Advancing early childhood development for children with disabilities and the Global Disability Summit 2025

In 2015, the global health community, represented by 193 UN Member States, committed to ensuring inclusive, high-quality education for children with disabilities under the Sustainable Development Goals (SDGs), 2015–2030. The SDGs also recognised optimal early childhood development (ECD) as a critical pathway to disability-inclusive education. It was, therefore, imperative to have a robust and globally coordinated disability-focused ECD initiative—one that prioritises early detection and intervention services from birth to 5 years of age—to ensure school readiness and lifelong inclusion for children with developmental delays and disabilities.¹,³ UNICEF was rightly designated under the SDGs as the lead custodian UN agency to advance this global vision for children with disabilities. In pursuit of the mantra ‘nothing about us, without us’, the Global Disability Summit (GDS) was launched in 2017 to promote disability inclusion across health, education, social and economic sectors as a fundamental human right (https://www.globaldisabilitysummit.org/). Since its inception, three summits have taken place: in 2018, 2022 and most recently in April 2025. This article examines the progress on ECD by UNICEF for children with disabilities against the backdrop of GDS 2025 and SDGs.

Children with disabilities have always been overlooked in global health, primarily due to the absence of population-based data to inform policy intervention. In 2021, UNICEF⁴ published a landmark report on The State of the World’s Children with Disabilities. Some 240 million children aged 0–17 years—including about 30 million under the age of 5 years—were estimated to have disabilities, based on parent- or caregiver-reported moderate-to-severe functional difficulties. In contrast, estimates from the Global Burden of Disease Study suggest a higher prevalence of 53 million children aged under 5 years with mild-to-severe impairments,⁵ in line with the International Classification of Functioning, Disability and Health (ICF).⁶ Besides the efforts towards disability estimation globally, UNICEF reported that children with disabilities face the highest risk of poor development in early childhood. For instance, children with disabilities are significantly more likely to have limited reading and numeracy skills, to never attend school or drop out early and to have lower expectations for their future, all compared with children without disabilities. These disadvantages are further compounded by systemic health, social and economic inequities experienced by persons with disabilities over the life course, particularly in low- and middle-income countries (LMICs) as highlighted by WHO.⁷

To address these challenges, in 2022, UNICEF launched the Disability Inclusion Policy and Strategy 2022–2030,⁸ which aims to promote disability inclusion across its key sectors. This includes early childhood screening and intervention, access to inclusive health and nutrition services, inclusive education and skills training, and support for protective child welfare systems.

In 2023, for the first time, UNICEF’s yearly report on the State of the World’s Children included data from a limited number of countries on children with disabilities. In February 2025, with 5 years remaining to meet the SDG targets, UNICEF reported that 4.7 million children with disabilities across more than 145 countries (approximately 2% of the global estimate of 240 million children) had been reached through its development and humanitarian programmes.⁹ Among these were 438 064 children who received assistive technologies, including hearing aids, spectacles, wheelchairs and prosthetics. Additionally, 158 543 children and their families received community-based mental health and psychosocial support. Countries such as Bangladesh, Ethiopia, Lesotho and Rwanda were supported in developing early identification tools and interventions within their health and education systems. However, it is unclear whether interventions were delivered early enough to optimise developmental outcomes. For example, providing hearing aids for congenital deafness at school entry rather than during infancy, despite strong global evidence on the importance of early intervention, can delay critical speech, language and cognitive development.

UNICEF has been an active partner of GDS since its inception. However, ECD has not been a central theme of the GDS—a gap echoed by several stakeholders during side events at GDS 2025. Discussions on inclusive education still primarily focus on school-age children, with occasional references to preschool education. For example, in 2022, out of 1416 pledges listed on the GDS Commitments Portal (https://gds.idata.tools/home), 10 or fewer addressed ECD or early detection and intervention, despite 231 pledges on inclusive education and 185 on inclusive health. Early signs suggest that promises made in 2025 will follow a similar pattern. Additionally, preventable risk factors for childhood disabilities are rarely discussed, considering the substantial lifetime challenges associated with disabilities. As the primary UN agency for promoting ECD under the SDGs, UNICEF can play a critical role in addressing these gaps in priorities within the disability community.

It is noteworthy that UNICEF, at GDS 2025, announced several commitments for the next 5 years, including:

• Supporting at least 50 countries to build multisectoral Early Childhood Intervention systems to provide individualised services for children with developmental delays and their families.

• Ensuring access to assistive technology for at least five million persons, especially children with disabilities.

• Advancing the collection of high-quality, internationally comparable data on children with disabilities.

UNICEF also launched the Global Research Agenda for Children with Disabilities to guide future research, policy and investment. Early identification and intervention were listed as one of its five priority themes. In addition, a new Children with Disabilities Fund—modelled after the successful Child Nutrition Fund launched in 2023—was announced to galvanise global financing towards disability inclusion. These are promising developments to foster disability inclusion, at a time when prominent donors and providers of development assistance for health to LMICs have announced drastic cuts in their foreign-aid budgets.

The needs of children with disabilities are broad and complex because of the diverse underlying health conditions and impairments. Given the considerable challenges experienced by these children as reported by UNICEF, an urgent, well-coordinated global ECD strategy is long overdue. This strategy should embrace the twin-track approach (mainstream and targeted interventions) in line with the UN Disability Inclusion Strategy and current practices in some countries.¹⁰ Evidence-based priority areas of support with prospects for immediate impact must be identified. For example, UNICEF can be guided by its own data on the global estimates of functional difficulties attributable to sensory, physical, motor, psychosocial and cognitive impairments. This would require that LMICs are assisted through strategic partnerships to build national capacity to support children with disabilities from birth through routine newborn screening for sensory and congenital disorders, along with family-centred monitoring of developmental milestones.

UNICEF has the global reach, resources and influence to lead a transformative agenda for disability-focused ECD by 2030. However, without a clear global strategy—ideally developed in partnership with other sister agencies, such as the WHO and the World Bank, and countries with established ECD programmes—it will be challenging to meet the SDG vision or deliver the reliable evidence needed to inform its implementation. Such a global initiative will advance health, social and educational equity for children with disabilities as a moral imperative and a fundamental human right, in line with the UN Convention on the Rights of the Child, the Convention on the Rights of Persons with Disabilities and the human rights modus operandi of GDS. It is also pertinent to emphasise that the concept of ‘nothing about us, without us’ cannot be achieved for very young children in early childhood without engagement with parents and caregivers. Yet, parents are rarely consulted or allowed to engage with the disability community. Moreover, paediatricians and other childcare providers have a leading, authentic and legitimate role as advocates and principal interventionists in facilitating evidence-based disability inclusion for every child from birth. We hope that the special collection on disability and development in early childhood in this journal will contribute to filling the current critical knowledge and policy gaps and ultimately foster a more inclusive and equitable future for the world’s youngest children with disabilities and their families, especially in LMICs.