UNICEF State of the Worlds Children _Focus Children With Disabilities_SOWC-Rapporten 2013

7/28/2019 UNICEF State of the Worlds Children _Focus Children With Disabilities_SOWC-Rapporten 2013

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Children withDisabilities

THE STATE OF THE WORLDS CHILDREN2013

EXECUTIVE SUMMARY


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CHILDREN WITH DISABILITIES

EXECUTIVE SUMMARY

THE STATE OF THE WORLDS CHILDREN2013

Key recommendations

International commitment to building more inclusive societies has resulted in improvements in the

situation of children with disabilities and their families, but too many of them continue to face barriers

to their participation in the civic, social and cultural affairs of their communities. Realizing the promise

of equity through inclusion will require action to:

1 Ratiy ad impemet the Cveti the Rights Perss with Disabiities ad theCveti the Rights the Chid.

2 Fight discrimiati ad ehace the awareess disabiity amg the geera pubic, decisi-makers, ad thse wh prvide essetia services r chidre ad adescets i such ieds as

heath, educati ad prtecti.

3 Dismate barriers t icusi s that a chidres evirmets schs, heath aciities, pubictrasprt ad s aciitate access ad ecurage the participati chidre with disabiities

agside their peers.

4 Ed the istitutiaizati chidre with disabiities, startig with a mratrium ewadmissis. This shud be accmpaied by the prmti ad icreased supprt r amiy-

based care ad cmmuity-based rehabiitati.

5 Supprt amiies s they ca meet the higher csts ivig ad st pprtuities t ear icmeassciated with carig r chidre with disabiities.

6 Mve beyd miimum stadards by ivvig chidre ad adescets with disabiities ad theiramiies i evauatig supprts ad services desiged t meet their eeds.

7 Crdiate services acrss a sectrs s as t address the u rage chaeges acig chidread adescets with disabiities ad their amiies.

8 Ivve chidre ad adescets with disabiities i makig decisis that aect them t just asbeeiciaries, but as agets chage.

9 Prmte a ccerted gba research ageda disabiity t geerate the reiabe ad cmparabedata eeded t guide paig ad resurce acati, ad t pace chidre with disabiities mre

ceary the devepmet ageda.

The ultimate proof of all global and national efforts will be local, the test being whether every child

with a disability enjoys her or his rights including access to services, support and opportunities on

a par with other children, even in the most remote settings and the most deprived circumstances.


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1

Victr, a 13-year-d with cerebra pasy, has u i the water

i Brazi. Adre Castr/2012

InTRoDUCTIon

Reprts such as this typicay begi with a statistic

desiged t highight a prbem. The girs ad bys

t whm this editi The State of the Worlds

Childrenis dedicated are t prbems. Rather, each

is a sister, brther r ried wh has a avurite

dish, sg r game; a daughter r s with dreams

ad the desire t ui them; a chid with a disabiity

wh has the same rights as ay ther gir r by.

Give pprtuities t urish as thers might,

chidre with disabiities have the ptetia t ead

uiig ives ad t ctribute t the scia, cu-

tura ad ecmic vitaity their cmmuities.

Yet survivig ad thrivig ca be especiay diicut

r chidre with disabiities. They are at greater

risk beig pr tha peers withut disabiities.

Eve where chidre share the same disadva-

tages, chidre with disabiities crt additia

chaeges as a resut their impairmets ad

the may barriers that sciety thrws i their way.

Chidre ivig i pverty are amg the east ikey

t ejy the beeits educati ad heath care,

r exampe, but chidre wh ive i pverty ad

have a disabiity are eve ess ikey t atted the

ca sch r ciic.

I may cutries, respses t the situati

chidre with disabiities are argey imited t isti-

tutiaizati, abadmet r egect. These

respses are the prbem, ad they are rted i

egative r pateraistic assumptis icapacity,

depedecy ad dierece that are perpetuated by

igrace. What is eeded is a cmmitmet t these

chidres rights ad their utures, givig pririty t

the mst disadvataged as a matter equity ad

r the beeit a.

Chidre with disabiities ecuter dieret rms

excusi ad are aected by them t varyig

degrees depedig the type disabiity they

have, where they ive ad the cuture r cass t

which they beg. Geder is as a crucia actr:

Girs with disabiities are as ess ikey t get

a educati, receive vcatia traiig r id

empymet tha are bys with disabiities r

girs withut disabiities.

Chidre with disabiities are te regarded as ie-

rir, ad this expses them t icreased vuerabiity:

Discrimiati based disabiity has maiested

itse i margiaizati rm resurces ad decisi-

makig, ad eve i iaticide. Excusi te

stems rm ivisibiity. Few cutries have reiabe

irmati hw may their citizes are chi-

dre with disabiities, what disabiities they have

r hw these disabiities aect their ives. Chidre

thus excuded are ukw t, ad therere cut

rm, pubic services t which they are etited.

These deprivatis ca have astig eects by im-

itig access t gaiu empymet r participati

i civic aairs ater i ie, r exampe. But access t

ad use supprtive services ad techgy ca

EXECUTIVE SUMMARY


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THE STATE OF THE WORLDS CHILDREN 2013: Children with Disabilities2

On the numbers

By e widey used estimate, sme 93 mii chidre r 1 i 20 thse aged 14 r yuger ive with amderate r severe disabiity sme kid.

Such gba estimates are essetiay specuative. They are dated this e has bee i circuati sice 2004

ad derived rm data quaity t varied ad methds t icsistet t be reiabe. I rder t prvide a

ctext r ad iustrate the issues uder discussi,The State of the Worlds Children 2013presets the resuts

atia surveys ad idepedet studies, but eve these must be iterpreted with cauti ad shud t be

cmpared t e ather. This is because deiitis disabiity dier by pace ad time, as d study desig,

methdgy ad aaysis.

psiti a chid with a disabiity t take her r his

pace i the cmmuity ad ctribute t it.

The uture is ar rm grim. By their cmmitmet

t uphdig the Cveti the Rights the

Chid (CRC) ad the Cveti the Rights

Perss with Disabiities (CRPD), gvermets

arud the wrd have take up themseves

the respsibiity esurig that a chidre,

irrespective abiity r disabiity, ejy their

rights withut discrimiati ay kid. The

Cvetis bear witess t a grwig gba

mvemet dedicated t the icusi chidre

with disabiities i cmmuity ie. They estab-

ish that chidre with disabiities have the same

rights as thers.

Icusi ges beyd itegrati. T take a

exampe rm the ied educati, itegrati

might be attempted simpy by admittig chidre

with disabiities t reguar schs. Icusi,

hwever, is pssibe y whe schs are

desiged ad admiistered s that a chidre ca

ear ad pay tgether. This wud etai prvid-

ig such eeded accmmdatis as access t

Braie, sig aguage ad adapted curricua.

Icusi beeits everye. T ctiue with the

exampe educati, ramps ad wide drways

ca ehace access ad saety r a chidre,

teachers, parets ad visitrs, t just thse wh

use wheechairs.

I erts t prmte icusi ad airess,

chidre with disabiities shud be abe t eist

the supprt their amiies, disabed pepes

rgaizatis, parets assciatis ad cm-

muity grups. They shud as be abe t cut

aies urther aied. Gvermets have the

pwer t hep by aigig their picies ad pr-

grammes with the CRPD ad CRC. Iteratia

parters ca prvide assistace cmpatibe with

the Cvetis. Crpratis ad ther private

sectr etities ca advace icusi ad attract

the best taet by embracig diversity i hirig.

May the deprivatis edured by chidre

with disabiities stem rm ad are perpetuated

by their ivisibiity. The research cmmuity

is wrkig t reder mre chidre visibe by

imprvig data cecti ad aaysis. Their wrk

wi hep t vercme igrace ad discrimia-

ti, t target resurces ad itervetis ad

gauge their eects. But decisi-makers eed t

wait r better data t begi buidig mre icu-

sive irastructure ad services: A that is eeded

is r these erts t remai exibe s they ca

be adapted as ew data cme t ight.


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ExEcutivE Summary 3

Six-year-d nemaja (ar et) sits with cassmates i nvi

Sad, Serbia. His primary sch was the frst t itegrate

chidre with disabiities uder a aw aimed at reducig

istitutiaizati. UnICEF/HQ2011-1156/Ht

FUnDAMEnTAlS oF InClUSIon

The CRC ad CRPD chaege charitabe

appraches that regard chidre with disabii-

ties as passive recipiets care ad prtecti.

Istead, the Cvetis demad recgiti

each chid as a u member her r his am-

iy, cmmuity ad sciety. This etais a cus

t traditia tis rescuig the chid,

but ivestmet i remvig the physica, cu-

tura, ecmic, cmmuicati, mbiity ad

attitudia barriers that impede the reaizati

the chids rights icudig the right t active

ivvemet i makig decisis that aect

chidres daiy ives.

The uderestimati the abiities pepe

with disabiities is a majr bstace t their icu-

si ad t the prvisi equa pprtuities.

Dismissive attitudes exist thrughut sciety

rm pressias, piticias ad ther decisi-

makers t amiies ad peers as we as pepe

with disabiities themseves, wh i the absece

evidece that they are vaued ad supprted

wi te uderestimate their w abiities.

Changing attitudes

litte wi chage i the ives chidre with

disabiities uess attitudes chage. Igrace

abut the ature ad causes impairmets,

ivisibiity the chidre themseves, serius

uderestimati their ptetia ad capaci-

ties, ad ther impedimets t equa pprtuity

ad treatmet a cspire t keep chidre with

disabiities sieced ad margiaized. But brig-

ig disabiity it pitica ad scia discurse

makes it pssibe t sesitize decisi-makers

ad service prviders as we as demstrate

t sciety at arge that disabiity is part the

huma cditi.

The imprtace ivvig chidre with dis-

abiities cat be verstated. Prejudice ca be

reduced thrugh iteracti, as demstrated by

activities that brig tgether chidre with ad

withut disabiities. Scia itegrati beeits

everye, ad chidre wh have experieced

icusi i educati, r exampe ca the

be scietys best teachers i reducig iequai-

ties ad buidig a icusive sciety.

Icusive media as have a key part t pay. By

icudig uaced prtrayas chidre ad

aduts with disabiities, media ca sed ut psi-

tive messages that they are members amiies

ad eighburhds ad ca as cuter mis-

represetatis ad steretypes that reirce

scia prejudices.

Simiary, participati i scia activities heps

t prmte a psitive view disabiity. Sprt,

i particuar, has heped vercme may sci-

eta prejudices. Seeig a chid surmut the

physica ad psychgica barriers t partici-

pati ca be ispiratia ad ca prmte

respect athugh care must be take t t

make chidre with disabiities wh d t


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perrm such physica eats ee ierir t thse

wh d.

Sprt has as bee hepu i campaigs t

reduce stigma, ad athetes with disabiities are

te amg the mst recgized represetatives

pepe with disabiities. Experieces i a um-

ber cutries have shw that access t sprt

ad recreati is t y direct beeit t chi-

dre with disabiities, but as heps t imprve

their stadig i the cmmuity as they are

see t participate agside ther chidre i

activities vaued by sciety.

Because the CRPD recgizes the amiy as the

atura uit sciety ad puts the State i

the re supprtig it, the prcess uiig

the rights chidre with disabiities begis

with supprtig their amiies ad estabishig

a hme settig cducive t eary iterveti.

Supporting children and families

Uder the CRPD, chidre with disabiities ad

their amiies have the right t a adequate sta-

dard ivig ad are as etited t such subsi-

dized r ree supprt services as day care, respite

care ad access t se-hep grups. Scia pr-

tecti r chidre with disabiities ad their

amiies is especiay imprtat because these

amiies te ace a higher cst ivig ad st

pprtuities t ear icme. Estimates the

additia csts disabiity bre by amiies

rage rm 9 per cet icme i Viet nam t

1169 per cet i the Uited Kigdm. I addi-

ti t medica, rehabiitati ad ther direct

expeses, amiies as ace pprtuity csts,

as parets ad amiy members must te

give up r imit their empymet i rder t

care r chidre with disabiities.

A review 14 devepig cutries ud that

pepe with disabiities were mre ikey t

experiece pverty tha thse withut disabii-

ties. Pepe with disabiities teded t be ess

we i terms educati, empymet, iv-

ig cditis, csumpti ad heath. Higher

heath-care csts tha thse husehds with-

ut members with disabiities ca urther reduce

a husehds stadard ivig.

States ca tacke the icreased risk chid

pverty with such scia prtecti iitiatives

as cash traser prgrammes, which have bee

shw t beeit chidre. A grwig umber

w- ad midde-icme cutries are buidig

prmisig resuts rm brader erts ad have

auched targeted scia prtecti iitiatives that

icude cash trasers speciicay r chidre

with disabiities. Rutie mitrig ad evaua-

ti the trasers eects the heath, educa-

tia ad recreatia attaimet chidre with

disabiities wi be essetia t make sure these

prgrammes achieve their bjectives.

Ather t gvermets ca use is disabiity-

speciic budgetig, whereby a gvermet sets

speciic gas r chidre with disabiities withi a

brader iitiative ad acates a suiciet prti

the avaiabe resurces twards them. Eective

access t services icudig educati, heath care,

habiitati, rehabiitati ad recreati shud

be prvided ree chage ad i a maer that

prmtes the uest pssibe scia itegrati

ad idividua devepmet the chid.

Community-based rehabilitation

Cmmuity-based rehabiitati (CBR) pr-

grammes which seek t esure that pepe

with disabiities have equa access t services ad

pprtuities reatig t heath, educati ad

iveihds are a exampe a iterveti

that is desiged ad ru by ca cmmuities

criticay, with the active participati chidre

ad aduts with disabiities.


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ExEcutivE Summary 5

CBR ca prve eective i addressig mutipe

deprivatis, such as thse acig chidre with

disabiities wh ive i rura ad idigeus

cmmuities. I a utreach iitiative r idig-

eus chidre i oaxaca, Mexic, r exampe,

CBR teams rm the Cetre r Research ad

Pst-Secdary Studies i Scia Athrpgy,

i cabrati with UnICEF, prmted the

rmati ca supprt etwrks amg

the amiies chidre with disabiities. over

three years (20072010), the iitiative saw the

icreased acceptace chidre with disabiities

by their w amiies ad cmmuities, imprved

prvisi scia services, cmmuity-ed c-

structi wheechair ramps t pubic spaces,

arragemets r ree services rm state ad

edera hspitas, ad 32 ew ermets

chidre with disabiities i maistream schs.

Icusive appraches are buit arud the c-

cept accessibiity, with the aim makig the

maistream wrk r everye rather tha creat-

ig parae systems. A accessibe evirmet

is essetia i chidre with disabiities are t

ejy their right t participate i the cmmuity

ad t have the chace t reaize their u pte-

tia. S, r istace, chidre with disabiities

eed access t a schs t reap the maximum

beeits educati. Chidre wh are educated

agside their peers have a much better chace

becmig prductive members their sciet-

ies ad beig itegrated i the ives their

cmmuities.

Depedig the type disabiity, a chid

may eed a assistive device (a prsthesis, r

exampe) r service (such as a sig aguage

iterpreter) t ucti uy i varius aspects

ie. Accrdig t WHo, hwever, i may

w-icme cutries y 515 per cet

thse wh eed assistive techgy are abe

t btai it. The csts such techgy ca

be prhibitive, especiay r chidre, wh eed

their devices repaced r adjusted as they grw.

Access t assistive techgy ad ay ther

speciaized supprt that chidre eed t aciitate

their iteracti ad participati shud be ree

ad avaiabe t a.

Uiversa desig is a apprach t accessibi-

ity that seeks t create prducts, structures ad

evirmets that a pepe ca use regardess

age, abiity r situati t the greatest extet

pssibe, withut the eed r adaptati r spe-

ciaized desig. Rea-wrd appicatis icude

curb cuts, audi bks, Vecr asteigs ad

w-r buses.

The cst itegratig accessibiity it ew

buidigs ad irastructure ca be egigibe,

amutig t ess tha 1 per cet the capita

devepmet cst. By ctrast, adaptatis t

cmpeted buidigs ca reach as much as 20 per

cet the rigia cst. It therere makes sese

t itegrate accessibiity csideratis it prj-

ects at the eary stages the desig prcess.

Accessibiity shud as be a csiderati

whe udig devepmet prjects.

Weju, 9, waks with her ster mther i Chia.

UnICEF/Chia/2010/liu


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A teacher with a hearig impairmet teaches a cass

hearig-impaired chidre i Guu, Ugada.

UnICEF/UGDA2012-00108/Sibii

A STRonG FoUnDATIon

Icusive heath ad educati services have a

critica re t pay i buidig a sid udati

which chidre with disabiities ca buid

uiig ives.

Inclusive health

Uder the CRC ad the CRPD, a chidre have

the right t the highest attaiabe stadard

heath. Chidre with disabiities are thus equay

etited t the u spectrum care rm

immuizati i iacy t prper utriti ad

treatmet r chidhd aimets ad ijuries,

t cidetia sexua ad reprductive heath

irmati ad services durig adescece

ad it eary aduthd. Equay critica are

such basic services as water, saitati ad

hygiee (WASH).

Esurig that chidre with disabiities actuay

ejy these rights a par with thers is the

bjective a icusive apprach t heath. It is

a matter scia justice ad respectig the

iheret digity a huma beigs, as we as

a ivestmet i the uture as heathy chidre

grw it mre eective prducers ad parets.

Immuizatis, amg the mst successu ad

cst-eective pubic heath itervetis, are a

key cmpet gba erts t reduce chid-

hd iess ad death. Mre chidre tha ever

bere are beig reached but chidre with dis-

abiities are sti t beeitig rm icreased

cverage. Icudig these chidre i immuiza-

ti erts is t y ethica but as imperative

r pubic heath ad equity; uiversa cverage

cat be reached i they remai excuded.

Whie immuizati ca pre-empt sme diseases

that ead t disabiities, it is ess imprtat

t immuize chidre wh are aready disabed.

Deied the u rage immuizatis, chidre

with disabiities are at risk devepmeta

deays, avidabe secdary cditis ad

prevetabe death.

Icudig chidre with disabiities i erts t

prmte immuizati r exampe, raisig

awareess by shwig them agside thers

i psters ad ther prmtia materias, ad

reachig ut t parets ad disabed pepes

rgaizatis wi hep t icrease immuiza-

ti cverage amg them.

nutriti is as critica. Isuiciet d r a diet

shrt certai vitamis ad mieras ca eave

iats ad chidre vuerabe t speciic cdi-

tis ad a hst iectis that ca ead t

physica, sesry r iteectua disabiities. Fr

exampe, betwee 250,000 ad 500,000 chidre

are csidered t be at risk becmig bid

each year rm vitami A deiciecy. This sy-

drme is easiy preveted by ra suppemeta-

ti cstig just a ew cets per chid. Simiary,

w-cst measures are avaiabe t prevet dis-

abiities arisig rm ther utritia deiciecies.


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ExEcutivE Summary 7

Pr utriti ad episdes diarrhea i

eary chidhd ca ead t stutig, idicated

by w height r age, which i tur ca resut

i pr cgitive ad educatia perrmace

that wi have csequeces thrughut ie.

Mautriti i mthers ca ctribute t a

umber prevetabe chidhd disabiities.

oe the mst prevaet causes disabiity

i the wrd is aaemia, which aects apprxi-

matey 42 per cet pregat wme i

w- ad midde-icme cutries (ver ha

suer ir deiciecy aaemia); it as aects

mre tha ha presch-aged chidre i

devepig cutries.

Whie mautriti ca be a cause disabiity,

it ca as be a csequece. Ideed, chidre

with disabiities are at heighteed risk ma-

utriti. Physica impairmets assciated with

cditis such as cet paate r cerebra pasy

may iterere with the mechaics csumig

d; certai cditis, such as cystic ibrsis,

may impede utriet absrpti; ad sme

iats ad chidre with disabiities may eed

specia diets r icreased carie itake t

maitai a heathy weight.

Yet chidre with disabiities may be hidde

away rm cmmuity screeig ad eedig

iitiatives. Thse wh d t atted sch

miss ut sch eedig prgrammes. I

additi t physica actrs, attitudes may as

adversey aect a chids utriti. I sme

scieties, mthers may t be ecuraged t

breasteed a chid with a disabiity; disabed

chidre may be ed ess, deied d r pr-

vided with ess utritius d tha sibigs

withut disabiities. Chidre with sme types

physica r iteectua disabiities may have

diicuty eedig themseves. It is prbabe that

i sme cases what is assumed t be disabiity-

assciated i heath ad wastig may i act be

cected with eedig prbems.

Thrughut the devepig wrd, perss with

disabiities rutiey ace particuar diicuties i

accessig sae drikig water ad basic saita-

ti. Faciities are te physicay iaccessibe,

ad i sme paces, ew es are sti beig

desiged ad buit withut adequate ccer r

chidre with disabiities. Eve thugh w-cst,

w-tech itervetis such as step atries are

icreasigy avaiabe, irmati abut them

has yet t be widey dissemiated ad icrp-

rated it WASH picies ad practice.

Scia barriers as impede access. Chidre with

disabiities te ace stigma ad discrimiati

whe usig husehd ad pubic aciities, r

exampe, because uuded ears that they

wi ctamiate them. Whe chidre with

disabiities, especiay girs, are rced t use

separate aciities, they are at icreased risk

accidets ad physica attack, icudig rape.

Chidre with disabiities might t atted sch

r wat a accessibe tiet; they te reprt

tryig t eat ad drik ess t cut dw the

umber visits t the tiet thus edagerig

their utritia status.

Chidre ad yug pepe with disabiities have

bee amst etirey verked i sexua ad

reprductive heath ad HIV/AIDS prgrammes,

as they are te icrrecty beieved t be sexu-

ay iactive, uikey t use substaces ad at ess

risk viece tha their peers withut disabii-

ties. May yug pepe with disabiities d t

receive eve basic irmati abut hw their

bdies devep ad chage, ad because they are

te taught t be siet ad bediet, they are at

heighteed risk abuse. I csequece, they are

at icreased risk HIV iecti.

Pepe with disabiities a ages wh are

HIV-psitive are ess ikey t receive apprpri-

ate services tha peers withut disabiities, as


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42%with

disability

53%

51%

61%

with

disability

without

disability

without

disability

Estimated rates of primaryschool completion

Source: Wrd Heath orgaizati, based surveys i 51 cutries.

aciities ad prgrammes rarey csider their

eeds, whie heath-care perse ack disabiity-

speciic traiig.

Because chidre devep rapidy durig the

irst three years ie, eary detecti ad iter-

veti are crucia r thse with disabiities.

Devepmeta screeig is a eective meas

detectig disabiity i chidre ad reerrig

them t urther assessmet ad iterveti

r exampe t treat ir deiciecy, admiister

ati-epieptic drugs r prvide cmmuity-based

rehabiitati as we as prvidig vita ir-

mati t amiy members. Such itervetis

are becmig icreasigy avaiabe i w- ad

midde-icme cutries.

The detecti ad treatmet impairmets is

t a separate area medicie but a itegra

aspect pubic heath. Whe picymakers ad

researchers characterize these measures as beig

i cmpetiti r resurces with measures t

prmte the heath pepe withut disabiities,

they perpetuate discrimiati ad iequity.

Heath-care services avaiabe t chidre with

disabiities may be pr quaity. Heath wrk-

ers ad ther pressias stad t beeit

rm beig educated abut chid devepmet

ad disabiity ad rm beig traied t deiver

itegrated services, with the participati the

exteded amiy where pssibe. Additiay, the

eedback chidre with disabiities shud be

sicited s that aciities ad services ca better

meet their eeds.

Inclusive education

Chidre with disabiities are disprprtiatey

deied their right t educati, which uder-

mies their abiity t ejy the u rights citi-

zeship, id gaiu empymet ad take up

vaued res i sciety. Husehd survey data

rm 13 w- ad midde-icme cutries shw

that chidre with disabiities aged 617 years are

sigiicaty ess ikey t be ered i sch

tha their peers withut disabiities.

As g as chidre with disabiities are deied

equa access t their ca schs, gvermets

cat achieve uiversa primary educati

(Mieium Devepmet Ga 2), ad States

parties t the CRPD cat ui their respsi-

biities uder Artice 24.

Rather tha segregatig chidre with disabiities

i specia schs, icusive educati etais

prvidig meaigu earig pprtuities t

a studets withi the reguar sch system.

Ideay, it aws chidre with ad withut dis-

abiities t atted the same age-apprpriate

casses at the ca sch, with additia, idi-

viduay taired supprt as eeded. It requires

physica accmmdati as we as a ew, chid-

cetred curricuum that icudes represetatis


11/28

ExEcutivE Summary 9

the u spectrum pepe ud i sciety

ad reects the eeds a chidre.

Studies acrss cutries shw a strg ik

betwee pverty ad disabiity, which is i tur

iked t geder, heath ad empymet issues.

Chidre with disabiities are te caught i a

cyce pverty ad excusi: Girs becme

caregivers t sibigs rather tha atted sch,

r exampe, r the whe amiy may be stigma-

tized, eadig t a reuctace t reprt that a chid

has a disabiity r t take the chid ut i pubic.

Educati thse wh are excuded r margi-

aized, hwever, brigs abut pverty reducti.

The irst steps twards icusi are take at

hme durig the eary years. Withut the ve,

sesry stimuati, heath care ad scia icu-

si t which they are etited, chidre ca miss

imprtat devepmeta miestes ad their

ptetia may be uairy imited, with sigiicat

scia ad ecmic impicatis r themseves,

their amiies ad their cmmuities.

A chid whse disabiity r devepmeta deay

is idetiied at a eary stage wi have a much

better chace reachig her r his u capacity.

Eary chidhd educati is imprtat because

80 per cet the brais capacity deveps bere

the age 3; the perid bere primary sch

prvides pprtuities t tair devepmeta

educati t the chids idividua eeds. Studies

suggest that the chidre wh are at greatest dis-

advatage stad t beeit mst. With amiy ad

cmmuity supprt rm the eariest days their

ives, chidre with disabiities are better paced

t make the mst their sch years ad t

prepare themseves r aduthd.

I sch, creatig a icusive ad eabig

earig evirmet r chidre with disabii-

ties depeds i arge part teachers havig a

cear uderstadig icusive educati ad

a cmmitmet t teachig a chidre. A t

te, teachers ack apprpriate preparati ad

supprt i teachig chidre with disabiities

i reguar schs, ad this ctributes t their

stated uwiigess i may cutries t sup-

prt the icusi chidre with disabiities i

their casses.

Resurces r chidre with disabiities ted t

be acated t segregated schs rather tha

t a icusive maistream educati system.

This is t y iapprpriate, but ca as prve

csty: I Bugaria, r istace, the budget per

chid educated i a specia sch ca be up t

three times higher tha that r a simiar chid

i a reguar sch.

Whe teachers ad perse are traied t

csider disabiity-reated issues, they k

up icusi chidre with disabiities mre

psitivey. The mst psitive attitudes a

have bee ud amg teachers with actua

experiece icusi. It has bee shw that

psitive attitudes amg teachers trasate it

ess restrictive pacemets r studets with

disabiities.

Yet pre-service traiig rarey prepares teachers

t teach icusivey, ad existig traiig is vari-

abe quaity. The ack pepe with disabiities

amg teachig perse presets ather cha-

ege t icusive educati; aduts with disabii-

ties te ace csiderabe bstaces t quaiyig

as teachers. I Cambdia, r istace, teachers

must by aw be ree disabiities.

Parterships with civi sciety are prvidig

ecuragig exampes ways t ehace

teacher traiig ad diversity. I Mzambique,

the atia nGo Ajuda de Desevvimet de

Pv para Pv has wrked with the atia

disabed perss rgaizati ADEMo t trai

studet teachers t wrk with chidre with


12/28


disabiities ad t trai studet teachers wh

have disabiities.

Icusive educati requires a exibe apprach t

sch rgaizati, curricuum devepmet ad

pupi assessmet. Such exibiity wud aw r

the devepmet a mre icusive pedaggy,

shitig the cus rm teacher-cetred t chid-

cetred t embrace diverse earig styes.

Teachers te have iadequate supprt i the

cassrm, ad they eed t be abe t ca

speciaist hep r istace, with Braie r

cmputer-based istructi whe the eeds

their studets with disabiities are beyd their

expertise. Such speciaists are i shrt suppy,

especiay i such w-icme areas as sub-

Sahara Arica. This presets a pprtuity r

apprpriate supprt rm prviders iacia

ad techica assistace rm the iteratia

t the ca eve.

Icusive educati as eeds t draw up

resurces rm utside the cassrm. Parets

have the ptetia t ctribute i may ways,

rm prvidig accessibe trasprt t raisig

awareess t iaisig with the heath ad scia

sectrs t btai equipmet, supprt ad grats.

The mst uderused resurce i schs ad

cmmuities a ver the wrd is the chidre

themseves. Athugh the imprtace chid

agecy ad chid participati is we dcu-

meted, they sit ucmrtaby withi existig

structures ad systems educati. Ivvig

chidre with disabiities i decisis ca be

particuary chaegig, t east because

igraied thikig ad behaviur that perceives

them as passive victims.

I participatry research, chidre requety

highight the imprtace a cea evirmet

ad hygieic tiets; r chidre with disabiities,

privacy ad accessibiity are paramut. Chidre

with disabiities ca ad must guide ad evau-

ate erts t advace accessibiity ad icusi.

Ater a, wh better t uderstad the meas

ad impact excusi?

Aspiratis r icusive educati are mre ike-

y t be reaized i gvermets ad their part-

ers are cear abut wh is t d what ad hw,

ad t whm they are expected t reprt. Where

picies ai t be impemeted, the prbem

may be e ucear madates. I Bagadesh,

r exampe, mst aspects the educati

chidre with disabiities are maaged by the

Miistry Scia Weare rather tha that

Educati. T make icusive educati a reaity,

Miistries Educati shud be ecuraged t

take respsibiity r a chidre sch age.

Crdiati with parters ad stakehders ca

pay a strg supprtig re i this prcess.

Excusi deies chidre with disabiities the ie-

g beeits educati: a better jb, scia ad

ecmic security, ad pprtuities r u par-

ticipati i sciety. I ctrast, ivestmet i the

educati chidre with disabiities ca ctrib-

ute t their uture eectiveess as members the

abur rce. Ideed, a perss ptetia icme

ca icrease by as much as 10 per cet with each

additia year schig.

Furthermre, basic readig ad writig skis as

imprve heath: A chid br t a mther wh ca

read is 50 per cet mre ikey t survive past the

age 5, ad wer matera educati has bee

iked t higher rates stutig amg chidre

i urba sums i Keya, Rma settemets i

Serbia, ad i Cambdia.

Educati is bth a useu istrumet ad a right.

As stated i the CRC, it prmtes the devep-

met the chids persaity, taets ad me-

ta ad physica abiities t their uest ptetia.


13/28

ExEcutivE Summary 11

A yug by with abiism reads Braie at sch i the

tw Mshi, Uited Repubic Tazaia.

UnICEF/HQ2008-1786/Pirzzi

ESSEnTIAlS oF PRoTECTIon

Chidre with disabiities are amg the mst

vuerabe members sciety. They stad t

beeit the mst rm measures t cut them,

prtect them agaist abuse ad guaratee them

access t justice.

I scieties where they are stigmatized ad their

amiies expsed t scia r ecmic excusi,

may chidre with disabiities are t eve abe t

btai a idetity dcumet. This is a viati

these chidres huma rights ad a udameta

barrier t their participati i sciety. It ca sea

their ivisibiity ad icrease their vuerabiity t

the may rms expitati that resut rm t

havig a icia idetity.

States parties t the CRPD have the cear biga-

ti t guaratee eective ega prtecti r

chidre with disabiities. T chage discrimiatry

scia rms, States eed t make sure existig

aws are erced ad that chidre with disabii-

ties are irmed abut their right t prtecti

rm discrimiati, ad hw t exercise this

right. The pricipe reasabe accmmdati

dictates that ecessary ad apprpriate adapta-

tis be made s that chidre with disabiities ca

ejy their rights a equa basis with thers.

Reegatig them t separate systems wud be

iapprpriate; equity thrugh icusi is the ga.

Discrimiati agaist ad excusi chidre

with disabiities reders them disprprtiatey

vuerabe t viece, egect ad abuse. Sme

rms viece are speciic t chidre with

disabiities. It may be perpetrated i the guise

treatmet r behaviur mdiicati, r exampe,

usig eectric shcks r drugs. Girs with disabii-

ties i may cutries are subject t rced steri-

izati r abrti.

I may cutries, chidre with disabiities c-

tiue t be paced i istitutis. It is rare r these

aciities t prvide the idividua atteti that

chidre eed t devep t their u capacity. The

educatia, medica ad rehabiitative care they

receive i such paces is te isuiciet, wig

t either w stadards r iadequate mitrig.

Separatig chidre with disabiities rm their

amiies is a viati their right t be cared r

by their parets uess this is deemed by a cm-

petet authrity t be i the idividua chids best

iterests. I immediate amiy is uabe t care r

a chid, the CRPD bigates State parties t prvide

aterative care withi the exteded amiy r cm-

muity, r istace i a ster amiy.

Where cutries have sught t retur istituti-

aized chidre t their amiies ad cmmuities,

chidre with disabiities have bee amg the ast

t be reeased. Such was the case, r exampe,

i Serbia, athugh the reaizati that rerms

had bypassed chidre with disabiities i the past

decade has sice added vigur t such erts (see

chart, page 12).

A States respsibiity t prtect the rights a

chidre uder its jurisdicti as exteds t chi-

dre with disabiities wh are i ctact with the

aw whether as victims, witesses, suspects r


14/28


Violence against children with disabilitiesChidre with disabiities are three t ur times mre ikey t be victims viece. Research teams at

liverp Jh Mres Uiversity ad the Wrd Heath orgaizati have cducted a systematic review ad

meta-aaysis existig studies viece agaist chidre with disabiities. The review csidered 17 studies

rm high-icme cutries, i the absece high-quaity studies rm w- ad midde-icme cutries.

Estimates risk idicated that chidre with disabiities were at sigiicaty higher risk experiecig

viece tha peers withut disabiities: 3.7 times mre ikey r cmbied measures viece, 3.6 times

r physica viece ad 2.9 times r sexua viece. Chidre with meta r iteectua disabiities were

ud t be 4.6 times mre ikey t be victims sexua viece tha peers withut disabiities.

Why are chidre with disabiities at greater risk viece? Severa expaatis have bee put rward:First, carig r a chid with a disabiity ca put extra strai caregivers, icreasig the risk abuse. Secd,

sigiicat umbers chidre with disabiities are sti paced i residetia care, a majr risk actr r sexua

ad physica abuse. Fiay, impairmets aectig cmmuicati reder sme chidre particuary vuerabe,

as they may t be abe t discse abusive experieces.

A chidre with disabiities shud be viewed as a high-risk grup i which it is critica t idetiy viece. They

may beeit rm itervetis such as hme visits ad traiig i paretig skis that have prve eective

i prevetig viece r mitigatig its csequeces amg chidre withut disabiities.

Under Serbias welfare reforms, children withdisabilities were released from institutions at a

slower rate than children without disabilities.

Children and youth (026 years old)

with disabilities in institutions

Children and youth (026 years old)

without disabilities in institutions

100% 100%

91%

79%

63%

83%

49%

37%

2000 2005 2008 2011 2000 2005 2008 2011

37%decrease

63%decrease

Source: Repubica Istitute r Scia Prtecti, Serbia.

Sampe sizes: Chidre ad yuth (026 years d) with disabiities: 2,020 i

2000, 1,280 i 2011. Chidre ad yuth (026 years d) withut disabiities:

1,534 i 2000, 574 i 2011.

Last to benefit cvicts. Speciic measures ca hep: Chidre cabe iterviewed i the apprpriate siged r spke

aguages; a pressias ivved i the admi-

istrati justice, rm aw ercemet icers

t judges, ca be traied t wrk with chidre

wh have disabiities; ad reguatis ad prt-

cs ca be estabished t esure equa treatmet

chidre with disabiities.

Furthermre, it is imprtat t devep aterative

sutis t rma judicia prceedigs, takig it

accut the rage chidres idividua capaci-

ties. Chidre with disabiities shud as t be

paced i reguar juveie deteti aciities; rather,

they shud be prvided apprpriate treatmet t

address the issues that ed them t cmmit a crime.

Such treatmet shud be carried ut i apprpriate

aciities with adequatey traied sta, with huma

rights ad ega saeguards uy respected.


15/28


Vijay, 12, survived a admie expsi ad has ge

t becme a mie risk educatr i Sri laka.

UnICEF/Sri laka/2012/Tuadar

HUMAnITARIAn RESPonSE

Humaitaria crises, such as thse stemmig

rm warare r atura disasters, pse particu-

ar risks r chidre with disabiities. Icusive

humaitaria respse is urgety eeded

ad easibe.

Armed cict is a majr cause disabiity

amg chidre, whm it aects i direct ad

idirect ways. Chidre sustai physica ijuries

rm attack, artiery ire ad admie expsis

icudig ater cicts have eded; they as

suer psychgica eects rm these ijuries r

rm witessig traumatic evets. Idirect eects

icude iesses utreated whe heath services

break dw ad mautriti that deveps whe

d becmes scarce. Chidre may as be sepa-

rated rm their amiies, their hmes ad their

schs, smetimes r years.

Simiar deprivatis ca esue as a resut

atura disasters, which particuary as thse

reated t cimate chage icrease i severity ad

requecy are expected t aect ever greater

umbers chidre ad aduts i cmig years.

Chidre with disabiities ace particuar cha-

eges i emergecies. They may be excuded

rm r uabe t access maistream supprt

services ad assistace prgrammes, such as

heath services r d distributi, because

physica barriers psed by iaccessibe buidigs

r egative attitudes. They may be rgtte i

the estabishmet targeted services ad dis-

regarded i eary warig systems, which te

d t take it accut the cmmuicati ad

mbiity requiremets thse with disabiities.

Disabiity-icusive humaitaria acti is

irmed by ad gruded i:

A rights-based apprach. Artice 11 the

CRPD speciicay cas duty bearers t take

a ecessary measures t prtect perss with

disabiities i emergecies.

A icusive apprach that recgizes that

i additi t their disabiity-speciic eeds,

chidre with disabiities have the same eeds

as ther chidre, ad that as addresses the

barriers, physica ad therwise, that impede

their participati i reguar prgrammes.

Esurig accessibiity ad uiversa desig

irastructure ad irmati.

Prmtig idepedet ivig ad participa-

ti i a aspects ie r chidre with

disabiities.

Itegratig age, geder ad diversity aware-

ess, with specia atteti t the discrimia-

ti aced by girs ad wme with disabiities.

This apprach cas r histic ad icusive pr-

grammes, rather tha just isated prjects ad

picies targetig disabiities. Key itervetis

icude:

Imprvig data ad assessmets i rder t

have a evidece base r the distict eeds

ad pririties chidre with disabiities.

Makig maistream humaitaria services

accessibe r chidre with disabiities ad

ivvig them i paig ad desig.

Desigig speciaized services r chidre


16/28


Risk, resilience and inclusive humanitarian action

Chidre with disabiities ad their amiies ace particuar chaeges i emergecies. They may have t cted

with ew evirmeta barriers such as capsed ramps; damaged r st assistive devices; ad the ss such

services as sig aguage iterpreters r visitig urses.

I amiy members die, there may be e et wh kws hw t care r a chid with a physica disabiity r

wh ca cmmuicate with a chid with a sesry impairmet. Feeig amiies may eave behid chidre wh

are uabe t wak r are i rai heath r they may abad a chid ut ear that they wi be reused asyum

i ather cutry that excudes pepe with disabiities. Istitutis ad residetia schs may cse r be

abaded by sta, eavig the chidre i their charge withut care.

I armed cict, chidre with disabiities, especiay thse with earig disabiities, may be pressed it service

as ighters, cks r prters, because they are csidered t be ess vauabe r ess ikey t resist tha chidre

withut disabiities. Prgrammes aimed at the reitegrati chid ex-cmbatats might t serve the eeds

chidre with disabiities, wh therere remai margiaized ad excuded, te havig t beg, as has bee the

case i liberia ad Sierra lee.

Chidre with disabiities shud be give the pprtuity t take part i the paig ad impemetati

disaster risk reducti ad peace-buidig strategies as we as i disaster respse ad recvery prcesses. This

has begu t happe as demstrated by erts i Pakista ad Haiti.

Disabiity is beig maistreamed it such emergecy guideies as the Sphere Prjects Humanitarian Charter and

Minimum Standards in Humanitarian Response. Such prgress shud be exteded t such areas as chid utriti

ad prtecti, ad the extet t which chidre with disabiities are icuded i humaitaria respse must be

audited t mitr ad imprve resuts.

with disabiities ad esurig that recvery

ad reitegrati prcesses ster we-beig,

heath, se-respect ad digity.

Takig measures t prevet ijuries ad abuse

ad prmte accessibiity.

Parterig with cmmuity, regia ad

atia actrs, icudig disabed perss

rgaizatis, t chaege discrimiatry atti-

tudes ad perceptis ad prmte equity.

Prmtig participati chidre with disabi-

ities by csutig them ad creatig pprtu-

ities r their vices t be heard.

Parties t cict have a bigati t prtect

chidre rm the eects armed viece ad

t prvide them with access t apprpriate heath

ad psychscia care t aid their recvery ad

reitegrati. The Cmmittee the Rights the

Chid has recmmeded that States parties t

the Cveti add expicit reerece t chidre

with disabiities as part their brader cmmit-

met t t recruit chidre it armed rces.


17/28


Explosive remnants of war

Expsive remats war (ERW) ad ati-perse admies represet a sigiicat ctributig

actr t chid disabiity. Such istrumets as the 1997 Mie Ba Treaty have heped t reduce the

vera umber pepe kied r ijured by these weaps, but the percetage chidre amg

tta casuaties has icreased.

Auay sice 2005, chidre have accuted r apprximatey 2030 per cet casuaties, ad there have

bee at east 1,000 chid casuaties each year sice mitrig bega i 1999. I 2010, chidre accuted r

55 per cet a civiia deaths, makig them the civiia grup r whm admies ad ERW are mst deady.

I sme the wrds mst mie-aected cutries, such as Aghaista ad Cambdia, the percetage

casuaties represeted by chidre is eve higher (see chart).

Sice 2008, bys have made up the sige argest casuaty grup, accutig r abut ha a civiia

casuaties; that year, they represeted 73 per cet chid casuaties. I may ctamiated cutries, bys

are mre ikey tha girs t cme acrss mies r ERW because they are mre ivved i utdr activities

0%

20%

40%

60%

80%

100%

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Afghanistan

Cambodia

Colombia

90%

70%

50%

30%

10%

Child casualties in the most affected countries*Percentage of children among civilian casualties (19992011)

* The three States parties t the Mie Ba Treaty with the highest aua casuaty rates.

Source: ladmie ad Custer Muiti Mitr.

(continued on p. 16)


18/28


such as herdig ivestck, gatherig wd r d, r cectig scrap meta. They are as mre ikey tha girs

t tamper with ay devices they id.

Chidre i geera are mre ikey t deiberatey hade expsive devices tha aduts, te ukwigy,

ut curisity r mistakig them r tys. We-paed risk educati is therere especiay imprtat r

chidre.

Mre tha e third a bast survivrs require amputati; the percetage ca be expected t be higher r

chidre, give their smaer size. Chidres physica rehabiitati is mre cmpex tha that aduts: Because

their bes grw aster tha their st tissue, they may eed severa re-amputatis. Prstheses must be adjustedr repaced as they grw.

The psychgica csequeces a ERW r admie bast are te devastatig r a chids devepmet.

They ca icude eeigs guit, ss se-esteem, phbias ad ears, seep disrders ad a iabiity t speak.

I et utreated, chidre may devep g-term meta disrders.

The scia ad ecmic reitegrati eeds chid survivrs as vary csideraby rm thse aduts. I

may cutries, chid survivrs are rced t cut shrt their educati wig t the time eeded r recvery r

the iacia burde that rehabiitati paces their amiies. They may be physicay uabe t wak t sch

ad ack access t aterative trasprtati; cassrms may t be accessibe, ad teachers may t be traied

t csider their eeds. Access t ree educati r chidre with disabiities as a resut admie r ERW

ijuries is ecessary bth t prmte a sese rmacy i their ives ad t reitegrate them with their peer

grup ad aw them t uy participate i sciety.

Few victim assistace prgrammes address age- ad geder-speciic ccers. I a 2009 survey mre

tha 1,600 survivrs rm 25 aected cutries cducted by Hadicap Iteratia, amst tw thirds

respdets reprted that services r chidre were ever r amst ever adapted t their speciic

eeds r age.

As chidre accut r a icreasig percetage the tta civiia casuaties rm ERW ad admies, it

is essetia t impemet speciic picy ad prgrammatic recmmedatis that meet their eeds. These

shud icude measures t disaggregate data casuaties by age ad geder; t trai heath ad educati

pressias t csider the eeds chid survivrs; ad t bster victim assistace, vera, as a key piar

respse t the impact ERW, with guideies that speciicay pertai t chidre.

(continued from p. 15)

Explosive remnants of war


19/28


A heath wrker assesses a by at the Ataua Sciety

r Dea Chidre, State Paestie. The rgaizati

ers educati ad vcatia traiig, ree heathcare, psychscia services ad jb pacemet.

UnICEF/HQ2008-0159/Davey

MEASURInG CHIlD DISABIlITY

A sciety cat be equitabe uess a chidre

are icuded, ad chidre with disabiities ca-

t be icuded uess sud data cecti ad

aaysis reder them visibe.

Measurig chid disabiity presets a uique set

chaeges. Because chidre devep ad

ear t perrm basic tasks at dieret speeds, it

ca be diicut t assess ucti ad distiguish

sigiicat imitatis rm variatis i rma

devepmet. The varyig ature ad severity

disabiities, tgether with the eed t appy

age-speciic deiitis ad measures, urther

cmpicate data cecti erts.

I additi, the pr quaity data chid

disabiity stems, i sme cases, rm a imited

uderstadig what disabiity is i chidre,

ad i ther cases, rm stigma r isuiciet

ivestmet i imprvig measuremet. The ack

evidece that resuts rm such diicuties

hiders the devepmet gd picies ad

the deivery vita services.

Whie there is geera agreemet that deiitis

disabiity shud icrprate bth medica ad

scia determiats, the measuremet disabi-

ity is sti predmiaty medica, with a cus

speciic physica ad meta impairmets.

oe ramewrk r csiderig heath ad dis-

abiity withi a brader ctext scia barriers

is the Iteratia Cassiicati Fuctiig,

Disabiity ad Heath (ICF), deveped by the

Wrd Heath orgaizati. This cassiicati

regards disabiity i tw mai ways: as a mat-

ter the bdys structure ad uctis, ad i

terms the perss activity ad participati.

Disabiity, as deied by the ICF, is a rdiary

part huma existece every pers ca

experiece sme degree it. The ICF deiiti

as recgizes that uctiig ad disabiity

ccur i ctext, ad therere it is meaigu

t assess t y bdiy but as scieta ad

evirmeta actrs.

Derived rm the ICF, the Iteratia

Cassiicati Fuctiig, Disabiity ad

Heath r Chidre ad Yuth (ICF-CY) takes a

step twards icrpratig the scia dimesi

by capturig t y the impairmet but as its

eect chidres uctiig ad participati

i their evirmet. It cvers ur mai areas:

bdy structures (e.g., rgas, imbs), bdy uc-

tis (e.g., isteig, rememberig), imitatis

activity (e.g., wakig, dressig) ad restric-

tis participati (e.g., payig with ther

chidre, perrmig simpe chres).

Data disabiity shud be iterpreted i c-

text. Prevaece estimates are a ucti bth

icidece ad surviva. Where chid mrtaity

rates are high, w reprted disabiity prevaece

may be the csequece w surviva rates r

yug chidre with disabiities r it may reect

the aiure t cut chidre wh ive i istitu-

tis, are hidde away by amiies, r ive ad

wrk the streets.


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Lessons learned

Sice 1995, UnICEF has supprted mre tha 100 w- ad midde-icme cutries i cductig Mutipe

Idicatr Custer Surveys (MICS) t track prgress i chidres ad wmes we-beig. Sice 20002001, sme

these surveys have icuded a mdue desiged t scree chid disabiity, ad this irmati is w beig buit

up t desig a imprved measuremet t.

The stadard disabiity mdue used i MICS betwee 2000 ad 2010 is the Te Questis Scree (TQ), which was

deveped i 1984 ad reects hw disabiity was uderstd at the time. The prcess starts by askig the primary

caregivers chidre aged 29 years r a persa assessmet the physica ad meta devepmet ad

uctiig the chidre i their care; respses are either psitive r egative, with rm r uaces.

The vaidity the TQ apprach has bee widey tested, but the resuts must be iterpreted with cauti. The TQ is

a screeig t ad requires w-up medica ad devepmeta assessmet i rder t yied a reiabe estimate

the umber chidre i a give ppuati wh have disabiities. Few cutries have had the budgets rcapacity t cduct the secd-stage ciica assessmet t vaidate resuts, ad they have bee urther hampered

by the ack a stadardized methdgy r cductig that assessmet.

Appyig the TQ durig the 20052006 MICS yieded a wide rage resuts acrss participatig cutries. The

percetage chidre screeig psitive r disabiity raged rm 3 per cet i Uzbekista t 48 per cet i the

Cetra Arica Repubic. It is t cear whether this variace reected true diereces amg the ppuatis

samped r additia actrs. Fr istace, the w reprted rate i Uzbekista may have reected a arge

ppuati chidre with disabiities ivig i istitutis, which are t subject t husehd surveys.

Cuture as pays a imprtat re. The iter-

pretati what may be csidered rma

uctiig varies acrss ctexts ad iueces

measuremet utcmes. The attaimet cer-

tai miestes may t y vary amg chi-

dre, but dier as by cuture, as chidre may

be ecuraged t experimet with ew activities

at dieret stages devepmet. Reerece va-

ues must therere be set with csiderati

ca circumstaces ad uderstadig.

Fr these reass, assessmet ts deveped

i high-icme cutries, such as the Wechser

Iteigece Scae r Chidre, cat be idis-

crimiatey appied i ther cutries r cm-

muities. Frames reerece may vary, ad

survey ts may ai t suiciety capture ca

custms, cutura uderstadig, aguages

ad expressis.

Furthermre, the speciic bjectives the data c-

ecti are ikey t iuece the deiiti what

cstitutes disabiity, the questis asked ad the

resutig igures. Fr istace, the criteria used t

deie eigibiity r a disabiity beeit are ikey

t be mre restrictive tha criteria r a survey

cducted t idetiy a perss with a uctia

imitati, yiedig dramaticay dieret umbers.

May chidre are idetiied as havig a disabiity

whe they cme it ctact with educati r

heath-care systems. But i w-icme cu-

tries r cmmuities, sch ad ciic sta may

t be abe t rutiey recgize r register the


21/28


From screening to assessment

Chid disabiity measuremet experts agree that screeig erts must be wed by i-depth assessmets.

Experieces i Bhuta, Cambdia ad the rmer Yugsav Repubic Macedia prvide imprtat esss

r the measuremet chid disabiity ad adaptati methdgy t ca ctext. They as testiy t the

trasrmative pwer data cecti.

The cmpsiti the cre assessmet team ad the type ts used were adapted t ca capacity. At the time

the study, bth Bhuta ad Cambdia aced a shrtage quaiied assessrs. I Cambdia, mbie assessmet

teams were empyed ad a hearig speciaist was brught i rm abrad, whie i Bhuta emphasis was put

traiig mid-eve pressias.

The assessmets demstrated that ts such as questiaires ad tests must be cay vaidated ad cuturay

apprpriate. Careu atteti must be paid t aguage r istace, i idig apprpriate iguistic equivaets

r the ccepts impairmet ad disabiity.

With assessmet cmes the ptetia r immediate iterveti. I Cambdia, r exampe, sme chidre

wh screeed psitive r hearig impairmet were ud t have ear iectis r a buid-up ear wax.

oce idetiied, these cditis were easiy treated ad mre serius secdary iectis ad ger-term

impairmets preveted.

Assessmet ca as aid awareess-raisig ad spark chage eve whie the prcesses cectig ad aaysigdata are sti uder way. Whe assessmets i Bhuta shwed a higher icidece mid cgitive disabiities

amg chidre rm prer husehds ad with ess educated mthers, the gvermet decided t cus

eary chidhd devepmet ad chidcare services i rura areas, where icme ad educati eves are wer.

A strategy r iterveti beha chidre idetiied as havig a disabiity shud be icrprated i the

assessmet rm the eariest stages paig. Such a strategy shud icude a mappig the avaiabe

services, the devepmet reerra prtcs ad the preparati irmative materias r amiies

hw t adjust chidres surrudigs t ehace uctiig ad participati i hme ad cmmuity ie.

presece chidre with disabiities. The resut-

ig paucity irmati chidre with dis-

abiities i w-icme cutries has ctributed

t a misccepti that disabiity des t merit

gba pririty.

Geera data cecti istrumets such as

cesus r husehd surveys are ikey t

uderestimate the umber chidre with dis-

abiities, particuary i the surveys d t ask

speciicay abut them. Targeted husehd

surveys that d s have prduced mre accu-

rate resuts tha thse that ask abut disabiity

i geera, withut reerece t chidre. Mre

umerus ad detaied questis the subject

ted t prduce higher prevaece rates.

T accuratey reprt chid disabiity, the chice

questis must be taired t a chids age i

rder t reect the devepmeta stages ad


22/28


evvig capacities chidre. Give the cm-

pexity devepmeta prcesses durig the

irst tw years ie, it ca be diicut t disti-

guish disabiity rm variatis i rma deve-

pmet withut speciaized ts r assessmet.

May data cecti istrumets are based

sey the respses parets, wh may t

have kwedge the speciic bechmarks used

t evauate chidre at each stage devep-

met. Parets may reprt diicuties that stem

rm temprary cditis, such as ear iec-

tis, ad they may as verk certai sigs,

r hesitate t reprt them because a ack

acceptace r stigma surrudig disabiity i

their cuture.

Erts t measure chid disabiity represet a

pprtuity t ik assessmet with iterveti

strategies. Thugh eary iterveti is critica,

capacity ad resurces r w-up assessmet

ad supprt r chidre wh scree psitive r

disabiity are te scarce.

A way forward

UnICEF, i partership with the Washigt Grup Disabiity Statistics ad a brad array stakehders, is

hdig csutatis t imprve the methdgy used t measure chid disabiity i Mutipe Idicatr Custer

Surveys ad ther data cecti erts, i rder t prduce atiay cmparabe igures ad prmte the

harmizati data chid uctiig ad disabiity iteratiay.

The screeig t uder devepmet cvers chidre aged 217 years ad uses a ratig scae t assess speech

ad aguage, hearig, visi, earig (cgiti ad iteectua devepmet), mbiity ad mtr skis,emtis, ad behaviurs; it as icudes aspects chidres abiity t participate i a rage activities ad

scia iteractis. As i devepmet is a stadardized vera methdgy r a mre i-depth assessmet

disabiity i chidre, with data cecti prtcs, assessmet ts ad a ramewrk aaysis.

Recgizig that speciaists may be i shrt suppy i sme areas, a tkit is beig desiged t eabe teachers,

cmmuity wrkers ad ther traied pressias t admiister the ew methdgy. This wi serve t

stregthe ca capacity t idetiy ad assess chidre with disabiities wh are at risk scia excusi

ad reduced participati.

Data that capture the type ad severity chidres

disabiities as we as the barriers t chidres

uctiig ad cmmuity participati, whe

cmbied with reevat sci-ecmic idicatrs,

hep t irm decisis abut hw t acate

resurces, eimiate barriers, desig ad prvide

services, ad meaiguy evauate such iter-

vetis. Fr istace, data ca be used t map

whether icme, geder r mirity status aects

access t educati r immuizati r chidre

with disabiities. Reguar mitrig makes it

pssibe t assess whether iitiatives desiged

t beeit chidre are meetig their gas.

There is a cear eed t harmize chid disabiity

measuremet i rder t prduce estimates that

are reiabe, vaid ad iteratiay cmparabe.

Hwever, the currety ragmeted state chid

disabiity data cecti is excuse t deer

meaigu acti twards icusi; as ew data

ad aayses emerge, they wi preset pprtui-

ties t adapt existig ad paed prgrammes

r chidre with disabiities ad their amiies.


23/28


As the atis the wrd have repeatedy

airmed their cmmitmet t buidig mre

icusive scieties, the situati may chidre

with disabiities ad their amiies has imprved.

But prgress has varied acrss cutries, ad t

may chidre with disabiities ctiue t ace

barriers t their participati i the civic, scia ad

cutura aairs their cmmuities. Reaizig the

prmise equity thrugh icusi wi require

acti i umerus areas ad by may actrs.

Ratify and implement the

ConventionsAs 2013 bega, 127 cutries ad the Eurpea

Ui had ratiied the CRPD ad 193 had ratiied

the CRC, thereby shwig a cmmitmet t a

their citizes.

Ratiicati ae wi t be eugh; hurig

cmmitmets i practice wi require t y

diiget ercemet but as rigrus mitrig,

accutabiity ad adaptati. The prcess wi

require ert the part atia gver-

mets, ca authrities, empyers, disabed

pepes rgaizatis ad parets assciatis.

Iteratia rgaizatis ad drs ca

aig their assistace with these iteratia

istrumets.

Fight discrimination

Discrimiati ies at the rt may the

chaeges crted by chidre with disabiities

ad their amiies. Airmatis equa rights ad

-discrimiati i aw ad picy eed t be

cmpemeted by erts t ehace awareess

disabiity amg the geera pubic, startig with

thse wh prvide essetia services r chidre i

such ieds as heath, educati ad prtecti.

States parties t the CRPD ad the Uited natis

ad its agecies have cmmitted themseves t

cductig awareess-raisig campaigs, ad

they are as required t prvide irmati t

chidre ad their amiies hw t prevet ad

reprt expitati, viece ad abuse.

Iteratia agecies ad their gvermet ad

cmmuity parters ca hep vercme prejudice

by prvidig icias ad pubic servats with a

deeper uderstadig the rights, capacities ad

chaeges chidre with disabiities. Parets

rgaizatis ca pay a pivta re ad shud

be reirced s that chidre with disabiities are

vaued, cherished ad supprted by their amiies

ad cmmuities.

Discrimiati the gruds disabiity is a

rm ppressi. The estabishmet a cear,

ega etitemet t prtecti rm discrimiati

is vita i reducig the vuerabiity chidre with

disabiities. Where egisati baig discrimia-

ti des t exist, disabed pepes rgaizatis

ad civi sciety as a whe wi ctiue t have a

crucia re t pay i pressig r such aws.

nguye, wh has autism, atteds a cass specifcay taired

t his eeds at the Da nag Icusive Educati Resurce

Cetre i Viet nam. Such cetres were set up t hep chidre

prepare r admissi t icusive maistream schs.

UnICEF/Viet nam/2012/Bisi

An AGEnDA FoR ACTIon


24/28


Convention on the Rights of Persons with Disabilities andOptional Protocol: Signatures and ratifications

155COUNTRIES HAVE

SIGNED THE

CONVENTION*

128

COUNTRIES HAVE

RATIFIED THE

CONVENTION*

91

COUNTRIES HAVE

SIGNED THE

PROTOCOL

76

COUNTRIES HAVE

RATIFIED THE

PROTOCOL

27

COUNTRIES HAVE

NOT SIGNED

Dismantle barriers to inclusion

A chidres evirmets schs, heath acii-

ties, pubic trasprt ad s ca be buit t

aciitate access ad ecurage the participati

chidre with disabiities agside their peers.

Whe chidre iteract ad uderstad each

ther acrss eves abiity, they a beeit.

Uiversa desig which prmtes usabiity

by a pepe t the greatest extet pssibe

shud be appied t the cstructi a

pubic ad private irastructure, as we as t

the devepmet icusive sch curricua,

vcatia traiig prgrammes, ad chid

prtecti aws, picies ad services.

Gvermets have the decisive re t pay i

itrducig ad impemetig the egisative,

admiistrative ad educatia measures eces-

sary t prtect chidre with disabiities rm a

*Icudes the Eurpea Ui.

Source: Un Eabe; Uited natis Treaty Cecti. Fr tes terms used, see p. 25.

Afghanistan

Albania

Algeria

Andorra

Angola

Antigua and Barbuda

Argentina

Armenia

Australia

Austria

AzerbaijanBahamas

Bahrain

Bangladesh

Barbados

Belarus

Belgium

Belize

Benin

Bhutan

Bolivia (Plurinational State of)

Bosnia and Herzegovina

Botswana

Brazil

Brunei Darussalam

Bulgaria

Burkina Faso

Burundi

Cambodia

Cameroon

CanadaCape Verde

Central African Republic

Chad

Chile

China

Colombia

Comoros

Congo

Cook Islands

Costa Rica

Cte dIvoire

Croatia

Cuba

Cyprus

Czech Republic

Democratic Peoples

Republic of Korea

Democratic Republic

of the Congo

DenmarkDjibouti

Dominica

Dominican Republic

Ecuador

Egypt

El Salvador

Equatorial Guinea

Eritrea

Estonia

Ethiopia

Fiji

Finland

France

Gabon

Gambia

Georgia

Germany

Ghana

Greece

GrenadaGuatemala

Guinea

Guinea-Bissau

Guyana

Haiti

Honduras

Hungary

Iceland

India


25/28

Ratified ConventionSigned Convention Signed Protocol Ratified Protocol Not signed

rms expitati, viece ad abuse. It is

t apprpriate t create separate systems r

chidre with disabiities the ga must be icu-

sive, high-quaity prtecti mechaisms suitabe

ad accessibe t a chidre.

oe such mechaism is birth registrati, a

essetia eemet prtecti. Erts t register

chidre with disabiities ad thereby reder

them visibe deserve pririty.

End institutionalization

Istitutis are pr substitutes r a urturig

hme ie, eve i they are we ru ad mitred.

Immediate measures t reduce verreiace

them cud icude a mratrium ew admis-

sis. This shud be accmpaied by the prm-

ti ad icreased supprt r amiy-based

care ad cmmuity-based rehabiitati. Makig

pubic services, schs ad heath systems

EXECUTIVE SUMMARY 23

Indonesia

Iran (Islamic Republic of)

Iraq

Ireland

Israel

Italy

Jamaica

Japan

Jordan

KazakhstanKenya

Kiribati

Kuwait

Kyrgyzstan

Lao Peoples

Democratic Republic

Latvia

Lebanon

Lesotho

Liberia

Libya

Liechtenstein

LithuaniaLuxembourg

Madagascar

Malawi

Malaysia

Maldives

Mali

Malta

Marshall Islands

Mauritania

Mauritius

Mexico

Micronesia (Federated States of)

Monaco

Mongolia

Montenegro

Morocco

Mozambique

Myanmar

NamibiaNauru

Nepal

Netherlands

New Zealand

Nicaragua

Niger

Nigeria

Niue

Norway

Oman

Pakistan

Palau

PanamaPapua New Guinea

Paraguay

Peru

Philippines

Poland

Portugal

Qatar

Republic of Korea

Republic of Moldova

Romania

Russian Federation

Rwanda

Saint Kitts and Nevis

Saint Lucia

Saint Vincent and the

Grenadines

Samoa

San Marino

Sao Tome and PrincipeSaudi Arabia

Senegal

Serbia

Seychelles

Sierra Leone

Singapore

Slovakia

Slovenia

Solomon Islands

Somalia

South Africa

South Sudan

SpainSri Lanka

Sudan

Suriname

Swaziland

Sweden

Switzerland

Syrian Arab Republic

Tajikistan

Thailand

The former Yugoslav Republic

of Macedonia

Timor-Leste

Togo

Tonga

Trinidad and Tobago

Tunisia

Turkey

Turkmenistan

TuvaluUganda

Ukraine

United Arab Emirates

United Kingdom

United Republic of Tanzania

United States

Uruguay

Uzbekistan

Vanuatu

Venezuela (Bolivarian

Republic of)

Viet Nam

YemenZambia

Zimbabwe


26/28


accessibe ad respsive t the eeds chidre

with disabiities ad their amiies wi reduce the

pressure t sed chidre away i the irst pace.

Support families

Disabiity i the amiy is te assciated with

higher csts ivig ad st pprtuities t

ear icme, ad thus may icrease the risk

becmig r remaiig pr. Pverty makes it

harder r chidre t btai eeded services

ad assistive techgy.

Scia picies shud take it accut the m-

etary ad time csts assciated with disabiity.

These ca be set with scia grats, subsidies

r trasprtati r udig r persa assis-

tats r respite care. Cash beeits are easier t

admiister, mre exibe at meetig particuar

eeds, ad as respect the decisi-makig rights

parets ad chidre. Existig cash traser

prgrammes ca be adapted s that amiies car-

ig r chidre with disabiities are t excuded

r ered isuiciet supprt.

Move beyond minimum standards

Existig supprts ad services shud be ctiu-

ay assessed with a view t achievig the best

pssibe quaity t just meetig miimum

stadards. Atteti eeds t cus servig

the idividua chid as we as trasrmig etire

systems ad scieties.

I this prcess evauati, the imprtace

participati by chidre with disabiities ad

their amiies cat be verstated. Chidre ad

yug pepe with disabiities are amg the mst

authritative surces irmati what they

eed ad whether their eeds are beig met.

Coordinate services to supportthe child

The eects disabiity cut acrss sectrs, requir-

ig crdiated services t address the u rage

chaeges acig chidre with disabiities

ad their amiies. A crdiated prgramme

eary iterveti acrss the heath, educati ad

weare sectrs wud hep t prmte the eary

idetiicati ad maagemet chidhd dis-

abiities. Earier itervetis have bee shw

t ead t arger gais i uctia capacity, ad

remvig barriers earier i ie esses the cm-

pudig eect the mutipe barriers aced by

chidre with disabiities.

Imprvemets i abiity wi have greater impact i

sch systems are wiig ad abe t accept chi-

dre with disabiities ad meet their eeds, whie

icusive sch-t-wrk prgrammes as we as

ecmy-wide erts t prmte the empymet

pepe with disabiities wi make acquirig a

educati mre meaigu r them.

Chidre with ad withut disabiities participate i

sch estivities i Bagadesh.

UnICEF/BAnA2007-00655/Siddique


27/28


Involve children with disabilities inmaking decisions

Chidre ad adescets with disabiities beg

at the cetre erts t buid icusive scieties

t just as beeiciaries, but as agets chage.

They are uiquey quaiied t prvide irmati

whether their eeds are beig met.

States parties t the CRC ad CRPD have

airmed the right chidre with disabiities t

express their views matters ccerig them

ad t be csuted whe egisati ad picies

ccerig them are deveped ad impemet-

ed. T that ed, decisi-makers wi eed t

cmmuicate i ways ad usig meas that are

easiy accessed ad used by chidre ad yug

pepe with disabiities.

The right t be heard appies t a chidre.

A chid wh is abe t express herse r himse

is much ess ikey t be abused r expited.

Participati is especiay imprtat r such mar-

giaized grups as chidre wh ive i istitutis.

Global promise, local test

I rder t ui the prmises the CRPD ad the

CRC, iteratia agecies ad drs ad their

atia ad ca parters ca icude chidre

with disabiities i the bjectives, targets ad

mitrig a devepmet prgrammes.

Reiabe ad bjective data are imprtat t assist

i paig ad resurce acati ad t pace

chidre with disabiities mre ceary the

devepmet ageda. T give impetus t the ec-

essary statistica wrk, iteratia drs ca

prmte a ccerted gba research ageda

disabiity. I the meatime, prgrammes ad bud-

gets ca be desiged t aw r mdiicatis as

additia irmati is made avaiabe.

The utimate pr a gba ad atia erts

wi be ca, the test beig whether every chid

with a disabiity ejys her r his rights icudig

access t services, supprt ad pprtuities

a par with ther chidre, eve i the mst remte

settigs ad the mst deprived circumstaces.

Conventions, optional protocols, signatures and ratifications

A Convention is a rma, mutiatera agreemet betwee may States parties.

A Optional Protocol t a Cveti is a ega istrumet iteded t suppemet the rigia agreemet by

estabishig additia rights r bigatis. Such a prtc is ptia i the sese that States parties t a

Cveti are t autmaticay bud by its prvisis, but must ratiy it idepedety. Thus, a State may

be party t a Cveti but t t its optia Prtcs.

I mst cases, a State becmes party t a Cveti by wig tw steps: sigature ad ratiicati.

By signing a Convention, a State idicates its iteti t take steps t examie the Cveti ad its

cmpatibiity with dmestic aw. A sigature des t create a ega bigati t be bud by a Cvetis

prvisis, but it idicates that a State wi t take actis that wud udermie the purpse the Cveti.

Ratification is the ccrete acti by which a State agrees t be egay bud by the terms a Cveti. The

prcedure varies accrdig t each cutrys particuar egisative structure. I sme cases, a state wi accede t a

Cveti r optia Prtc. Essetiay, accession is ike ratiyig withut irst havig t sig.

More detailed definitions are available at.

The Convention on the Rights of Persons with Disabilities is available at .

The Optional Protocol is available at.


28/28

Somewhere, a child is being told he cannot play because he

cannot walk, or another that she cannot learn because she cannot

see. That boy deserves a chance to play. And we all benefit when

that girl, and all children, can read, learn and contribute.

The path forward will be challenging. But children do not accept

unnecessary limits. Neither should we.

Anthony Lake

Executive Directr, UnICEF

Cover photograph:

Schoolchildren queue to enter their classroom in this 2007 photograph

from the Syrian Arab Republic. UNICEF/HQ2007-0745/Noorani

Design by Prographics, Inc.

United Nations Childrens Fund

3 United Nations Plaza

New York, NY 10017

[email protected]

www.unicef.org/sowc2013

United Nations Childrens Fund (UNICEF)May 2013

To read this report online,

scan this QR code or go to

www.unicef.org/sowc2013

UNICEF State of the Worlds Children _Focus Children With Disabilities_SOWC-Rapporten 2013

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