Papers by Cecilia Breinbauer
Nature Medicine, 2023
UNICEF and other international bodies must produce a clear plan that prioritizes development and ... more UNICEF and other international bodies must produce a clear plan that prioritizes development and education for children with disabilities, especially in low-and middle-income settings, as required for achieving the United Nations Sustainable Development Goals. In 2015, 193 world leaders, under the auspices of the United Nations (UN), adopted 17 Sustainable Development Goals (SDGs) as a universal call to action to be achieved by 2030 (ref. 1). The fourth goal (SDG 4) included a commitment to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all 1. To achieve this goal, the leaders further agreed that "by 2030, all children should have access to quality early childhood development, care, and pre-primary education so that they are ready for primary education" (SDG 4.2). To assess the progress made toward achieving this target globally, UNICEF is required to monitor the proportion of children under five years of age (revised subsequently to children 24-59 months of age) who are developmentally on track in health, learning and psychosocial wellbeing, (SDG 4.2.1), while UNESCO is charged with monitoring school readiness as indexed by "the participation rate in organized learning, one year before the official primary entry age" (SDG 4.2.2). Optimizing the readiness of children with disabilities for school, to facilitate their access to inclusive and equitable quality education, is the overarching purpose of the global pledge and the commitment to early childhood development. Given the 2030 deadline, there is a need to prioritize early childhood development and education for children with disabilities, in addition to implementing effective governance, monitoring and accountability mechanisms, to realize the global commitment to inclusive education.
Nature Medicine
Boo & Global Research on Developmental Disabilities Collaborators (GRDDC) nature medicine Comment... more Boo & Global Research on Developmental Disabilities Collaborators (GRDDC) nature medicine Comment in all its actions, as a statutory, evidence-based and ethical imperative. Effective and accountable leadership is crucial to realizing the unfulfilled commitments for the world's children with disabilities.
Frontiers in Public Health
The Lancet Global Health, 2022
Accelerating progress on early childhood development for children under 5 years with disabilities... more Accelerating progress on early childhood development for children under 5 years with disabilities by 2030 The Global Research on Developmental Disabilities Collaborators* The likelihood of a newborn child dying before their fifth birthday (under-5 mortality rate) is universally acknowledged as a reflection of the social, economic, health, and environmental conditions in which children (and the rest of society) live, but little is known about the likelihood of a newborn child having a lifelong disability before their fifth birthday if he or she survives. Available data show that globally the likelihood of a child having a disability before their fifth birthday was ten times higher than the likelihood of dying (377•2 vs 38•2 per 1000 livebirths) in 2019. However, disability funding declined by 11•4% between 2007 and 2016, and only 2% of the estimated US$79•1 billion invested in early childhood development during this period was spent on disabilities. This funding pattern has not improved since 2016. This paper highlights the urgent need to prioritise early childhood development for the beneficiaries of global child survival initiatives who have lifelong disabilities, especially in low-income and middle-income countries, as envisioned by the Sustainable Development Goals agenda. This endeavour would entail disability-focused programming and monitoring approaches, economic analysis of interventions services, and substantial funding to redress the present inequalities among this cohort of children by 2030.
The Lancet Global Health, 2021
Pediatrics, 2020
BACKGROUND: Estimates of children and adolescents with disabilities worldwide are needed to infor... more BACKGROUND: Estimates of children and adolescents with disabilities worldwide are needed to inform global intervention under the disability-inclusive provisions of the Sustainable Development Goals. We sought to update the most widely reported estimate of 93 million children ,15 years with disabilities from the Global Burden of Disease Study 2004. METHODS: We analyzed Global Burden of Disease Study 2017 data on the prevalence of childhood epilepsy, intellectual disability, and vision or hearing loss and on years lived with disability (YLD) derived from systematic reviews, health surveys, hospital and claims databases, cohort studies, and disease-specific registries. Point estimates of the prevalence and YLD and the 95% uncertainty intervals (UIs) around the estimates were assessed. RESULTS: Globally, 291.2 million (11.2%) of the 2.6 billion children and adolescents (95% UI: 249.9-335.4 million) were estimated to have 1 of the 4 specified disabilities in 2017. The prevalence of these disabilities increased with age from 6.1% among children aged ,1 year to 13.9% among adolescents aged 15 to 19 years. A total of 275.2 million (94.5%) lived in lowand middle-income countries, predominantly in South Asia and sub-Saharan Africa. The top 10 countries accounted for 62.3% of all children and adolescents with disabilities. These disabilities accounted for 28.9 million YLD or 19.9% of the overall 145.3 million (95% UI: 106.9-189.7) YLD from all causes among children and adolescents. CONCLUSIONS: The number of children and adolescents with these 4 disabilities is far higher than the 2004 estimate, increases from infancy to adolescence, and accounts for a substantial proportion of all-cause YLD. WHAT'S KNOWN ON THIS SUBJECT: The World Disability Report 2011 indicated that at least 93 million (∼5.1%) children ,15 years old had a moderate-to-severe disability and 13 million (0.7%) had a severe disability on the basis of the Global Burden of Disease Study 2004. WHAT THIS STUDY ADDS: More than 291 million children aged ,20 years had epilepsy and intellectual and sensory disabilities in 2017. The top 10 countries accounted for 62% of the children with these disabilities, and 95% lived in low and middle income countries.
American Journal of Electroneurodiagnostic Technology, 2003
Full night polysomnography (PSG) is proring to he useful in evaluating children with language and... more Full night polysomnography (PSG) is proring to he useful in evaluating children with language and derelopmental disorders. PSG emluation sometimes demonstrates epileptiform activity in children with loss of language who have had no seizures. PSG is also helpful in diagnosing syndromes within the autistic spectrum. a step critical to early intervention and specific treatment.
Global Social Welfare, 2018
Author Contribution PB contributed to the study conception and design, drafting of manuscript, an... more Author Contribution PB contributed to the study conception and design, drafting of manuscript, and acquisition of the data; JZ and MK provided critical revision; BH, BW, and DO contributed to analysis and interpretation of data, and CB contributed to conception and design of the study.
The Lancet Global Health, 2018
Background The Sustainable Development Goals (SDGs) mandate systematic monitoring of the health a... more Background The Sustainable Development Goals (SDGs) mandate systematic monitoring of the health and wellbeing of all children to achieve optimal early childhood development. However, global epidemiological data on children with developmental disabilities are scarce. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 provides a comprehensive assessment of prevalence and years lived with disability (YLDs) for development disabilities among children younger than 5 years in 195 countries and territories from 1990 to 2016. Methods We estimated prevalence and YLDs for epilepsy, intellectual disability, hearing loss, vision loss, autism spectrum disorder, and attention deficit hyperactivity disorder. YLDs were estimated as the product of the prevalence estimate and the disability weight for each mutually exclusive disorder, corrected for comorbidity. We used DisMod-MR 2.1, a Bayesian meta-regression tool, on a pool of primary data derived from systematic reviews of the literature, health surveys, hospital and claims databases, cohort studies, and disease-specific registries. Findings Globally, 52•9 million (95% uncertainty interval [UI] 48•7-57•3; or 8•4% [7•7-9•1]) children younger than 5 years (54% males) had developmental disabilities in 2016 compared with 53•0 million (49•0-57•1; or 8•9% [8•2-9•5]) in 1990. About 95% of these children lived in low-income and middle-income countries. YLDs among these children increased from 3•8 million (95% UI 2•8-4•9) in 1990 to 3•9 million (2•9-5•2) in 2016. These disabilities accounted for 13•3% of the 29•3 million YLDs for all health conditions among children younger than 5 years in 2016. Vision loss was the most prevalent disability, followed by hearing loss, intellectual disability, and autism spectrum disorder. However, intellectual disability was the largest contributor to YLDs in both 1990 and 2016. Although the prevalence of developmental disabilities among children younger than 5 years decreased in all countries (except for North America) between 1990 and 2016, the number of children with developmental disabilities increased significantly in sub-Saharan Africa (71•3%) and in North Africa and the Middle East (7•6%). South Asia had the highest prevalence of children with developmental disabilities in 2016 and North America had the lowest. Interpretation The global burden of developmental disabilities has not significantly improved since 1990, suggesting inadequate global attention on the developmental potential of children who survived childhood as a result of child survival programmes, particularly in sub-Saharan Africa and south Asia. The SDGs provide a framework for policy and action to address the needs of children with or at risk of developmental disabilities, particularly in resource-poor countries. Funding The Bill & Melinda Gates Foundation.
PsycEXTRA Dataset
ABSTRACT Publications of the Pan American Health Organization enjoy copyright protection in accor... more ABSTRACT Publications of the Pan American Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights are reserved. The designa-tions employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the Pan American Health Organization concerning the sta-tus of any country, territory, city or area or of its authorities, or con-cerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers' prod-ucts does not imply that they are endorsed or recommended by the Pan American Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.
Publicacion Cientifica Y Tecnica, 2008
Lancet (London, England), Jan 9, 2016
Young people's health has emerged as a neglected yet pressing issue in global development. Ch... more Young people's health has emerged as a neglected yet pressing issue in global development. Changing patterns of young people's health have the potential to undermine future population health as well as global economic development unless timely and effective strategies are put into place. We report the past, present, and anticipated burden of disease in young people aged 10-24 years from 1990 to 2013 using data on mortality, disability, injuries, and health risk factors. The Global Burden of Disease Study 2013 (GBD 2013) includes annual assessments for 188 countries from 1990 to 2013, covering 306 diseases and injuries, 1233 sequelae, and 79 risk factors. We used the comparative risk assessment approach to assess how much of the burden of disease reported in a given year can be attributed to past exposure to a risk. We estimated attributable burden by comparing observed health outcomes with those that would have been observed if an alternative or counterfactual level of expos...
C O N C L U S I O N Healthy child development during the first years of life is considered critic... more C O N C L U S I O N Healthy child development during the first years of life is considered critical to achieving later school success and to reduce inequalities. Since 1960, Chile has taken actions to promote early child development, particularly among those in poverty. In 1974, Rodriguez, Arancibia and Undurraga published a national scale to measure psychomotor delays among children from 0 to 2 months. In 1985, Haeussler and Marchant published another screening tool to measure child development among children 2 – 5 years old. These scales were implemented as screening tools in primary health care check ups. Although the coverage of children (0-6 years old) check ups in Chile is over 80%, there is no systematic information about the usage of developmental screening tests, and about the prevalence of functional developmental delays in the population. At present, the Government of Chile is working on a National System of Social Protection for Infancy and Childhood. This policy priority has produced a growing need for national data about the prevalence of developmental delays and about the demands for child services of different modalities and their determinants. According to that, the Ministry of Health is including in its national survey on quality of life a module on child development and chronic diseases.
PsycEXTRA Dataset, 2005
for their continuous support to our work. A special debt of gratitude is owed to Stanley Greenspa... more for their continuous support to our work. A special debt of gratitude is owed to Stanley Greenspan and Georgia DeGangi, who generously shared their time and clinical experiences, thereby providing important underpinnings for Section Three's focus on the preadolescent and early adolescent stages of development and on the importance of early intervention. Finally, the authors reserve a special mention for the leadership and talent of PAHO's Publications Area team, without whom this book could not have been possible. The Pan American Health Organization extends its appreciation to the Norwegian Agency for Development Cooperation (Norad) and the Swedish International Development Cooperation Agency (Sida) for their collaboration on this project. The support of these organizations has been crucial to the formation of this book's developmental approach and focus on innovative ways to promote healthy lifestyles among youth.
Youth: Choices and Change presents a comprehensive guide to the psychology of change in adolescen... more Youth: Choices and Change presents a comprehensive guide to the psychology of change in adolescents and youths, with the purpose of stimulating change in lifestyle behavior, health promotion policies, and socio-cultural attitudes toward healthy lifestyles.The second part of Section II of the book includes the following chapters:• Chapter Sixteen / The Social Cognitive Theory• Chapter Seventeen / The Social Networks and Social Support Theories• Chapter Eighteen / The Authoritative Parenting Model• Chapter Nineteen / The Resiliency Theory• Chapter Twenty / The Stress and Coping Theories• Chapter Twenty-one / At A Glance: The Interpersonal Level Theories and Models for Behavior ChangeChapters Sixteen through Twenty-one present theories of behavior change at the interpersonal level. Chapters Sixteen and Seventeen focus on the impact of social relationships on adolescent behavior. Chapters Eighteen and Nineteen focus on the effect that parents have through their parenting styles and prom...
Youth: Choices and Change presents a comprehensive guide to the psychology of change in adolescen... more Youth: Choices and Change presents a comprehensive guide to the psychology of change in adolescents and youths, with the purpose of stimulating change in lifestyle behavior, health promotion policies, and socio-cultural attitudes toward healthy lifestyles.The Section III of the book includes the following chapters:• Introduction• Chapter Twenty-six / A New Approach to Classifying Adolescent Developmental Stages• Chapter Twenty-seven / Gender Differences and Adolescent Behaviors• Chapter Twenty-eight / Early Intervention during Adolescence: The Preadolescent Period• Chapter Twenty-nine / Early Intervention during Adolescence: The Early Adolescent PeriodChapter Twenty-six presents the PAHO classification of adolescent development, integrating a wide range of recent theories. The system organizes adolescent development into six development stages (pre-, early, middle, and late adolescence, youth, and young adulthood) and five domains (body, brain, sexual, emotional, and social developm...
Cambio de paradigma Históricamente la visión del desarrollo infantil se ha basado en observar el ... more Cambio de paradigma Históricamente la visión del desarrollo infantil se ha basado en observar el progreso de las que han sido descritas como las clásicas "áreas del desarrollo": Desarrollo cognitivo, de lenguaje comprensivo y expresivo, desarrollo de la motricidad gruesa y fina, y desarrollo socio-emocional. Se han descrito hitos del desarrollo en cada una de estas áreas y se han desarrollado instrumentos para evaluar cada una de ellas por separado, de acuerdo a las edades promedios en que un niño/a con desarrollo típico va logrando estos hitos. Posteriormente se ha descrito que el desarrollo de todas estas áreas se encuentra entrelazado y se afectan mutuamente, pero ha prevalecido la noción, desde Piaget, de que el desarrollo cognitivo comanda e impulsa el desarrollo de las otras áreas. El enfoque clásico en el trabajo terapéutico con niños con trastornos del desarrollo, también conocidos como "niños con necesidades especiales" ha consistido en la búsqueda de un...
Youth: Choices and Change presents a comprehensive guide to the psychology of change in adolescen... more Youth: Choices and Change presents a comprehensive guide to the psychology of change in adolescents and youths, with the purpose of stimulating change in lifestyle behavior, health promotion policies, and socio-cultural attitudes toward healthy lifestyles.The first section of the book includes seven chapters, as follows:• Introduction• Chapter One / Adolescent Lifestyles in Latin America and the Caribbean: The Challenges and Their Scope• Chapter Two / The Knowledge-Behavior Gap in Health Promotion• Chapter Three / The Importance of Behavior Theories to Successful Adolescent Health Programs• Chapter Four / Adolescents Living in a Complex Environment of Multiple Levels of Influence• Chapter Five / Listening to Adolescents' Needs and Wants: A Respectful Intervention• Chapter Six / The Crucial Link between Theories and Developmental Stages of Adolescence•Chapter Seven / The Youth: Choices and Change Model for Designing Effective Interventions for AdolescentsThe first chapter discuss...
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Papers by Cecilia Breinbauer