The efficacy of the current instrument to assess the social assistance needs of children with chronic health conditions in South Africa is questioned. To develop an improved assessment instrument for South African use, this instrument was pitted against two international social assistance assessment instruments, the United Kingdom (UK) Disability Living Allowance (DLA) and the Australian Child Disability Assessment Tool (CDAT). A purposive sample of 18 children representing six types of disability and chronic illnesses was selected, and all three assessment instruments were used to assess the needs of these children. A juxtaposition of the outcomes of the assessment instruments revealed significant differences. The South African instrument deemed the majority (56%) of the sample ineligible for assistance. On the contrary, significant majorities were deemed eligible for assistance in terms of the U.K. (94%) and Australian (89%) instruments. The study recommended that a holistic approach to need assessment be adopted in the design of a more appropriate assessment instrument for South African use.