Children with special needs

The health and well-being of children is a vital component of a country’s future; the children of today are the economically productive population of the future. The young are often the vulnerable population susceptible to the turmoil in life and the societal challenges in many developing countries. The children with special needs are even more at risk; in many countries where resources and facilities are limited, the ability to provide for and optimize the potential of these children with disabilities can be even more critical.

Disability is thus not just a health problem. It is a complex phenomenon, reflecting the interaction between child, the society and the whole environment. Overcoming the difficulties faced by children with disabilities requires interventions to remove not only environmental but also personal and social barriers.

Children with disabilities have the same health needs as non-disabled people – for immunization, nutrition etc. They often also experience a narrower margin of health, both because of poverty and social exclusion, and also because they may be vulnerable to secondary conditions, such as chronic diseases and even face barriers in accessing the health and rehabilitation services they need in many settings.

It is therefore important to focus on the problems and the needs of these children at risk and identify the strategies to improve their health and well-being. As child health professionals and child health advocates, it is our responsibility to provide an equitable opportunity for these children with special needs to optimize their potential and help them (where possible) function as a contributory member of society.

Definition of ‘Children with Special Needs’:

• Collins English Dictionary: Children suffering from any of a wide range of physical disabilities, medical conditions, intellectual difficulties, or emotional problems, including deafness, blindness, dyslexia, learning difficulties, and behavioural problems.
• COBUILD Advanced British English Dictionary: People with special needs are people who need special help or care, for example because they have a disability.
• Webster dictionary: An individual with a disadvantaged background or a mental, emotional, or physical disability or a high risk of developing one
• WHO definition of disabilities: Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions.An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.

What we need to better understand:

• What are the features/indicators* that we can use to define /describe the children with special needs in our region?
• What are the key problems/barriers faced by the children with special needs (in each country) in our region?
• How can we as child-health professionals and advocates do to improve the lives and well-being of children with special needs?
• What are the top 5 priorities in each of the countries in the region that we can adopt/implement to improve the outcomes in children with special needs? Who are the key stakeholders and strategic effectors for these initiatives?
• What **parameters can we use to monitor the progress of interventions and initiatives to improve the health and well-being of children with special needs?

*Features /indicators to describe children with special needs

• Size of problem (in each country/region)
• Trends and factors contributing to the problem
• Descriptors or indices reflecting or describing the problem: (Note: each of these headings can have multiple subheadings)
  • Physical health
  • Mental health and well-being
  • Education
  • Environmental issues
  • Family and Social factors
  • Specific local issues eg ‘left-behind kids’

**Parameters useful for the understanding and monitoring /surveillance of the status:

• Mortality rates
• Morbidity rates
• Happiness index (well-being)
• Facilities and resources for this group of children
• Educational support and literacy rates
• Screening and early intervention

Action steps:

• Identify a common working definition that can be applied across the region
• To establish the parameters necessary for a useful database.
• Develop a template for data collection to determine the baseline situation as well as for future surveillance.

Desired primary objectives and outcomes:

• Identify the main groups of children with special needs (children at risk)
• Estimate the burden/size of the problem in each country/region
• Identify the main problems faced by this group of children in each country/region
• Identify the main initiatives that can be undertaken to improve the lives of these children with special needs in each country/region including the key stakeholders and the key effectors of these initiatives
• Identify parameters to monitor the progress of this problem and the impact of initiatives

Secondary objectives:
Produce a document (publishable in a peer review journal) on the problem and the strategic plans to improve the lives and well-being of these children with special needs in the Asia Pacific region

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The TAG group will convene a meeting at the coming IPC in Vancouver in August 2016