
      • regarding production of sounds, the child persistently makes a wide range of mistakes that are frequent and unusual for his or her age, making the child's speech unintelligible most of the time,
      • regarding sentence structure, the child's sentences are ungrammatical and no more than 3 or 4 words long;
  5. the child is at least 6 years of age, the scores on formal assessment tests are corroborated by a qualitative analysis of his or her day-to-day language skills and:
    • with respect to receptive language, the child obtains scores equal to or below the 5th percentile on at least 3 tests standardized for the child's population group, and obtains no scores above the 5th percentile on any other test; or
    • with respect to expressive language, at least 2 of the following language components are impaired:
      • regarding vocabulary, the child obtains scores equal to or below the 5th percentile on at least one test standardized for the child's population group,
      • regarding production of sounds, the child persistently makes a wide range of mistakes that are frequent and unusual for his or her age, making the child's speech unintelligible most of the time,
      • regarding sentence structure, the child uses simple syntactic structures, mostly without grammatical markers, and cannot use complex syntactic structures;
  6. the child is at least 9 years of age and less than 15 years of age, and his or her oral or written language disorder delays his or her acquisition of reading and mathematics skills, with the result that they are below those of a child two-thirds his or her age;
  7. the child is at least 15 years of age, and his or her oral or written language disorder delays his or her acquisition of reading and mathematics skills, which are no longer progressing beyond the second cycle of elementary school despite the child's still being in school.

Assessment parameters

A language disorder must be assessed by a speech therapist, in accordance with the applicable standards of practice.

A speech therapist's report for a particular case must describe the child's language skills for a period that may not precede the time the child reaches the minimum age provided for in regard to that case. It must also describe interpreted data of the assessment of communication, speech and all components of receptive and expressive language. This analysis must be corroborated by more than one document, such as by intervention plans at a daycare, school or rehabilitation centre.

In the cases set forth in paragraphs (d) and (e), the 3 formal tests referred to respecting receptive language must demonstrate different aspects of comprehension. In this regard, a subtest that demonstrates a specific aspect of comprehension may count as a test.

In the case of children exposed to more than one language, the attending speech therapist interprets the language data for the child, taking explicit account of the multilingual context, and the following information must be on file:

  • mother tongue or tongues, language or languages spoken at home and dominant language or languages;
  • the age of exposure, and the duration and percentage of exposure, to each of the languages.

Exclusion

A child who is assessed in a single language he or she is learning is not presumed to be handicapped due to a language disorder, unless the child was exposed to that language on a sustained basis for a period of at least 2 years. In this regard, a child will be considered to be have been exposed on a sustained basis to the language he or she is learning if, for at least 40% of his or her waking hours, the child interacts with a person who is proficient in that language.

The following documents are required for a child with an impairment related to language disorders.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • School Achievement Report (page 7 of the Parent's part of the form) to be filled out by a school or daycare official
  • Complete results of a recent speech-language assessment, including the case history
  • Speech-language progress notes, if any
  • Most recent individual education plan, if any
  • Most recent report card, if any.

Psychopathologic disorders

The child's condition is assessed basis of the severity of his or her limitations in carrying out life habits for a period expected to last for at least one year. The analysis of the child's limitations takes into account the disabilities resulting from the impairment or the mental function disability, as well as the environmental factors as facilitators of, and obstacles to, the performance of life habits.

The following documents are required for a child with a psychopathologic disorder.

Documents to be provided by the parent

  • The Application for the Supplement for Handicapped Children
  • School Achievement Report (page 7 of the Parent's part of the form) to be filled out by a school or daycare official
  • A detailed list of all medications that have been prescribed by a physician (including prescription renewals). The prescriptions must have been filled at a pharmacy.
  • Results of the most recent evaluation by a child psychiatrist or psychologist, if the child has been assessed
  • Copy of the medical follow-up notes for the last 12 months related to the psychopathologic disorder.

Other useful information

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