Abstract
The usual approach in disability surveys is to screen persons with disability upfront and then ask questions about everyday problems. The objectives of this paper are to demonstrate the impact of screeners on disability rates, to challenge the usual exclusion of persons with mild and moderate disability from disability surveys and to demonstrate the advantage of using an a posteriori cut-off. Using data of a pilot study of the WHO Model Disability Survey (MDS) in Cambodia and the polytomous Rasch model, metric scales of disability were built. The conventional screener approach based on the short disability module of the Washington City Group and the a posteriori cut-off method described in the World Disability Report were compared regarding disability rates. The screener led to imprecise rates and classified persons with mild to moderate disability as non-disabled, although these respondents already experienced important problems in daily life. The a posteriori cut-off applied to the general population sample led to a more precise disability rate and allowed for a differentiation of the performance and needs of persons with mild, moderate and severe disability. This approach can be therefore considered as an inclusive approach suitable to monitor the Convention on the Rights of Persons with Disabilities.
Highlights
Article 31 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD)mandates that ratifying states “collect appropriate information, including statistical and research data, to enable them to formulate and implement policies to give effect to the present Convention” [1].Currently, there is a lack of consensus on how to measure disability, and disability prevalence estimates are still strongly influenced by each country’s conceptual or legal definitions of disability and by the questions used to operationalize these definitions in disability, health and social surveys and censuses [2,3]
In an effort to support the use of disability data collection strategies suitable for monitoring the CRPD, this study aimed to analytically demonstrate both the impact of disability screeners on disability rates and the advantage of using an a posteriori cut-off in a general population sample to identify persons experiencing disabilities
Our results show that disability screeners, i.e., screeners applied to a population at the outset to identify ‘people with disabilities’ for a survey, lead to imprecise disability rates and failed to correctly identify more than 20% of persons with severe disabilities
Summary
Article 31 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD)mandates that ratifying states “collect appropriate information, including statistical and research data, to enable them to formulate and implement policies to give effect to the present Convention” [1].Currently, there is a lack of consensus on how to measure disability, and disability prevalence estimates are still strongly influenced by each country’s conceptual or legal definitions of disability and by the questions used to operationalize these definitions in disability, health and social surveys and censuses [2,3]. Countries tend to tailor this broad definition to their needs and to the goals of specific data collection efforts, such as surveys targeting eligibility for social programs. This might be done, for example, by introducing additional criteria specifying that a person will be considered disabled only if he or she experiences limitations that have lasted longer than one year. These country-specific additional criteria are usually operationalized in filter questions used to select participants for the survey and have an important impact on disability estimates and the comparability of these estimates across countries
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