Children with Disabilities

26
such settings may vary depending on cultural and
geographical context, as well as by the type of
disability a child may have: A child with a physical
impairment may face significant difficulties in
using a hand pump or an outdoor latrine; a child
who is deaf or who has an intellectual disability
may have little physical difficulty but be vulnerable
to teasing or abuse, which can render these
facilities inaccessible.
Children with disabilities might not attend school
for want of an accessible toilet. Children with disabilities
often report that they try to drink and eat
less to cut down the number of times they need
to go to the toilet, especially if they have to ask
someone to help them. This adds to the risk that
these children will be poorly nourished. It is also
cause for concern that in some places, new water,
sanitation and hygiene (WASH) facilities are still
being designed and built without adequate concern
for children with disabilities. Low-tech, lowcost
interventions for persons with disabilities
Beatriz, a 10-year-old girl with cerebral palsy, blows soap
bubbles in Brazil. © Andre Castro/2012
THE STATE OF THE WORLD’S CHILDREN 2013: Children with Disabilities
are increasingly available – new step latrines
and easy-to-use water pumps, for example. This
information has yet to be widely disseminated
among WASH professionals or incorporated into
WASH policies and practice. 51
Sexual and reproductive health and
HIV/AIDS
Children and young people who live with a
physical, sensory, intellectual or psychosocial
disability have been almost entirely overlooked
in sexual and reproductive health and HIV/AIDS
programmes. They are often – and incorrectly –
believed to be sexually inactive, unlikely to use
drugs or alcohol, and at less risk of abuse, violence
or rape than their non-disabled peers, and
therefore to be at low risk of HIV infection. 52
In consequence, children and young people
who have disabilities are at increased risk of
becoming HIV-positive.
People with disabilities of all ages who are
HIV-positive are less likely to receive appropriate
services than peers without disabilities.
Treatment, testing and counselling centres are
very rarely adapted to their needs, and healthcare
personnel are seldom trained to deal with
children and adolescents with disabilities. 53
Many young people with disabilities do not
receive even basic information about how their
bodies develop and change. Structured education
about sexual and reproductive health and relationships
is seldom a part of the curriculum and
even where it is, children with disabilities may
be excluded. Many have been taught to be silent
and obedient and have no experience of setting
limits with others regarding physical contact. 54
The risk of abuse is thus increased, as illustrated
by a study in South Africa that suggests deaf
youth are at heightened risk of HIV infection. 55
Early detection and intervention
Children develop rapidly during the first three
years of life, so early detection and intervention