Leaving no one behind during the pandemic: Children with disabilities and COVID-19

Even in the absence of a global threat, children living with disabilities are among the world’s most vulnerable, marginalized and stigmatized populations. The current coronavirus disease 2019 (COVID-19) context has disrupted life in every corner of the world and will likely disproportionally affect those children with pre-existing vulnerabilities. The greater burden faced by children living with disabilities means that additional efforts will be required to ensure their needs are being met when transitioning to the different pandemic phases. Programmatic actions will need to address these specific challenges during the pandemic and post-pandemic period along differentiated, inclusive policy responses.

Some underlying health conditions place children living with disabilities at higher risk for becoming infected with and developing severe illness as a result of COVID-19.  Additionally, children living with disabilities, especially those with difficulties in the domains of hearing, seeing and cognitive functioning, also face important barriers in the access to inclusive public health information and communication strategies that are crucial as preventative measures during pandemic periods. Access to essential health services and WASH facilities are also important factors, not only because many children living with disabilities live in poverty contexts but also due to the intrinsic barriers in accessing these services and the limited capacities of health systems to deliver inclusive health care services.

The social distancing measures implemented by many countries have caused severe disruptions to daily routines. As of April 26, 2020, schools have been suspended nationwide in 189 countries.[1] For all children, such closures may imply a lack of access to important resources. For children with disabilities, remote home schooling not only requires access to adequate IT resources and internet, availability of books and other learning materials, but also, access to specific assistive devices or special education curriculums that allow for a continuous education at home that accommodates the child’s specific learning needs.

There are also widespread concerns about the effect of social isolation or social distancing on child wellbeing, including increased anxiety, depression, stress, and concern about exacerbation or relapse of pre-existing mental health issues, placing children at increased risk for clinically significant mental health issues, alcohol and substance misuse and suicide.[2] Children with existing mental health functioning difficulties, might be particularly affected by disruptions to services, isolation, and possible exacerbation of symptoms in response to pandemic-related information and behaviors. Quarantine constrains and overall burden faced by families might also place children with disabilities at increased risk for discrimination and of being exposed to violent discipline methods in the household.

Finally, ongoing monitoring efforts, including surveys and censuses, have been severely affected as a result of the strategies to contain the spread of COVID-19 across the globe. In many countries, National Statistical Offices are suspending or adjusting current operations to protect the health and safety of their staff and the public, trying to make sure that they still recollect data from the population using alternative methods, such as telephone and internet-based data collection. While these methods will likely provide important data to track and capture the burden and effects of the COVID-19, there are concerns about the need to ensure that these approaches are inclusive of people with disabilities.

What UNICEF is doing

The barriers and exacerbated burden experienced by children living with disabilities can be reduced if key stakeholders take appropriate action. UNICEF has traditionally been in a privileged position to deliver prompt response in terms of data and evidence to guide programmatic approaches that can address needs of children during emergency and contingency situations.

Since 2011, UNICEF and the Washington Group (WG) have been working on the development of a comprehensive set of tools to strengthen capacities for countries to collect, analyse, understand, use, and disseminate data on children living with disabilities. This includes the Module on Child Functioning (CFM), which reflects current thinking around disability and allows to produce internationally comparable data on the percentage of children 2 to 17 years of age with functional difficulties in the domains of communication, hearing, vision, learning, mobility and motor skills, and emotions. Since its release in 2016, the module has been used in many surveys, including in the sixth round of Multiple Indicator Cluster Survey program (MICS6).

UNICEF is undertaking dedicated data analyses to identify specific vulnerabilities faced by children with disabilities that place them at heightened risk for disadvantaged outcomes. Data analyses will allow to document and anticipate the capacity of the pandemic to exacerbate current inequities affecting children living with disabilities results of this analysis will be made available on data.unicef.org when they are published.

Generating disability inclusive evidence will help countries to be better equipped when transitioning into the post-pandemic period and to inform differentiated policy responses for children living with disabilities. Now more than ever, a focus on disability measurement should be harnessed as to contribute to the reformulation of data collection methodologies to ensure that newly collected information on the burden and impacts of COVID-19 does not leave children living with disabilities behind.

Resources on children with disabilities and COVID-19

References

[1] UNESCO: COVID-19 Educational Disruption and Response available at: https://en.unesco.org/covid19/educationresponse , consulted April 27 2020

[2] Holmes E., O’Connor R, Perry, V, et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry, Published Online April 15, 2020 https://doi.org/10.1016/S2215-0366(20)30168-1