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Spinal Cord Injury Disability Snapshot
This Disability Snapshot provides general information about Spinal Cord Injury to assist you in communicating effectively and supporting the participant in developing their goals. Each person is an individual and will have their own needs, preferences and experiences. This information has been prepared for NDIA staff and partners and is not intended for external distribution.
Peak body consulted
In developing this resource we consulted with Spinal Cord Injuries Australia.
What is Spinal Cord Injury?
Spinal Cord Injury (SCI) occurs as a result of trauma or catastrophic injury such as a fall or car accident, or from a medical condition such as a stroke or other spine conditions. The impacts of an injury will depend on where it occurs on the spine. Generally, the higher the injury level on the spine, the greater the functional impairment. The types of SCI are:
Quadriplegia or Tetraplegia which is motor or sensory impairment of all four limbs
caused by SCI above the first thoracic vertebrae in the cervical spine. Paraplegia which is impairment in motor or sensory function of lower extremities
caused by SCI below the seventh cervical vertebrae in the thoracic, lumbar or sacral
spine.
Each injury is either complete, with no movement or sensation below the level of injury, or incomplete which means there is some sensation and/or movement below the injury level.
As a result of SCI, an individual may experience the following:
bowel or bladder dysfunction skin issues such as pressure areas or skin breakdown because of mobility difficulty regulating body temperature and increased likelihood of hypothermia
(dangerously low) sexual dysfunction autonomic dysreflexia (overactivity of the autonomic nervous system), commonly
caused by bladder, bowel or skin irritation, which can lead to seizures, stroke or
death if not managed immediately and correctly.
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How is Spinal Cord Injury diagnosed?
SCI is an acquired disability diagnosed by a neurosurgeon or spinal physician using the American Spinal Injury Association classification for motor and sensory impairment level. Spinal cord injuries lead to paralysis, which means that people will often spend many months in hospital in a specialist spinal injury unit for intervention and rehabilitation. Physiotherapists and occupational therapists may provide treatment and rehabilitation.
Language and terminology
When talking with a person with a spinal cord injury, you should focus on the person, not the impairment. Inclusive person first language should generally be used, but some people have their own preferences. Avoid negative language such as ‘wheelchair-bound’. A wheelchair is a mobility aid supporting independence; ‘wheelchair user’ is an appropriate term.
Enabling social and economic participation
As SCI is an acquired disability, it is likely a person’s routine and activities before their injury will have been severely disrupted. They may need time to come to terms with their disability and support to re-engage in social and economic participation. Some people with SCI may be able to continue with their role with some workplace adjustments. However if they cannot continue working in their pre-injury role, many others may need to develop or relearn skills, look for a different career or participate in vocational training to re-enter the workforce. You should consider these factors when discussing employment goals, and include employment related supports in the participant’s plan.
Social and community participation is important to build confidence and connect with people as the person with SCI adjusts to their new reality of impairment. The impact of the injury will vary for each person, so supports will need to be highly individualised.
Supports to enable the participant’s social and economic participation may include assistive technology (AT) such as:
manual and power wheelchairs and other mobility aids to help get around equipment to maintain good health and facilitate independence, such as electric
beds, pressure relieving mattresses and wheelchair cushions, and shower commode
chairs environmental control units that allow for controlling the home, including lights, doors
and electrical appliances speech recognition software for home, education and vocational needs.
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People with SCI may use consumables associated with incontinence. These items, and the daily regimes to manage bowel and bladder function, are important for ongoing social and economic participation.
Families and carers
SCI is a significant injury and it has a long-term impact on the individual and their family members. SCI will cause many individuals and their families to experience sudden and significant changes following the injury. It is important for the individual and their family to take some time to learn about the injury and adjust to the disability and changes in the individual’s life.
The role that family plays after an injury is different for everyone. This will depend on their age and how they balance formal and informal supports for assistance with daily living, personal care, and social and economic participation. It may take some time for the individual and their family members or carers to find supports and strategies to manage SCI.
Family members and carers may feel overwhelmed as they support the person with SCI, as well as balance other commitments such as work and the needs of other family members. It is important to offer support to the family during this time and offer strategies to balance informal and formal supports and give carers a break. This can be through funded supports to offer the participant independence from their family and provide respite to family members.
How can I tailor a meeting to suit a participant with Spinal Cord Injury?
When meeting with a person with SCI, always communicate directly with the individual, even if family members join them. Make sure the meeting is held in a place with accessible facilities and that you give the person plenty of time to make themselves comfortable.
A person with SCI is likely to engage with the NDIS soon after their injury. They may still be undergoing rehabilitation and adapting to life with their disability. They may not know what supports they need and how their condition will progress over time. You should be mindful of this when meeting them for the first time and deciding what supports to include in their first plan. Consider following up with them before finalising their plan to see how they are adjusting and if anything has changed, and whether any additional supports might be needed.
What people with Spinal Cord Injury want you to remember
SCI is an acquired disability which will require time to adjust to supports in a plan should empower the individual and focus on finding different ways
to engage in social and economic participation no two injuries are the same and each person should receive individualised support
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each person’s individuality and right of choice should be respected.
Helpful links
Spinal Cord Injuries Australia ParaQuad NSW Agency for Clinical Innovation - Spinal Cord Injury Resources Spinal Cord Injury Levels and Classification
Version control
Version Amended Brief Description of Change Status Date by
1.0 ZWECKM Initial Version APPROVED 2020-08-24
Class 3 Approved
2.0 BPP585 Minor edits following updates from peak body APPROVED 2020-09-08
Class 1 Approved
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