49. Learning and Developmental Disabilities
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Editors/Authors: Maureen S. Durkin, Helen Schneider, Vikram S. Pathania, Karin B. Nelson, Geoffrey C. Solarsh, Nicole Bellows, Richard M. Scheffler, and Karen J. Hofman
Disease / Condition
Adolescent & Childhood Diseases
Learning & Developmental Disabilities
Maternal & Neonatal Conditions
Learning and developmental disabilities (LDDs) include functional limitations that manifest in infancy or childhood as a result of disorders or injuries to the developing nervous system. These limitations, which range from mild to severe, may be caused by genetic or nutritional factors, infections, toxic exposures, trauma, perinatal factors, and multifactorial conditions.
Information on the prevalence and impact of disabilities in low– and middle–income countries (LMIC) is scarce, but some factors suggest that LDDs are, or should be, a public health priority in LMIC. These include data on specific causes and types of LDDs in LMIC, the lifelong adverse impact of these conditions, the health and social costs, and the cost–effectiveness of proven interventions.
Folic acid fortification of the food supply is one of three cost–effective interventions for LDDs. Prenatal screening and selective pregnancy termination can be highly cost–effective under some conditions, but these methods raise ethical, social, and cultural concerns that may preclude their use. Neonatal screening and treatment for congenital hypothyroidism are highly cost–effective in developed countries, but effectiveness may be reduced in places where only a part of the newborn population can be reached by screening.
The costs and benefits of community–based rehabilitation have not been sufficiently quantified to allow cost–benefit analysis. An intervention that is not recommended is electronic fetal monitoring in labor, because it has been associated with a higher risk of cerebral palsy and is unsuccessful in preventing neurological disability from premature birth.
Click on the links below to read the full text.
- LDD and the Global Burden of Disease
- Impairment, Disability, and Participation
- Three Levels of Prevention
- Unintended Consequences of Successful or Partially Successful Interventions
- Other Factors Leading to Increases in Measured Prevalence
- Interventions in Low- and Middle-Income Countries
- Research Agenda for Prevention of Disabilities in Low- and Middle-Income Countries
- 49.1 Categories of Causes of LDD
- 49.2 Classification of Interventions to Prevent LDD
- 49.3 Distribution of DALYs Lost to and Deaths Caused by Down Syndrome, by World Bank Region, 2002
- 49.4 Financial Cost-Effectiveness and Efficacy of Prenatal Screening and Pregnancy Termination for the Prevention of Down Syndrome Births
- 49.5 Cost-Effectiveness of Neonatal Screening for Congenital Hypothyroidism by World Bank Region