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Editor's Note: Editor's Note: The following article is reprinted from Disability World, Issue no. 19, June-August, 2003.

In early 2003 many of the international disability organizations wrote to UNICEF to request that it strengthen its programming and commitment in the area of childhood disability. The following information was provided by Rehabilitation International (RI) headquarters to clarify the need for UNICEF leadership in bringing children and youths with disabilities into the mainstream of beneficiaries of global policies and programs designed to reach all children.

Statistics

Global disability statistics are not easy to obtain, but most of the UN agencies use the rough calculation developed by RI in the 1970s that 10% of the world's population, i.e., currently 600,000,000 are born with or acquire a disability within their lifetimes. Of this 600 million, UNICEF has estimated that around one quarter or 150 million are children (It Is Our World Too! A Report on the Lives of Disabled Children, Disability Awareness in Action 2001).

However, some studies indicate that particularly in developing countries, the proportions and numbers may be significantly higher and on the rise. A recent World Bank study (Poverty and Disability: a Survey of the Literature, 1999) noted that "The proportion of disabled children in developing countries is generally higher than in developed countries .It is estimated that 6 to 10% of children in India are born disabled and that, because of low life expectancy, possibly a third of the disabled population are children."

A 1999 UNICEF commissioned study by anthropologist Nora Groce (An Overview of Young People Living with Disabilities: their needs and their rights) concluded that, "With half the world's population under 15 years old, the number of adolescents and youth with disabilities can be expected to rise markedly over the next decade. This rise will not simply reflect an increasing birthrate. Adolescents and youth are at increased risk for acquiring a disability due to work-related injuries and risk taking behaviour (including motor vehicle accidents, experimentation with drugs and unprotected sex). Furthermore, many chronic disabling illnesses and mental health conditions first appear only during the second decade of life."

In OECD countries, statistics consistently identify between 12 and 20% of the population as disabled. UN demographers familiar with disability have predicted that if WHO's new measurement tool, the International Classification of Functioning and Health (ICF), were applied to countries of the South, substantially higher rates of disability would be identified, possibly raising the global proportion from 10% to closer the rates found in the OECD countries.

The United Nations and Children Among the many United Nations agencies, only UNICEF is wholly focused on representing children (defined as age 0-18) and responding to their needs. Other UN agencies include children within various program priorities, e.g., the ILO's actions in the area of child labour, WHO's emphasis on global immunization, and UNESCO's program, "Education for All."

In 1980, the UNICEF Board adopted a disability policy, based on a commissioned study by RI, calling for system-wide initiatives to support the inclusion of disabled children within all UNICEF programs. The village-based study, conducted in several developing countries, determined that child development principles were as integral to the improvement of the lives of disabled children as they are to other children. In other words, although attention to their disabilities is important, paramount is their need to be raised within families, with attention to early stimulation, intervention, health care and education.

Within the United Nations family of agencies, it is only UNICEF with its worldwide staff of child development workers that can implement these principles on the field level and thus work to ensure that disabled children become valued members of their families. On the interagency level, it is only UNICEF that can advocate for children with disabilities on a global basis and represent their needs effectively within interagency collaborations and joint planning.

The estimated 150-250 million disabled children worldwide (see statistics above) need UNICEF as their champion, vigilant on an ongoing basis to negotiate their inclusion in global programs aimed at all children in need.

Importance of Early Intervention Comes Full Cycle

In the 1970s disability specialists began to recognize that early intervention could arrest and diminish the effects of disability in children, whether involving intense stimulation with developmentally delayed children, targeted exercises and therapy with physically disabled children, orientation and mobility work with blind children or early introduction of sign language with deaf children.

Concerning all children, in the late 1990s and early years of the 21st century, there was substantial new research published to show that: "The years 0-3 are critical in the formation of intelligence, personality and social behaviour, and the effects of neglect are cumulative;" and "Brain development before the age of one year is more rapid and intense than previously realized--the brain nearly triples in size within the first year of life, and the brain is much more vulnerable to environmental influences than suspected, including nutrition, but also the quality of interaction, care and stimulation." (RI/UNICEF One in Ten on Early Intervention, Volume 20/1999).

Following is a critical example of what disability researchers discovered that is now being applied to all children, as summarized by child development specialist Barbara Kolucki: "Every infant, disabled or not, can benefit from nurturing and stimulation of their senses. The more a child is spoken to, sung to, read to, danced with, exercised, played with, encouraged to explore in a safe environment, the more the brain and body will develop." (RI/UNICEF One in Ten, Early Intervention for Children with Disabilities,1999)

In essence, the disability field led the way in recognizing that concerning infants and young children, the earlier concentrated attention was given to a problem, the greater the chance for reducing or reversing its impact.

Now, when worldwide attention is being given to infant stimulation and low-cost early intervention techniques with all young children, RI reminds program planners that children with disabilities will benefit at even greater rates, if provided with these opportunities, and recommends that disabled children be included in all early childhood development projects. They deserve a chance to prove themselves, as do all children.

Architectural and Environmental Barriers to Progress

In 1969 RI developed and began disseminating throughout the world the International Symbol of Access, the world's first graphic indicator that a building or facility could be used by people with physical disabilities, including those in wheelchairs. This symbol, now in use the world over, was the first "welcome sign" for disabled children and adults who can't enter or use public buildings and facilities.

UNICEF has a new program called "Child Friendly Schools," which require a certain number of changes to school curricula and buildings so that more pupils can use them more easily. RI would request that this program be strengthened so that its "Child friendly schools" programs around the world will be both architecturally and programmatically welcoming of children with disabilities. This may mean the addition of a ramp, or an accessible bathroom or training of teachers in "disability friendly and accessible classrooms." For blind or deaf children, it may mean making educational materials available in braille or on tape or presenting lessons in sign language.

It is important that all UNICEF country program directors be encouraged to creatively explore how disabled children can be brought into existing outreach projects. For example, its efforts to increase the numbers of girls in education should include girls with disabilities as a target.

Appropriate Assistive Technology

Many UNICEF projects and programs emphasize the use of appropriate technology. There are innumerable examples of low cost and appropriate technology to assist people in poverty, and recently, disabled persons. RI advocates that these projects include outreach to disabled children, including low cost wheelchairs, prosthetics, hearing aids, and orientation and mobility aids. In addition, the new inclusive design approach called Universal Design, incorporates "disability-friendly"

features in accessing information and new technologies.

UNICEF Information on Disability

Since the 1980s RI has produced together with UNICEF a practical newsletter on disability and childhood, "One in Ten" in English, French and Spanish and, occasionally in Arabic.

These periodicals are produced by RI on contract with UNICEF but currently appear nowhere on UNICEF websites or via publication orders. This unique resource, which features 20 years of practical information on childhood disability in developing countries can be ordered from RI: www.rehab-international.org

UNICEF should be requested to make these practical newsletters more widely available and in more local languages.

UNICEF Priorities

On the UNICEF website, there is a description of Executive Director Bellamy's top 5 priorities for 2003:

1. immunizing every child;

2. getting all girls and boys into school;

3. reducing spread of HIV/AIDS and its impact on young people;

4. fighting for protection of children from violence and exploitation;

5. introducing early childhood programs in every country.