# Presentation: 398847

## Disability among children: a statistical perspective  Howard MeltzerHealth and Care Division Office for National Statistics, London, UK Washington Group on Disability Statistics4th meetingBangkok, ThailandSeptember 29 – October 1, 2004

## Definition of children

**Age (minimum and maximum)**
**Kinship relationships**
**birth parents**
**step children**
**foster children**
**Usual place of residence****	**** **

**Notes:**
The first national survey of the mental health of children and adolescents in Great Britain was a collaboration between the Social Survey division of  the Office for National Statistics and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry in London.

## Definition of disability for children

**Questions addressed to adults are inappropriate (e.g. ADL, behavioural problems)**
**What is normal for a particular age is an essential part of assessing disability (walking, running, speaking, co-ordination)**
**General delay versus functional delay: both poorly recognised by parents**
**Functional limitations, dependence on compensatory mechanisms, specialised services.**
**Focus on impairments due to the difficulty in**
**operationalising functional limitations. **

**Notes:**
The first national survey of the mental health of children and adolescents in Great Britain was a collaboration between the Social Survey division of  the Office for National Statistics and the Department of Child and Adolescent Psychiatry, Institute of Psychiatry in London.

## ICF for Children and Youth (ICFCY) 

**Clinical utility of the ICFCY is being tested at the moment.**
**Participants with access to clinical populations are completing questionnaires for children in four age groups:**
**0-2**
**3-6**
**7-12**
**13-18**
**These can be used as a framework for developing instruments for epidemiological research.**

**Notes:**
Decided not to use the DISC, DICA or CAPA. Started from scratch. Produced a structured questionnaire but with some open-ended questions so that parents and children could describe the problems in their own words.

The key question is how did we get over the problem of having possibly conflicting information from three sources plus some missing data (mainly 20% of teachers). Used the case vignette procedure to look at the clinical significance of both the quantitative and qualitative data, using qualified raters blind to each others assessments. 

## What is the purpose of collecting disability data for children 

**Service provision and resource allocation**
**Unmet need**
**Less well-developed services for children**
**16-17 year olds least well served**
**Equalisation of opportunity**
**schooling**
**employment**
**Health monitoring of the total population**

**Notes:**
Decided not to use the DISC, DICA or CAPA. Started from scratch. Produced a structured questionnaire but with some open-ended questions so that parents and children could describe the problems in their own words.

The key question is how did we get over the problem of having possibly conflicting information from three sources plus some missing data (mainly 20% of teachers). Used the case vignette procedure to look at the clinical significance of both the quantitative and qualitative data, using qualified raters blind to each others assessments. 

## How are children dealt with in censuses and surveys?

- Census
- which include all children (from birth)
- which include children from a certain age.
- Surveys
- which ask questions about all household members including children
- which ask questions about all household members including children from a certain age.
- Separate surveys of children.
- Choice of procedure depends on the country’s statistical infrastructure, the resources available for data collection and the political will to make data collection a priority.

**Notes:**
Decided not to use the DISC, DICA or CAPA. Started from scratch. Produced a structured questionnaire but with some open-ended questions so that parents and children could describe the problems in their own words.

The key question is how did we get over the problem of having possibly conflicting information from three sources plus some missing data (mainly 20% of teachers). Used the case vignette procedure to look at the clinical significance of both the quantitative and qualitative data, using qualified raters blind to each others assessments. 

## Sampling children for national surveys

**Sampling school records**
**Screening the population (enumeration or by mail)**
**Using centralised records - health or benefits**
**Piggy-backing on other surveys**

**Notes:**
Decided not to use the DISC, DICA or CAPA. Started from scratch. Produced a structured questionnaire but with some open-ended questions so that parents and children could describe the problems in their own words.

The key question is how did we get over the problem of having possibly conflicting information from three sources plus some missing data (mainly 20% of teachers). Used the case vignette procedure to look at the clinical significance of both the quantitative and qualitative data, using qualified raters blind to each others assessments. 

## Ethical issues in surveying children

**Participation of children **
**capability**
**confidentiality**
**privacy**
**Severely disabled children **
**appropriateness of questions**
**distress to parents**
**Child abuse **
**Suicidal thoughts**

**Notes:**
Decided not to use the DISC, DICA or CAPA. Started from scratch. Produced a structured questionnaire but with some open-ended questions so that parents and children could describe the problems in their own words.

The key question is how did we get over the problem of having possibly conflicting information from three sources plus some missing data (mainly 20% of teachers). Used the case vignette procedure to look at the clinical significance of both the quantitative and qualitative data, using qualified raters blind to each others assessments. 

## Disability among children: a statistical perspective  Howard MeltzerHealth and Care Division Office for National Statistics, London, UK Washington Group on Disability Statistics4th meetingBangkok, ThailandSeptember 29 – October 1, 2004