Communication disability in low and middle-income countries: a call to action

Abstract

### SUMMARY BOX Communication is essential to interaction and participation in life. The right to communicate is enshrined in the Universal Declaration of Human Rights1 and impacts achievement of all United Nations Sustainable Development Goals, enabling connectedness, expression of needs and participation in education, employment and society. Living with communication disability can impact education, work, play and well-being. Despite the high prevalence of communication disability, it is frequently overlooked in global disability service developments, policy initiatives and research. The needs of people with communication disability (PWCD) remain unheard. To achieve equity in health and disability services, communication disability needs foregrounding, particularly in low and middle-income countries (LMICs), where formal supports for PWCD are limited or non-existent and stigma is widespread.2 It is time to put the needs of PWCD on the agenda. Communication encompasses speaking, understanding, written, signed and non-verbal modalities. Communication disability is experienced when an individual communicates differently from the majority of people in their community, affecting their participation. Communication disability may result from a primary communication impairment, for example, developmental language disorder, voice disorder, stammering or can be linked to congenital, developmental, acquired and degenerative health conditions, for example, hearing loss, cerebral palsy, autism spectrum disorder, stroke, Parkinson’s disease. How an individual experiences communication disability depends on environmental and personal factors, such as the skills …