Exploring the impact of measurement approaches on disability prevalence: findings from a comprehensive child survey

Understanding how disability prevalence differs between social and medical models across socioeconomic contexts helps inform policies aimed at improving the well-being of children with disabilities. Additionally, consistent data collection methods are essential to support the shift from medical to social models of disability. This study examined associations between two measures of disability: parent-reported functional limitations based on the Washington Group/UNICEF Child Functioning Module (CFM) and medically documented impairments.

We analyzed data from Türkiye's 2022 child survey, which provided a comprehensive assessment of parent-reported functional limitations and medically documented impairments in 14,705 children aged 0-17 from 9,010 households. Using principal component analysis and logistic regression, we identified and tested associations between the two measures.

Disability prevalence was 2% based on medically documented impairments but rose to 14.1% when using the CFM, highlighting significant discrepancies across measures. The CFM responses suggested three distinct sub-populations: (1) physical, sensory, and cognitive domains, (2) social domains, and (3) emotional domains, with each group displaying unique socioeconomic characteristics. Additionally, children with medical disability reports were three times more likely to report symptoms of depression or anxiety than those without such reports, underscoring the importance of integrating functional and clinical measures for a comprehensive understanding of disability.

The findings indicate that the CFM's functional approach provided a complementary perspective to the medical model, offering global comparability and a fuller profile of childhood disability. This dual-model approach supports disability-inclusive policies by capturing a broader spectrum of functional needs, thereby aiding resource allocation and public awareness initiatives.