The Circumstances of Children with and without Disabilities or Significant Cognitive Delay Living in Ordinary Households in 30 Middle- and Low-Income Countries

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Home-based early intervention is a key component of strategic approaches to preventing the loss of developmental potential among young children in middle- and low-income countries. We undertook secondary analysis of nationally representative data collected in 30 middle- and low-income countries during Round 6 (2017-) of UNICEF’s Multiple Indicator Cluster Surveys. Our analyses, involving over 100,000 children with/without disabilities or significant cognitive delay, indicated that children with disabilities and/or significant cognitive delay were more likely than their peers to: be living in relative household poverty and in rural areas; have a mother with only primary level education; live in households where intimate partner violence was considered acceptable by the child’s mother; be less likely to be receiving any pre-school education; have a mother with disabilities; receive low levels of parental stimulation; be exposed to violent parental discipline. For many of these indicators of poorer home circumstances, the level of risk was notably higher for children with significant cognitive delay than for children with disabilities. Our study findings suggest the need to consider tailored, evidence-based approaches to reduce and (potentially) overcome the increased risks that young children with disabilities and young children with significant cognitive delay experience in middle- and low-income countries.