6.

MODIFICATIONS FOR ATHLETES WITH DISABILITIES

Athletes with disabilities differ significantly in the degree of their disabilities that may range from
mild to severe. The DCO will need to understand the special needsofathletes with disabilities during
asample collection session and make any modification to the notification or sample collection
procedures.Modifications made must not compromise the integrity, security or identity of the
samples, and any modification should be authorised by the athlete and/or athlete representative.

The Sample Collection Authority (SCA) has the responsibility in ensuring that the DCOs have
sufficient information and samplecollection equipment necessary to conduct a sample collection
session with an athletewith disability.

6.1 GeneralRequirements and Modifications

6.1.1 When planning for a sample collection test, the SCAshall inform the DCOs on any sample
collection for athletes with disabilities that may require modifications to the standard
procedures for notification or sample collection procedures, including sample collection
equipment and facilities.

6.1.2 All aspects of notification and sample collection for athletes with disabilities shall be carried
out in accordance with the standard notification and sample collection procedures unless
modifications are necessary due to the athlete’s disability.

6.1.3 Athletes with disabilities should be treated like able-bodied athletes. Assistance may be
rendered when requested, but DCOs should not feel obligated to act as carers for the
athletes. Athletes are strongly encouraged to have anathlete representativewith them.

6.1.4 A DCO should be open and honest with the athlete. If the DCO is unsure of the athlete’s
disability, ask the athlete so that the sample collection session could be managed
appropriately.

6.1.5 DCOs should explain to the athletes and their representatives the witnessing procedure,
processing procedures, and modifications made.

6.1.6 All modifications must be documented.Any modifications made for an athlete should be
noted on the “DCO’s comments” section (Box 32) of the Doping Control Form(DCF) or ona
Supplementary Report Form.

6.1.7 The SCA and the DCO have the authority to make modifications as the situation requires.
Such modifications shouldnot compromise the identity, security or integrity of the samples.

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 (A) If the athlete is unable to write, handle the Sample Collection Vessel (SCV), carry the
sample, pour the sample into A and B bottles, or seal the A and B bottles, the athlete
representativemay perform these tasks on behalf of the athlete with his/her
permission.

(B) If the athlete does not have a representative at the sample collection session, the DCO
or chaperone may perform these tasks on behalf of the athlete with the athlete’s
permission.

a. In all cases requiring assistance, the athlete representative, DCO or chaperone shall
wear protective gloves while handling the sample, exercising caution not to allow
the gloves come into direct contact with the sample or interior of the SCV.

(C) Alternative sample collection equipment (such as a bigger SCV) or facility can be used as
required to enable the athlete to provide the sample.

6.1.8 When testing an athlete with a disability, the complete name of the sport should be written
in the “Sport and Discipline” (Box 20) section on the Doping Control Form (e.g. Paralympic
Cycling, Wheelchair Rugby, etc.).The name of the sport may be indicated on the mission
order.

6.1.9 Modifications to the urine sample collection procedure will be required for athletes who
have:

(A) Restricted mobility or coordination that prevents application of the standard sample
collection procedure;
(B) Visual impairment;
(C) Neurological or developmental disabilities; or
(D) A catheter or condom device to allow urine production.

Note: The athlete may authorise his/her athlete representative to accompany him/her into the toilet
area to observe the DCO when providing his/her sample. The athlete representative may not view the
passing of the athlete's sample unless authorised to do so by the athlete. In all cases, however, the
DCO must directly observe the passing of the sample.

6.1.10 When collecting blood samples from athletes, the BCO, in consultation with the athlete,
shalldetermine the most appropriate site for venipuncture, especially if the athlete is an
amputee or multiple-amputee.

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6.2 Modifications Based OnDisability Categories

6.2.1 Amputees
(A) The ankle is the next preferred site for venipuncture for athletes with both arms
amputated.

(B) Athletes with both arms amputated may need help to sign theDoping Control Form, and
also during the sample provision and sealing. They may have a representative present at
all times.

6.2.2 Athletes in Wheelchairs

(A) Quadriplegics (or tetraplegic) may require assistance to sign the notification form and
will require a representative at the DCS.

(B) Athletes unable to walk may require the use of a catheter. However, some athletes may
be able to provide samples normally (e.g. stand and use a urinal) and do not require the
use of a catheter.

6.2.3 Hearing impairment

(A) When speaking to athletes with hearing impairment, the DCO should face the athlete
and speak in a slow and clear manner so that the latter can lip-read.

(B) If necessary a third party should be notified to relay the message in sign language.

6.2.4 Intellectual Disability

(A) An athlete with an intellectual disability that has been selected for sample collection
must be notified in the presence of their representatives. There should be a
representative representing the athlete throughout the procedure and fill up Box 33
(Athlete’s representative) and 39 (Athlete’s Signature) of the Doping Control Form.

(B) The DCO should speak simply and clearly to the athlete so that they can understand the
procedure involved in providing a sample.

6.2.5 Cerebral Palsy and Acquired Brain Injury

(A) Athletes with cerebral palsy (CP) or an acquired brain injury do not have an intellectual
disability. Within this disability, athletes may range from being totally independent to
totally dependent on assistance from their carer.

(B) Although athletes with CP may appear to have severe physical disabilities, including the
absence of coherent speech, the DCO/chaperone should not underestimate the
intelligence of the athletes as the brain is usually unaffected by this condition.

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 (C) If there is difficulty communicating with these athletes, DCOs should ask the carers to
interpret as they should be able to interpret what their athletes are saying.

6.2.6 Visual Impairment

(A) An athlete with a visual impairment should be accompanied at all times during the
sample collection session by an athlete representative, preferably of the athlete’s
choice.

(B) When addressing a visually-impaired, the DCO should speak to the athlete directly and
not to his/her representative.

(C) A DCO should ask if the athlete requires any assistance with the test (e.g. to sign the
notification form). If assistance isrequired,the DCO or the athlete representative may
need to place the pen in his/her hand and guide his/her hand to the correct place on
the form.

(D) The DCO/chaperone may not need to guide the athlete to the DCS as not all visually-
impaired athletes are totally blind.

(E) It is necessary for visually-impaired athletes to be accompanied by a representative

throughout the sample collectionsession. Subject to permission by the athlete, the
representative may have to be present in the sample collection area and witness the
provision of the sample.

(F) The athlete should be given the opportunity to inspect all selected equipment through
touch. The athlete may, however, request their representatives to inspect the
equipment and verify certain aspects of the procedure that require visual
confirmation(e.g.matching of sample code on bottle A and B to that on the box of
Sample Collection Kit).

(G) The DCO and/or athlete representative should read key statements from the DCF to the
athlete so that he/she fully understands the requirements of the sample collection
session.

6.2.7 Les autres

Les autres is French for 'the others'. It is a term used to describe athletes with a range of
conditions which result in locomotive disorders - such as dwarfism, multiple sclerosis and
congenital deformities of the limbs - that do not fit into the traditional classification systems
of the established disability groups. DCOs must use their discretion and make modifications
as required in accordance with the condition of the athletes.

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6.3 Athleteswith Drainage Systems

6.3.1 Athletes who are using urine collection or drainage systems should choose one of the
following means to provide their samples:

(A) If indwelling catheter or condom drainage is used, the athlete should ideally replace it
with a new and unused catheter or drainage system. The urine collected in this new bag
will be drained into the SCV as the sample to be processed.

(B) If replacing/disconnecting the bag already in use is difficult due to the type of catheter
used, the existing bag must be fully emptied toallow fresh urine to be collected. The
fresh urine collected in the bag will be drained into the SCV to be processed.

i. Elimination of existing urine from a collection / drainage system should be

conducted as soon as possible following the athlete’s notification of his/her
selection for doping control test. This elimination must be done under the
DCO/chaperone’s direct observation.

(C) The sample may also be taken directly from the catheter into the SCV. The athlete or
representative, under the athlete's instruction, may temporarily clamp off the catheter
to the leg bag.

6.3.2 Additional equipment may or may not be provided during thesample collection session.

(A) Athletes should preferably use their own catheter or leg bag.Both the catheter or leg
bag should be checked by the DCO to ensure that it is connected to the athlete’s body
and that the urine sample is from theathlete.

(B) Any existing urine in the leg bag will have to be drained off prior to the provision of
urinesample. When sufficient urine has been collected, the DCO has to instruct the
athlete to decant it into a selected SCV.

(C) The athlete must be advised to use a clean sterile catheter if possible. It is their
responsibility if they choose to reuse a non-sterile catheter and to ensure the
cleanliness of the system. If the catheter is being reused, the DCO must visually inspect
to ensure it contains negligible urine, and record the details in the“DCO’s comments”
section (Box 32) on theDCF.

(D) When new equipment is used, the DCO must visually inspect and ensure that it does not
affect the integrity of the sample.

(E) If the athlete has used any product to sterilise his/her leg bag, it should be declared in
the“Medicaldeclaration”section (Box 29)on the DCF. The DCO should also advise the
athlete that such product used is not likely to affect the analytical results of the sample.

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 (F) Use of catheters and leg bags during sample collection must be documented in the
“DCO’s comments” section (Box 32) of the DCF.

Reference ToAnnexes

Annex 9F – Doping Control Form User Guide

Annex 9G – Supplementary Report Form User Guide

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