Ascertaining the prevalence of childhood disability.
OBJECTIVE
To reapply 1985 Office of Population Census and Surveys (OPCS) disability survey methods, modified as necessary, to a sample of children to ascertain presence of disability. To compare OPCS-based prevalence with prevalence based on carer's views and medical records.


METHODS
Analytical study. Setting Community Child Health Department in UK.


METHODS
Principal carers of 100 children aged 5-15, selected from a district special needs register. Main outcome measures Comparable information about disability from three sources and diagnosis from carers and medical records.


RESULTS
Medical records of 46% contained a diagnosis. Carers were always aware of this, although a single question did not always elicit their knowledge. OPCS-derived threshold disability criteria in categories of Hand function, Personal care, Consciousness and Continence gave prevalence results similar to medical records and carers. OPCS criteria yielded higher prevalence of disability in the areas of Locomotion (8%), Communication (14%) and Hearing (18%). Carers, OPCS and medical records disagreed markedly about prevalence of disabilities of Vision, probably because of the use of differing definitions. OPCS learning criteria were judged unsuitable and standard attainment targets (SATs) were substituted. These provided similar prevalence figures to carers and medical records. OPCS behaviour criteria were also unsuitable and were replaced by the General Health and Behaviour Questionnaire (GHBQ). This found an increased prevalence of problems compared with carers and doctors.


CONCLUSIONS
Diagnostic labels have limited use when collecting data about disabled children. Doubt is cast on the validity of some of the 1985 OPCS threshold criteria, and reassessment is suggested before their future use. Further work is needed on the use of SATs and GHBQ in the benchmarking of disability. To collect population data it would be easier and at least equally effective (with caution in the case of Vision) to ask carers directly rather than applying descriptive thresholds and external judgements. Similar information could be obtained from medical records, however, they are likely to be out of date.
Hutchison
T
T
Child Health Department, Bath and North-east Somerset Primary Care Trust, Bath,UK. tom.hutchinson@banes-pct.nhs.uk
Gordon
D
D
D000293:Adolescent; D017677:Age Distribution; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology; D006311:Hearing Disorders / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008499:Medical Records; D015995:Prevalence; D006113:United Kingdom / Q000453:epidemiology; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology