Exploring the Child Functioning Module in Multiple Surveys in Ghana and Niger.

The Washington Group/UNICEF Child Functioning Module (CFM) represents progress in identifying and measuring disability among children and adolescents in censuses and surveys. This paper reports from a study among school children in Ghana and Niger aimed at investigating the stability in assessment using CFM over time and across different respondents. Four surveys and one mapping exercise using teachers and households/parents as proxies were implemented among primary school children in Ghana and Niger in 2022-2023. The surveys included CFM and variables intended to generate new knowledge about school achievement among children with disabilities. The results demonstrate considerable variation in disability classification across time and between respondent groups. Observed assessment consistency among and between teachers and parents varied largely between 60 and 70%, implying a discrepancy in disability status assessment of 30-40% over time and between respondent groups. Agreement was further analyzed using Prevalence-Adjusted and Bias-Adjusted Kappa (PABAK), yielding improved agreement as compared to Cohen's Kappa. The study supports that CFM is useful as a survey instrument for identifying patterns of functional difficulties in children at the group or population level, but also that multiple respondents are recommended when proxy reporting is used. Further studies are needed in different contexts to explore CFM statistical properties and to reach a stronger evidence base on discrepancies in disability assessment over time and across different groups of respondents.