New approaches to categorising childhood disability: an international comparative analysis of the UNICEF/Washington...

Area of Science:

• Child development
• Disability studies
• Public health

Background:

• The Child Functioning Module (CFM) assesses functional difficulties in children across six domains.
• Current cut-off points for CFM data are limited in representing complex, co-occurring difficulties.
• This limitation impacts accurate identification for international monitoring and intervention.

Purpose of the Study:

• To propose and test a novel analytical approach for identifying multiple co-occurring difficulties using CFM data.
• To expand the understanding of disability profiles beyond simple cut-offs.
• To utilize data from the 6th round of UNICEF-supported Multiple Indicator Cluster Surveys (MICS) in seven African countries.

Main Methods:

• Confirmatory Factor Analysis (CFA) was used to validate the theoretical functional domains within the CFM.
• Latent Profile Analysis (LPA) was applied to factorial scores to identify distinct groups with specific disability profiles.
• The analysis was conducted across seven African countries using MICS data.

Main Results:

• The 6-factor CFA model demonstrated adequate fit, confirming the functional domains.
• Factorial correlations indicated co-occurrence of difficulties across domains, with emotional functioning being largely independent.
• LPA successfully identified six distinct disability profiles, showing remarkable consistency in nature and frequency across the studied countries.

Conclusions:

• The proposed analytical approach effectively identifies co-occurring difficulties in children's functioning.
• This method provides policymakers with crucial information for tailoring interventions to the specific needs of children with disabilities.
• The findings have significant implications for developmental disability models, global health planning, and resource allocation.