Table 1 Clinical assessment method and definitions of impairment
From: Childhood disability in rural Niger: a population-based assessment using the Key Informant Method
Impairment/health condition | Washington Group screening triggers | Screen/Exam | Assessment | Case definition |
|---|---|---|---|---|
Moderate/severe vision impairment | At least some difficulty seeing (with glasses if used), learning | Exam | Visual acuity test using PeekAcuity. Eye exam with direct ophthalmoscope by paediatrician | logMar ≥ 0.5 for both eyes |
Moderate/severe hearing impairment | At least some difficulty hearing (with hearing aids if used), being understood by people inside or outside of the household, learning | Exam | Pure Tone Audiometry (PTA) using HearTest; ear exam by paediatrician using an otoscope | ≥ 31 dB for both ears |
Moderate/severe physical impairment | At least some difficulty walking 100 m or 500 m, with equipment if used, with self-care, being understood by people inside or outside of the household, self-care | Exam | Standardised observation of activities (ability to hold and change position, mobility, and hand function) | Cannot do at least one activity, with functional difficulty reported to have lasted at least one month |
Epilepsy | (Non-Washington group): Child has ever had a seizure | Screen | Four screening questions on type and frequency of epilepsy episodes in the last year | Reported three or more seizures in the last year |
Albinism | (Non-Washington Group): Caregiver report/visual confirmation | n/a | n/a | Caregiver report, visual confirmation |
Intellectual impairment | At least some difficulty with self-care, being understood by people inside or outside of the household, learning, remembering, concentrating on an enjoyed activity, accepting changes to his/her routine, controlling his/her behaviour, making friends, self-care | Screen | 12 age-relevant questions on communication, behaviour, comprehension, concentration, relationships and learninga | Screens positive on at least 3 questions |
Emotional distress | At least some difficulty being understood by people inside or outside of the household, learning, remembering, concentrating on an enjoyed activity, accepting changes to his/her routine, controlling his/her behaviour, making friends; seems anxious, nervous or worried daily or weekly; seems sad or depressed daily or weekly | Screen | PHQ-A (depression) [25] | Depression (PHQ-A): score ≥ 10 PTSD: score of ≥ 17 |