Sonja Mensch

12 Chapter 1 2009) (Mergler et al., 2016), dysphagia (Calis et al., 2008), gastro-oesophageal reflux (Bohmer et al., 1999), nutritional state (Rieken, Calis, Tibboel, Evenhuis, & Penning., 2010), sensory problems (Evenhuis, Theunissen, Denkers, Verschuure, & Kemme., 2001), constipation (Veugelers et al., 2010), respiratory problems (Proesmans et al., 2015) (Seddon & Khan., 2003) (Veugelers et al., 2005), scoliosis (Halawi, Lark, & Fitch., 2015) and epilepsy (Dannenberg, Mengoni, Gates, & Durand., 2016). Prevalence and care The large majority of Dutch children with intellectual disabilities live with their parents and visit regular or special schools. For those who are not able to attend a school, there is a network of specialised day-care centres. Reasons for admission might be severe behavioural problems, autism spectrum disorders, or severe or profound intellectual disabilities combined with sensory and health problems. In the day-care centres children with SMD are a small but significant subgroup. The prevalence of persons with intellectual disabilities is based on estimations; around 1% of the Dutch population has an intellectual disability of whom 68,000 have a severe intellectual disability (Rijksinstituut voor Volksgezondheid en Milieu (RIVM)., 2013). An inventory by the Dutch Health Care Inspectorate in 2000 showed that of the 2016 children with SMD aged under 18 receiving formal care, 1336 visited day-care centres and 680 lived in residential care (Health Care Inspectorate., 2000). The report also provided information on staffing of specialised day-care centres for this group, showing that in all centres behavioural therapists, intellectual disability physicians, physiotherapists and speech and hearing therapists were employed. In a number of centres occupational therapists and dieticians were active, which reflects the extensive motor and other neurological problems of these children. Almost 90% of the children visiting day-care centres receive physiotherapy (Health Care Inspectorate., 2000). Paediatric physiotherapy and motor abilities in the context of the ICF-CY The paediatric physiotherapist uses the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) (World Health Organization., 2008) in the context of clinical reasoning, policy, documentation and reporting, mono-and interdisciplinary communication, development of guidelines, research and education (Steiner et al. 2002). The ICF-CY is a classification that describes functioning of children and youth in detail from different perspectives, and distinguishes the levels of ‘body functions and anatomical characteristics’, ‘activities’ and ‘participation’. ICF-CY also contains external factors, the immediate and wider environment of a child. An illustration of the ICF with SMD as example of a health condition is given in figure 1 (World Health Organization., 2008).