2 December 2022 - Global

The right to rehabilitation & assistive technology: A must for Children with Disabilities

Elaf*, 17, plays the keyboard while her sister Malak*, 12, watches, North East Syria

Elaf*, 17, plays the keyboard while her sister Malak*, 12, watches, North East Syria. Muhannad Khaled / Save the Children

There are nearly 240 million children with disabilities in the world. These children are 20 per cent less likely to have expectations of a better life compared to children without disabilities. [1]

In 2016, it was estimated that globally 52.9 million children younger than five years old experienced a developmental disability, such as sensory impairment, intellectual disability, and autism spectrum disorders, and 95% of them lived low-middle income countries.[2]

To change this, children with disabilities must be supported through early intervention and their rights to rehabilitation and assistive technologies must become a reality.

The right to rehabilitation is enshrined in the UN Convention on the Rights of Persons with Disabilities’ Article 26 on Habilitation and rehabilitation which states that:

“States Parties shall (…) enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social and vocational ability, and full inclusion and participation in all aspects of life.” This should “Begin at the earliest possible stage, and are based on the multidisciplinary assessment of individual needs and strengths;” and include the promotion of “the availability, knowledge and use of assistive devices and technologies, designed for persons with disabilities, as they relate to habilitation and rehabilitation.”

Rehabilitation means a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interactions with their environment. A person with an impairment has the right to rehabilitation as well as the right to decline rehabilitation if that is their choice.

Assistive technologies (AT) is the application of organized knowledge and skills related to assistive products, including systems and services. Assistive products are divided into six domains; Mobility, Vision, Cognition, Communication, Hearing, Environment.

Rehabilitation and AT are part of Universal Health Coverage. When it comes to children, it is specifically important to address the right to rehabilitation and assistive technologies as part of early intervention programmes. These programmes identify and address the needs of individual children during the prenatal period until they turn eight years old.

There are many different types of assistive products that can help children focus and thrive. Each child's needs are slightly different – therefore all communities need to have  access to a range of quality AT that is locally available, appropriate for the specific users, and suitable for use in the environments in which they will use them. Every child, their family, teachers and all other people close to the child must also be supported to maintain the assistive product.

Here are three ways in which Save the Children has supported children with disabilities to enjoy their right to rehabilitation and AT in our programmes:

LINKING CHILDREN TO SERVICES IN RURAL COLOMBIA

As part of Save the Children Colombia’s project on positive parenting, we have identified children with disabilities in rural communities of Nariño, a department in Colombia that continues to be heavily affected by armed conflict. Children, adolescents and their families in these communities are at risk of forced displacement, forced confinement, recruitment and use by illegal armed groups and access to essential and basic services is limited including healthcare and medical diagnosis for children with disabilities.

Save the Children staff, through child protection activities and house-to-house visits, help identify children with disabilities and cover their initial medical consultations. 

After having their consultations and getting their measurements taken, children are provided with assistive products such as wheelchairs, walking frames or mattresses. Then, children and caregivers are supported to understand how each product works and how to comfortably use them together with receiving guidance on how to maintain them.

STRENGTHENING CAREGIVERS TO PROVIDE THERAPIES TO THEIR CHILDREN IN MALAWI

In Malawi, we are implementing an inclusive early childhood and development programme focusing on therapeutic early stimulation of young children with disabilities. This is an early child home-based programme which is designed according to the individual needs of the child. The project is implemented together with our partner St John of God and aims to remove experienced  barriers to accessing and using professional assistive technologies.

The project provides services of physiotherapy, occupational therapy, psychosocial support such as positive parenting skills, postural equipment, social intervention. The project is supported by professionals who work to transfer appropriate home-based therapeutic skills to parents and caregivers so that children do not go without important services when they are at home.

The initiative includes regular visits from professionals to ensure caregivers are doing well and get continued support. Visits also include growth monitoring services and specialized support and referrals are provided when needed.  

SUPPORTING CHILDREN INJURED BY CONFLICT IN GAZA

Ahmed*, 10, from Gaza lost the home he lived in with his parents and six siblings as it was completely destroyed by shelling in May 2021. This day, his leg was also injured by shrapnel. Ahmed's* mother says that the challenges imposed by the Israeli blockade, including the closure of crossings and the rejection of his medical referrals, delayed his vital treatment and surgery.

Eventually, Ahmed* underwent three surgeries inside Gaza and in Egypt, but he will need a joint transplant once he turns 16, and there are concerns that his leg might have to be amputated. Ahmed's* family now lives in difficult conditions, in a temporary shelter. He says he lives in fear and anxiety, and he suffers from insomnia, nightmares, and recurrent pain.

Ahmed* outside his house in Gaza. Photo by Randa Ghazy/ Save the Children.

Ahmed* says that when he grows up, he hopes to become a doctor and perform surgeries on children who are in need.

Through or partner in Gaza, MAAN, Save the Children has been able to provide Ahmed's* family with financial support, as well as psychosocial support to him and his siblings. He has received with blankets, cushions, a closet, a heater and a medical mattress to ensure his condition is not made worse between rehabilitation sessions and surgery.

SUPPORTING THE RIGHT TO REHABILITATION IS SOMETHING EVERYONE CAN HELP WITH!

The World Health Organization estimates that today, more than 1 billion people need at least one assistive product and that this number will double to 2 billion by 2030.  

To allow more children to enjoy their lives without barriers and pain, Save the Children will continue to support children’s access to identification, assessments and provision of rehabilitation and AT. Doing so is relevant to all our work and we believe that everyone can contribute. 

Parents and caregivers can help by finding out which services are available in their communities and bring their children there.

Personnel at schools, social services and within the health care system can broaden their knowledge of early identification, screening and referral pathways.

Organisations and service providers working with children can map out service providers and actively refer children as necessary for early detection and intervention.   

International actors and governments can build partnership with expert organisations to implement and contribute to the World Health Organization’s Rehabilitation 2030 Initiative

Humanitarian actors can ensure to procure and stock the items on the Priority Assistive Products List as non-food items.  

Together we can reverse the trend and enhance access to rehabilitation and assistive products for children around the world. Read our Disability Inclusion Policy. 

 


[1] United Nations Children’s Fund, Seen, Counted, Included: Using data to shed light on the well-being of children with disabilities, UNICEF, New York, 2021.
Seen, Counted, Included: Using data to shed light on the well-being of children with disabilities - UNICEF DATA

[2] Olusanya BO, Davis AC, Wertlieb D, Boo N-Y, Nair M, Halpern R, et al. Developmental disabilities among children younger than 5 years in 195 countries and territories, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet Global Health (2018) 6(10):e1100–21. doi: 10.1016/S2214-109X(18)30309-7