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Communication is one of the challenges for children with severe and multiple disabilities due to their impairments (Turnbull et al, 2004). There is about forty percent of unknown causes of severe and multiple disabilities, but prenatal biomedical is the majority known cause of the disabilities.
In the Middle East and North Africa, the leading causes of premature death and disability and their percentage changes between 1990 and 2010 were: 1  Ischemic heart disease: 44% increase. 2  Lower respiratory infections: 47% decrease. 3  Stroke: 35% increase.  Low back pain: 77% 1  increase. Major depressive disorder: 58% increase.