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Profile of disability among childrenType of disabilities among
children Type of disabilities among childrenThe PALS survey questions allow the identification of the following types of disabilities among children under 15: Hearing (applicable to all children under 15): Difficulty hearing. Seeing (applicable to all children under 15): Difficulty seeing. Speech (applicable to children aged 5 to 14): Difficulty speaking and/or being understood. Mobility (applicable to children aged 5 to 14): Difficulty walking. This means walking on a flat firm surface, such as a sidewalk or floor. Dexterity (applicable to children aged 5 to 14): Difficulty using hands or fingers to grasp or hold small objects, such as a pencil or scissors. Learning (applicable to children aged 5 to 14): Difficulty learning due to the presence of a condition, such as attention problems, hyperactivity or dyslexia, whether or not the condition was diagnosed by a teacher, doctor or other health professional. Developmental delay (applicable to children under 5): Child has a delay in his/her development, either a physical, intellectual or another type of delay. Developmental disability or disorder (applicable to children aged 5 to 14): Cognitive limitations due to the presence of a developmental disability or disorder, such as Down syndrome, autism or mental impairment caused by a lack of oxygen at birth. Psychological (applicable to children aged 5 to 14): Limited in the amount or kind of activities that one can do due to the presence of an emotional, psychological or behavioural condition. Chronic condition (applicable to all children under 15): Limited in the amount or kind of activities that one can do due to the presence of one or more chronic health conditions that have lasted or are expected to last six months or more and that have been diagnosed by a health professional. Examples of chronic conditions are asthma or severe allergies, heart condition or disease, kidney condition or disease, cancer, epilepsy, cerebral palsy, Spina Bifida, Cystic Fibrosis, Muscular Dystrophy, Fetal Alcohol Syndrome, etc. Unknown (applicable to all children under 15): The type of disability is unknown if the respondent answered YES to the general questions on activity limitations, but did not provide any YES to the questions about type of disability that followed.
Some types of disabilities are not identified before age 5Considering the stages and the rate of children’s physical, emotional and intellectual development, it is sometimes difficult to specifically identify some types of disabilities in children aged 0 to 4. Disability in young children can often be described only as a certain delay in development, whether physical, intellectual or other. Thus, for children aged 0 to 4, PALS identifies the following five types of disabilities: hearing, vision, chronic health conditions, developmental delay, and disability of an unknown nature. On the other hand, for children aged 5 and over, PALS identifies 10 types of disabilities, substituting more specific types of disabilities for developmental delay, namely disability related to speech, mobility, dexterity or a psychological condition, as well as learning disabilities and developmental disability. For further information on the different types of disabilities, see the section entitled Type of disabilities among children.
Among children aged 0 to 14, the most widespread disability is that related to a chronic health condition such as asthmaA disability due to one or more chronic health conditions affects about 118,000 children aged 0 to 14, representing 65% of children with disabilities (2.1% of all children). Half of children aged 0 to 14 with this type of disability are limited by a single chronic health condition, nearly 30% by two such conditions, and more than 20% by three or more (data not shown). Chronic health conditions that do not cause activity limitations are not considered a disability for the purposes of PALS.
Developmental delay is the most common disability in children aged 0 to 4Among children aged 0 to 4, developmental delay is the most common disability. In 2001, nearly 18,000 children with a disability, or 68%, had a developmental delay, representing 1.1% of all children aged 0 to 4. In this group, 59% had a delay in their intellectual development, 54% a delay in their physical development and 38%, another type of delay such as speech difficulties (data not shown). It is important to note that developmental delay is identified by the child’s parent/guardian and is not necessarily diagnosed by a health care professional. The identification of the disability is therefore based on the parent’s perception of his/her child’s development.
Among school-age children (aged 5 to 14), learning disabilities are one of the two most often-reported disabilitiesLearning disabilities are almost as common as activity limitations related to chronic health conditions in children aged 5 to 14. In 2001, over 100,000 children aged 5 to 14, or 2.6% of all children in that age group, were reported to have learning disabilities. This represented 64.9% of children with disabilities in the 5 to 14 age group. Among these school-age children with disabilities, boys were more likely to have a learning disability than girls (68.9% and 58.0% respectively).
Speech difficulties affect a significant number of school-age childrenHearing and vision difficulties affect nearly 24,000 and 17,000 children aged 0 to 14 respectively, or 13.1% and 9.2% of children with disabilities. Speech difficulties may have been identified by parents as a delay in development for children aged 0 to 4 but are categorized as being a specific disability for children aged 5 to 14. Speech-related disability affects about 67,000 children aged 5 to 14 (43.3% of children with disabilities). Boys are more likely to have this disability than girls (46.6% compared with 37.6%). Disabilities related to mobility and dexterity are reported in just over 21,000 children and nearly 31,000 children aged 5 to 14 respectively, or 13.7% and 20.3% of those with disabilities. While a larger proportion of boys experience dexterity problems, girls are more likely to have mobility problems. Nearly 32% of children aged 5 to 14 with disabilities, or roughly 49,000 children, were identified by their parent as having emotional, psychological or behavioural conditions that limit their activities. Developmental disability affects nearly 46,000 children aged 5 to 14, or 29.8% of children with disabilities. Among children with disabilities, disability of an unknown nature is more often observed in those aged 0 to 4 (8.9%) than in those aged 5 to14 (3.2%). Indeed, it is more difficult to specifically identify the type of disability in younger children.
The transition from home to school: a key factor in identifying certain types of disability in childrenWhile proportions of some types of disability, such as activity limitations related to chronic health conditions and learning disabilities, increase with the age of the child, others such as speech difficulties and dexterity problems, decrease with age. The transition from home to school may explain some of this variation. For example, learning disabilities are often not apparent until the child begins to attend school; as well, these difficulties are more easily detected within the school context. At the same time, the school system can provide specialized resources and services that might tend to reduce some activity limitations, such as those associated with speech difficulties.
Some children have several disabilitiesWhile survey results show more than half of children with disabilities aged 0 to 4 have only one type of limitation, almost 40% have two, and just under 10%E have three or more. Of children aged 5 to 14 with disabilities, 28.1% have only one disability, 36.5% have two or three and 24.8% have four or five. More than 10% of school-age children with disabilities have six or more. It should be noted that for a sizable proportion of children with only one disability, the nature of the disability was not identified. As well, children may be limited by more than one chronic health condition, but these count for only one disability. The number of disabilities influences the degree of severity associated to a person’s disability. In other words, the severity of overall disability depends not only on the severity of each type of disability but also the number of disabilities that an individual has. For further information on the development of the severity scale, see Severity of disability.
Severity of disabilityAn index measuring the severity of the disability was constructed based on the answers to the survey questions. Points were given according to the intensity and the frequency of the activity limitations reported by the respondent. A single score was computed for each type of disability. Each score was then standardized in order to have a value between 0 and 1. The final score is the average of the scores for each type of disability. Since the survey questions differ depending on the age of the respondent, a different scale was constructed for adults (15 years and over), for children under 5 and for children aged 5 to 14. Each scale was then divided into different severity levels. The scale for adults and for children aged 5 to 14 was divided into four groups (that is, mild, moderate, severe and very severe), while the scale for children under 5 was divided into two groups (that is, mild to moderate and severe to very severe).
Among children aged 0 to 14 in Canada, 1.4% have a severe or very severe disabilityOf the 181,000 children with disabilities aged 0 to 14, 57.4% experienced a mild to moderate disability and 42.6%, a severe to very severe disability. Thus, at the national level, 1.4% of children aged 0 to 14 had a severe or even very severe disability. The severity of disability among children varies little with age. The severity scale for children aged 5 to 14 can be disaggregated to obtain a more precise profile. Of these children, 32.1% had a mild disability, while at the other end of the scale, 17.2% had a very severe disability. The proportions of moderate and severe disabilities were relatively the same. A disability due to one or more chronic health conditions affects about 118,000 children aged 0 to 14, representing 65% of children with disabilities (2.1% of all children). Half of children aged 0 to 14 with this type of disability are limited by a single chronic health condition, nearly 30% by two such conditions, and more than 20% by three or more (data not shown). Chronic health conditions that do not cause activity limitations are not considered a disability for the purposes of PALS. The level of severity of activity limitations is different for boys and girls aged 5 to 14. Boys appear more likely to experience a very severe disability (19.1%), compared to girls (13.9%) of the same age group. Girls, for their part, seem more likely to have mild activity limitations (36.8%) than boys (29.4%). |
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