State of the World's Children 2013 - Unicef

FOCUS
From screening
to assessment
Child disability measurement
experts agree that screening
efforts, such as interviews
using the Ten Questions Screen
(TQ), need to be followed by
in-depth assessments. These
allow the initial screening
results to be validated, and
make possible a better understanding
of the extent and
nature of child disability in a
country. Cambodia, Bhutan and
the former Yugoslav Republic
of Macedonia are three countries
to have undertaken such
assessments. Their experiences
provide important lessons for
the measurement of child disability
and adaptation of methodology
to local context. They
also testify to the transformative
power of data collection.
In Cambodia, all children
who screened positive under
the Ten Questions and a randomly
selected 10 per cent
who screened negative were
referred for further assessment
by a multi-professional
team consisting of doctors,
hearing and vision specialists,
and psychologists. The team
was trained and dispatched
around the country to conduct
child disability assessments in
local health centres and similar
facilities. The decision to use
a mobile team of specialists
was made to ensure consistent
quality of screening across the
country and to minimize the
lag between screening and
assessment.
The same sampling approach
was employed in Bhutan,
where the screening stage
identified 3,500 children at risk,
out of a sample of 11,370 children.
A core team of seven professionals
received two weeks
of training in how to conduct
the assessment. In turn, they
were responsible for training
another 120 health and education
professionals. These professionals
were then split into
two groups. The first consisted
of 30 supervisors recruited
from among general-practice
physicians, paediatricians, eye
specialists, physiotherapists
and special educators. The second
group of 90 field surveyors
and assessors was made
up largely of primary school
teachers and health workers.
The methodology used in the
former Yugoslav Republic of
Macedonia was derived from
that used in Cambodia, with
some adaptations shaped by
the technical expertise and
tools available in the local
context. Two studies were
conducted: a national study
and one focusing on the Roma
population. The assessment
consisted of one hour with a
physician and psychologist and
a 10–15 minute assessment
with an ophthalmologist and
audiologist.
Experiences in all three
countries demonstrate the
importance of partnerships in
mobilizing limited resources
and ensuring high response
rates, which in turn provide for
robust findings. These partnerships
involved government
agencies and their international
partners, disabled people’s
organizations and other civil
society organizations. In the
former Yugoslav Republic
of Macedonia, for example,
partners made it possible
to conduct assessments in
local kindergartens during
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THE STATE OF THE WORLD’S CHILDREN 2013: Children with Disabilities