GRDDC
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Research Notes

From inception, GRDDC recognised the challenges presented by various debates on terminologies for children with developmental disabilities in different cultural contexts. There is also a lack of consensus in the literature on which health condition or disorder constitutes a developmental disability. We recognise that diverse conditions and disorders may impair the development of children in early childhood. Guided by the United Nations' Convention on the Rights of Persons with Disabilities, we consider children under 5 years with developmental disabilities as children under 5 years who have long-term physical, visual, hearing and communication, learning (cognitive and intellectual) and psychosocial/behavioural impairments which, in interaction with various barriers, may hinder their full and effective participation in society on an equal basis with other children. While we are committed to serving all children with disabilities and their families, we are constrained to align our target conditions and terminologies with those derived from ICD Codes and other Classification Systems for which there is an existing infrastructure for estimating the burden of disease in line with international practice. As a result, GRDDC has chosen to focus on the following conditions for which global estimates are periodically reported by the Institute of Health Metrics and Evaluation (IHME), a global leader in population health metrics. 
 
  • Attention-Deficit/Hyperactivity Disorder
  • Autism Spectrum Disorder
  • Cerebral Palsy
  • Epilepsy
  • Hearing Impairment
  • Developmental Intellectual Disability
  • Vision Impairment
  • Congenital Birth Defects (including Neural Tube Defects and Down Syndrome)
 
This approach allows us to link mortality, disabilities and other health outcomes among children under-5 years in a manner that will optimise our advocacy engagements with policy makers in global health. This list will be updated in our future data analysis as more global, regional and national estimates for all the 194 countries included in the Global Burden of Disease (GBD) Study become available.
 We also hold the view that "a rising tide lifts all boats!

Global Estimates of Children under 5 years with Developmental Disabilities
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Globally, 52·9 million (95% uncertainty interval [UI] 48·7m–57·3m; or 8·4% [7·7%–9·1%]) children younger than 5 years (54% males) had epilepsy, intellectual disability, hearing loss, vision loss, autism spectrum disorder, and attention deficit hyperactivity disorder in 2016 compared with 53·0 million (49·0m–57.1m; or 8·9% [8·2%–9·5%]) in 1990. About 95% of these children lived in low-income and middle-income countries. YLDs among these children increased from 3·8 million (95% UI 2·8m–4·9m) in 1990 to 3·9 million (2·9m–5·2m) in 2016.

These disabilities accounted for 13·3% of the 29·3 million YLDs for all health conditions among children younger than 5 years in 2016. Vision loss was the most prevalent disability, followed by hearing loss, intellectual disability, and autism spectrum disorder.

However, intellectual disability was the largest contributor to YLDs in both 1990 and 2016. Although the prevalence of developmental disabilities among children younger than 5 years decreased in all countries (except for North America) between 1990 and 2016, the number of children with developmental disabilities increased significantly in sub-Saharan Africa (71·3%) and in North Africa and the Middle East (7·6%). South Asia had the highest prevalence of children with developmental disabilities in 2016 and North America had the lowest.
 
In 2019, 8.1 million (95% UI: 7.1m-9.2m or 1.2% [1.1%-1.4%]) children under 5 years were estimated to have cerebral palsy globally. This condition accounted for 1.8 million (95% UI: 1.2m-2.4m) YLDs. Additionally, 15.7 million (95% UI: 13.7m-17.9m, or 2.4% [2.1%-2.7%]) children younger than 5 years had congenital birth defects including children with neural tube defects [256,852  or 38.8 per 100,000] and Down syndrome [278,694 or 42 per 100,000].
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Sources:
  • GRDDC. Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Glob Health. 2018 Oct;6(10):e1100-e1121
  •  Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019 (GBD 2019) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2020.  Available from http://ghdx.healthdata.org/gbd-results-tool.
  • Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2021 Dec 19;396(10267):2006-2017. doi: 10.1016/S0140-6736(20)32340-0. 

Steering Committee

Prof. Nihad Almasri
Jordan
Prof. Nem-Yun Boo
​Malaysia
Dr. Cecilia Breinbauer
​Chile
Prof. Adrian C. Davis
​UK
Prof. Mijna Hadders-Algra
​Netherlands
Prof. M.K.C. Nair
India
Dr. Bolajoko O. Olusanya
Nigeria
Prof. Scott M. Wright
USA
Advisory Board 
Prof. Charles R.J.C. Newton (Kenya), Prof. Maureen Samms-Vaughan (Jamaica), Prof. Donald Wertlieb (USA) 
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    • HISTORY
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