Children with intellectual disability in rural South Africa: prevalence and associated disability

Abstract

The objective of the present study was to determine the prevalence of intellectual disability (ID) and its associated disabilities in rural South African children aged 2-9 years. It was undertaken in eight villages in the district of Bushbuckridge, Northern Province, South Africa. A two-phase design was utilized. The first phase involved screening children on a house-to-house basis by interviewing mothers or caregivers using an internationally validated questionnaire for detecting childhood disability in developing countries. The second phase consisted of a paediatric/neurodevelopmental assessment of the children who screened positive. A total of 6692 children were screened; 722 (10.8%) had a paediatric evaluation and 238 children were diagnosed with ID, giving a minimum observed prevalence of 35.6 per 1000 children in this population. The prevalence of severe and mild ID was 0.64 per 1000 and 29.1 per 1000 children, respectively. The male:female ratio of children with ID was 3:2. In the affected children, a congenital aetiology for the ID was determined in 49 subjects (20.6%), an acquired aetiology in 15 (6.3%) and the aetiology was undetermined in 174 children (73.1%). Epilepsy (15.5%) and cerebral palsy (8.4%) were the commonest associated disabilities. The present study represents the first data on the prevalence of ID and associated disabilities in rural South African children. The prevalence of ID was comparable with results from a study performed in one other African country (Zambia) as well as those from other developing countries. The data provide an initial factual insight into ID and its associated disabilities for healthcare, social service and educational policy planners. This study provides a basis for the initiation and development of appropriate and integrated services for the best possible care of individuals affected with these disabilities, and for their possible prevention.

Professionals’ Perceptions about the Need for Pain Management Interventions for Children with Cerebral Palsy in South African School Settings

“…The neurological disorder occurs in 8.4% of children with intellectual disabilities (Christianson et al, 2002). In attempts to correct and rehabilitate orthopedic problems, such as hip dislocations, children with CP often undergo surgical and medical procedures and interventions that may alleviate frequent pain in the long run (Engel & Kartin, 2006;Ramstad, Jahnsen, Skjeldal, & Diseth, 2011).…”

He Lived Experiences of Black African Mothers Following the Birth of a Child With Down Syndrome: Implications for Indigenisation of Social Work

“…There is a stigma attached to giving birth to a child with congenital malformation or mental retardation as found in DS among African families (Boswell & Wingrove, 1974, Christianson, Zwane, Manga, Rosen, Venter, Downs & Kromberg, 2002180; Department of Social Development, Department of Women, Children and People with Disabilities and the United Nations Children 's Fund, 2012;Rosenkranz, 2004). In African families such a birth is widely viewed as a curse by the ancestors for some form of misdeed either by the parents or by the family as a whole (Christianson et al, 2002).…”

“…In African families such a birth is widely viewed as a curse by the ancestors for some form of misdeed either by the parents or by the family as a whole (Christianson et al, 2002). Anecdotal incidents have been reported of gross neglect and abuse of children with DS or any other condition involving intellectual disabilities (Rosenkranz, 2004).…”

“…Cowles (2003) further emphasises the fact that a diagnosis of DS made prenatally or shortly after birth makes it a sensitive issue to handle. The fact that there is a stigma attached to giving birth to a child with congenital malformation and mental retardation as found in DS among African families (Boswell & Wingrove, 1974;Christianson et al, 2002:180; Department of Social Development, Department of Women, Children and People with Disabilities and the United Nations Children's Fund, 2012; Rosenkranz, 2004) is a further reason for the disclosure of the diagnosis of DS to be handled with care. As a result, the Department of Health (2001) created a platform through its policy guidelines for interdisciplinary collaboration and cooperation undergirded by a desire to achieve a holistic approach in total patient care.…”

“…These needs include early developmental enrichment programmes, including physiotherapy and speech therapy; special education; medical treatment for recurrent respiratory infections and other medical complications (Christianson et al, 2002). These needs add to an already difficult socio-economic state of extreme poverty with little or no access to basic health services, social facilities and infrastructure (Pillay, 2001).…”