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This section presents a review of
literature related to this research. The literature review was done under the
following subheadings; pattern of disability 
and associated impairments; salient features of an effective care
pattern for children with disability; 
quality of staff expected in institution caring for children with
disabilities; expected outcome of children with disabilities leaving
institutions. outcome of and summary of literature review

2.2.1   Characteristics of children with disability

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 In a rapid assessment of residential child
care institutions in the republic of Armenia conducted by Mira Antonyan in
2010, 1711 (out of a total of 4902) children living in or attending residential
care institutions have certified disabilities. Of these children, 28% have
physical disabilities, 31% learning disabilities and 41% combined disabilities
(both physical and learning). The study also stated that 35 of these 1711
children are both parentless and have a certified disability. 453 children in
orphanages are with complex disabilities, yet 450 children in the rest of
institutions are institutionalized due to physical disabilities. (Mira 2010).

Another
study group investigated children’s disability patterns and its severity
in  Australia (Australian Institute of
Health and Welfare, 2004) . For this study they selected 296,400 children aged
0-14 years. Of the children selected 7.6% were almost disable and 3.7% had
severe in disability. In disability patterns and its severity, they found, both
intellectual/learning (3.7%) and physical (3.7%) were two fold higher than the
other patterns, sensory /speech (3.1%), psychiatric (1.1%), ABI (0.3%), but
intellectual/learning (2.1%) and sensory/speech (2%) in severity were almost
twice as many as other disability patterns. In sex-wise analysis the study
found that boys (192,800 or 9.6%) compared to girls (103,600 or 5.4%) were
two-fold higher in disability patterns and its severity.

Another
study group investigated children’s disability patterns and its severity in
Australia (Australian Institute of Health and Welfare, 2004). For this study
they selected 296,400 children aged 0-14 years. Of the children selected 7.6%
were almost disable and 3.7% had severe in disability. In disability patterns
and its severity, they found, both intellectual/learning (3.7%) and physical
(3.7%) were two fold higher than the other patterns, sensory /speech (3.1%),
psychiatric (1.1%), ABI (0.3%), but intellectual/learning (2.1%) and
sensory/speech (2%) in severity were almost twice as many as other disability
patterns. In sex-wise analysis the study found that boys (192,800 or 9.6%)
compared to girls (103,600 or 5.4%) were two-fold higher in disability patterns
and its severity.

  Mckay and Atkinson (2007) in their study
found that out of 14,000 children aged 3-16 2.5% were working problems, 2.7% for
intellectual, 2.9% for physical health, 6.9% for speech and hearing, 8.5% for
sensory, and 48% for severe long-term health problems which could differ
between the sexes: males and females, rates of the disability were somewhat
higher for boys (4.9%) than for girls (3.6%). For both genders, rates of
disability rose steadily from birth until around age 6 or 7, at which point
they tended to vary less with age, although they packed at age 12 for boys and
15 for girls. They also explored that the low rates for very young children may
simply reflect the length of time taken to get a diagnosis of the potential
problem.  .

Another study group (MMWR, the
metropolitan Atlanta developmental disabilities surveillance program,
1996)  conducted in metropolitan Atlanta,
U. S. found that children with age 3-10 irrespective of age, sex and race were
from 5.2 to 16.6 per 1,000 for mental retardation in which 1/3 of the children
were severe retardation (i.e. an intelligence of <50). The rate of moderate to severe hearing impairment was 1.1 per 1,000 in which black males were more severe hearing problems than were other sex and race, whereas rate of vision impairment was also slightly different between the groups studied. In a recent study (Bizier et al. 2007) examined disability patterns and its severity across the age and sex groups in Canada. Of the age and sex groups rate of children's (>15)
disability was 3.7%. It was 1.7% for 0 to 4 age group and 4.6% for 5-14 ones.
This study also explored that disability patterns and its severity were to some
extent higher for boys than for girls. Likely, a study group in New Zealand (
Ministry of Social Welfare, Bangladesh, 2002) 
examined 716,500 respondents to determine disability patterns and its
severity. Of the respondents 7256 were disabling: 22% for adults and 11%
children. Among the children sex and age differences in disability were also
note worthy: 13% for boys and 9% for girls.

 A high proportion of the children in public
care population is reported to experience mental health difficulties. In
addition, it is reported that more disabled boys than girls are in public care,
and that they tend to enter care at an older age than their non-disabled peers.
In terms of impairment type, those with intellectual disabilities form a
greater proportion of the population than other types of impairment.  ( Kelly et al 2012).

 A research in Bangladesh (Chowdhury et al
2009 indicate that disability patterns and its severity are  increasing daily, like many other developed
and underdeveloped regions of the world.

Centre
for Services and Information on Disability (CSID), 2002 reported that out of
310 samples aged 13+ (girls and women) 37.33% girls were physically disabled.
In addition, speech, hearing and intellectual disabilities were next positions
and about 10% were multiple disabilities. In 
severity, there were 36.13% for moderate and 9.35% for profound
disabilities.

In  another 
study (Anam et al 2006) of the 120 street children aged 0-16 years
prevalence of male children’s disability pattern and its severity was higher
than the female children’s ones (39.17% boys and 12.5% girls for physical
disability, 10% boys and 5% girls for speech and hearing, 10% both for visual,
7.5% boys and 2 girls for intellectual, and 2 boys and 4.17% girls for
multiple). In the middle age group, 6-15 prevalence of disability and its
severity was also higher than the other age groups of the selected samples.
Over the past several decades, the incidence of disability and its underlying
health conditions has shifted away from physical disorders toward mental health
disorders. 

In
2008–09, the top five limiting conditions of children were behavioral or
developmental. More than one in five parents reporting a child with a
disability cited ADHD as an underlying condition; another 19 percent cited
other mental, emotional, or behavioral problems. Today ADHD is almost three
times more likely than asthma to contribute to childhood disability.

In a study by Uddin et al (2010)
in Ibadan, Nigeria, there were a total of 644 cases during the study period,
369 males and 275 females, giving a male to female ratio of 1.3:1. There were
1353 consultations at the paediatric neurology clinic and these accounted for
21.0% of the total 6,442 consultation s at the paediatric specialist clinics in
the hospital. The most frequent paediatric neurological disorders were epilepsy
(45.3%), cerebral palsy (36.0%), neuro-muscular disorders (4.5%) and mental
retardation (4.5%). (Lagunju, Okafor 2009).  

A disability survey in kogi and
niger states of Nigeria showed the pattern of disability as vision (37%),
mobility (32%) or hearing (15%). A third of these were less than 21 years of
age and had no occupation, and 72% were Muslim 
(Natalie smith 2005).

The author is not aware of any study showing to age,
sex, and severity pattern of children with disabilities attending institutions
in any region in Nigeria

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