Childhood Disability from a Public Health Perspective: Functioning, Participation, and Modifiable Determinants

Background/Objectives: Childhood disability is a major public health issue affecting functioning, participation, social inclusion, and quality of life. These outcomes reflect interactions between individual functional limitations and healthcare, educational, family, social, and environmental factors. This review aimed to critically synthesize evidence on childhood disability, emphasizing functioning, participation, and potentially modifiable determinants. Methods: A structured narrative review was conducted using PubMed, Scopus, and Web of Science, with searches updated in August 2026. English-language publications addressing epidemiology, functional consequences, healthcare, rehabilitation, educational inclusion, family factors, and social determinants were included. Evidence was synthesized qualitatively, considering study design, consistency, and methodological limitations. Results: Childhood disability encompasses heterogeneous conditions with varying functional consequences and support needs. Prevalence estimates differ across definitions, populations, and assessment methods, with substantial evidence gaps in low- and middle-income countries. Children’s participation is associated with family support, environmental accessibility, educational inclusion, and healthcare access. Financial barriers, fragmented services, stigma, and discrimination may further restrict participation opportunities. However, evidence linking modifiable determinants to participation is generally stronger than evidence demonstrating that interventions targeting these determinants improve participation. Improvements in clinical status, functional abilities, or healthcare delivery do not necessarily establish meaningful participation gains. Conclusions: Childhood disability requires a public health approach addressing both individual functioning and potentially modifiable barriers. Future interventions should evaluate participation as a distinct outcome, incorporate children’s perspectives, and examine whether coordinated, accessible, and family-centered support produces sustained improvements in everyday participation.