Disabilities in Early Childhood: A Global Health Perspective

Abstract

Prior to the launch of the United Nations Sustainable Development Goals (SDGs) in 2015, childhood disability was rarely considered an important subject in global health. The SDGs till 2030 now require that children under 5 years who are at risk of not benefitting from inclusive quality education are identified, monitored, and promptly supported. A new tool for identifying children who are not developmentally on track has been developed by UNICEF but has limited sensitivity for detecting children with disabilities due to reliance on parental assessment of child behavior in certain everyday situations. In this paper, we identified conditions that are commonly associated with developmental disabilities based on the International Classification of Diseases (ICD) codes and clarified the concept of “developmentally on track” as it relates to children with developmental disabilities and developmental delays. We summarized the latest evidence on the global burden of developmental disabilities in children under 5 years based on the diagnostic and functional approaches for measuring disabilities at the population level. We highlighted the global health context for addressing the needs of children with developmental disabilities and provided an overview of the opportunities and the role of pediatric caregivers in supporting children with developmental disabilities.

Early Childhood Development Is Not Enough: In Defense of Children with Developmental Delays and Disabilities and Their Right to Family-Centered Early Childhood Intervention (In the Global South)

“…Additionally, the research and early childhood community have consistently included the "next 1000 days" of the two-to five-year-olds as just as critical [18]. In this paper, early childhood will be classified as the first five years of life, the period of life in which 90% of the child's brain develops [10]. Shonkoff [19] argues that the "brain science story" makes for undeniable evidence for the case for investment in these critical early years.…”

“…In line with understanding this childhood disability, the global burden of disease estimates suggest that nearly 53 million children under the age of five have developmental disabilities [5] encompassing conditions such as epilepsy, intellectual disability, autism spectrum disorder, and attention deficit/hyperactivity disorder. Alarmingly, 95% of these young children are reported to reside in low-and middle-income countries (LMICs) [10].…”

“…This population of children with disabilities below the age of five years is estimated to be 49.8 million, and Sub-Saharan Africa and South Asia account for more than half of the children with disabilities [8,9]. Identified as "the most vulnerable population" within the global health and early childhood landscape [10], children with developmental disabilities remain largely invisible on the global stage [11,12] with little progress towards prioritizing their needs in global early childhood development initiatives [13,14]. The next section will briefly define the field of Early Childhood followed by descriptions of the key concepts, including early childhood development, early childhood intervention, and, finally, family-centered early childhood intervention.…”

Early childhood development strategy for the world’s children with disabilities

“…Globally, over 50 million children under-5 have mild-to-severe disabilities predominantly in low- and middle-income countries (LMICs), with 30 million having moderate-to-severe disabilities ( 4 , 5 ). Childhood disabilities are diverse in nature, type and severity and are associated with functional difficulties typically from hearing impairment, visual impairment, deaf-blindness, speech and language disorders, intellectual disability, learning disabilities, autism spectrum disorder, attention-deficit/hyperactivity disorder, epilepsy, cerebral palsy, muscular dystrophies, spina bifida or multiple disorders that require wide-ranging support services ( 6 ). The disproportionate disadvantages faced by children with disabilities compared to children without disabilities, including higher risk of morbidity, premature death, lower rates of school enrolment and completion, and social exclusion are widely reported ( 4 , 7 , 8 ).…”

Presentation_1.pdf

“…Globally, over 50 million children under-5 have mild-to-severe disabilities predominantly in low-and middle-income countries (LMICs), with 30 million having moderate-to-severe disabilities (4,5). Childhood disabilities are diverse in nature, type and severity and are associated with functional difficulties typically from hearing impairment, visual impairment, deaf-blindness, speech and language disorders, intellectual disability, learning disabilities, autism spectrum disorder, attentiondeficit/hyperactivity disorder, epilepsy, cerebral palsy, muscular dystrophies, spina bifida or multiple disorders that require wideranging support services (6). The disproportionate disadvantages faced by children with disabilities compared to children without disabilities, including higher risk of morbidity, premature death, lower rates of school enrolment and completion, and social exclusion are widely reported (4,7,8).…”