1

Disability among children: a statistical perspective

Howard Meltzer

Health and Care Division Office for National Statistics, London, UK

Washington Group on Disability Statistics

4th meetingBangkok, Thailand

September 29 – October 1, 2004

2

Definition of children

• Age (minimum and maximum)

• Kinship relationships– birth parents– step children– foster children

• Usual place of residence

3

Definition of disability for children Questions addressed to adults are

inappropriate (e.g. ADL, behavioural problems) What is normal for a particular age is an

essential part of assessing disability (walking, running, speaking, co-ordination)

General delay versus functional delay: both poorly recognised by parents

Functional limitations, dependence on compensatory mechanisms, specialised services.

Focus on impairments due to the difficulty in operationalising functional limitations.

4

ICF for Children and Youth (ICFCY)

• Clinical utility of the ICFCY is being tested at the moment.

• Participants with access to clinical populations are completing questionnaires for children in four age groups:– 0-2

– 3-6

– 7-12

– 13-18

• These can be used as a framework for developing instruments for epidemiological research.

5

What is the purpose of collecting disability data for children

• Service provision and resource allocation– Unmet need– Less well-developed services for children– 16-17 year olds least well served

• Equalisation of opportunity– schooling– employment

• Health monitoring of the total population

6

How are children dealt with in censuses and surveys?

Census which include all children (from birth) which include children from a certain age.

Surveys which ask questions about all household members

including children which ask questions about all household members

including children from a certain age.

Separate surveys of children. Choice of procedure depends on the country’s statistical

infrastructure, the resources available for data collection and the political will to make data collection a priority.

7

Sampling children for national surveys

• Sampling school records

• Screening the population (enumeration or by mail)

• Using centralised records - health or benefits

• Piggy-backing on other surveys

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Ethical issues in surveying children

• Participation of children – capability– confidentiality– privacy

• Severely disabled children – appropriateness of questions– distress to parents

• Child abuse • Suicidal thoughts

9

Disability among children: a statistical perspective

Howard Meltzer

Health and Care Division Office for National Statistics, London, UK

Washington Group on Disability Statistics

4th meetingBangkok, Thailand

September 29 – October 1, 2004