OO213 - English Federation of Disability Sport

are particularly important. Developmentalscreening is an effective means of detecting disabilityin children. 56 It can take place in primaryhealth-caresettings, for example, during immunizationvisits or growth monitoring check-upsat community health centres. The purpose ofscreening is to identify children at risk, to referthem for further assessment and interventionas needed, and to provide family members withvital information on disability. Screening involvesvision and hearing examinations as well asassessments of children’s progress against suchdevelopmental milestones as sitting, standing,crawling, walking, talking or handling objects.Health-care systems in high-income countriesprovide numerous opportunities to identify andmanage developmental difficulties early in achild’s life. But interventions to improve youngchildren’s development are becoming increasinglyavailable in low- and middle-income countries.These include such interventions as treating irondeficiency, training caregivers and providingcommunity-based rehabilitation. 57Recent studies in high- and low-income countrieshave shown that up to 70 per cent of childrenand adults newly diagnosed with epilepsycan be successfully treated (i.e., their seizurescompletely controlled) with anti-epileptic drugs.After two to five years of successful treatment,drugs can be withdrawn without danger ofrelapse in about 70 per cent of children and60 per cent of adults. However, approximatelythree quarters of people with epilepsy in lowincomecountries do not get the treatmentthey need. 58 The treatments exist – efficientdissemination is often lacking.The detection and treatment of impairments isnot a separate area of medicine but an integralaspect of public health. Nevertheless, policymakersand researchers typically characterize thesemeasures as being in competition for resourceswith measures to promote the health of peoplewithout disabilities. 59 This merely serves toperpetuate discrimination and inequity.Children with disabilities who overcome thediscrimination and other obstacles that standbetween them and health care may yet find thatthe services they access are of poor quality.Children’s feedback should be invited so facilitiesand services can be improved to meet theirneeds. In addition, health workers and other professionalsdealing with children stand to benefitfrom being educated about the multiple issuesof child development and child disability andfrom being trained to deliver integrated services– where possible, with the participation of theextended family. International cooperation canplay an important role in efforts to make higherqualityservices available to children identified ashaving or at risk of developing disabilities, and inchanging the competitive approach to allocatingresources described in the preceding paragraph.Inclusive educationEducation is the gateway to full participationin society. It is particularly important for childrenwith disabilities, who are often excluded.Many of the benefits of going to school accrueover the long run – securing a livelihood inadult life, for example – but some are almostimmediately evident. Taking part at school is animportant way for children with disabilities tocorrect misconceptions that prevent inclusion.And when these children are able to attendschool, parents and caregivers are able to findtime for other activities including earning aliving and resting.In principle, all children have the same right toeducation. In practice, children with disabilitiesare disproportionately denied this right. In consequence,their ability to enjoy the full rightsof citizenship and take up valued roles in society– chiefly, through gainful employment – isundermined.Household survey data from 13 low- and middleincomecountries show that children with disabilitiesaged 6–17 years are significantly lesslikely to be enrolled in school than peers withoutA STRONG FOUNDATION27