Validation of the key informant method to identify children with disabilities: methods and results from a pilot study...

Area of Science:

• Global Health
• Pediatric Disability
• Public Health Interventions

Background:

• Identifying children with disabilities in low-income settings presents significant challenges.
• Existing methods may be costly or inaccessible, hindering early intervention.
• The key informant method (KIM) offers a potential community-based solution.

Purpose of the Study:

• To evaluate the effectiveness of the key informant method (KIM) for identifying children with disabling sensory or physical impairments, or epilepsy in a low-income context.

Main Methods:

• Key informants (KIs) in five subdistricts were trained to recognize specific childhood disabilities: visual impairment, hearing impairment, physical impairment, and epilepsy.
• One subdistrict utilized KIs trained for all four conditions simultaneously.
• Children identified by KIs were subsequently examined to confirm diagnoses.

Main Results:

• A total of 2260 children were identified by KIs, with 1227 (54%) attending examinations.
• Of those examined, 911 (74%) were diagnosed with a disabling impairment.
• KIM demonstrated high sensitivity (average 98%) for case detection across all impairment types, though specificity was lower (average 44%), particularly for hearing impairment.

Conclusions:

• Key informants successfully identified children with epilepsy and various sensory and physical impairments.
• The key informant method (KIM) is a cost-effective strategy for identifying children with disabilities in resource-limited settings.
• KIM shows promise as a sensitive tool for disability screening in underserved populations.