Childhood disability rate jumps 16 percent over past decade
Number of kids with neurodevelopmental disabilities increases, but limitations due to physical conditions decrease
WASHINGTON, DC – More children today have a disability than a decade ago, and the greatest increase is among kids in higher-income families, according to a study to be presented Sunday, May 5, at the Pediatric Academic Societies (PAS) annual meeting in Washington, DC.
The study also found that disabilities related to physical health conditions have decreased, while disabilities due to neurodevelopmental and mental health problems have increased greatly.
“Nearly 6 million kids had a disability in 2009-2010 — almost 1 million more than in 2001-2002,” said lead author Amy J. Houtrow, MD, PhD, MPH, chief, Division of Pediatric Rehabilitation Medicine at Children’s Hospital of Pittsburgh of University of Pittsburgh Medical Center and associate professor of physical medicine and rehabilitation and pediatrics at University of Pittsburgh School of Medicine.
Dr. Houtrow said previous studies have indicated that the prevalence of childhood disability is increasing. She and her colleagues wanted to look more closely at the conditions and socio-demographic factors associated with disabilities.
The researchers analyzed data from the National Health Interview Survey conducted by the Centers for Disease Control and Prevention in 2001-2002 and survey data from 2009-2010. A total of 102,468 parents of children ages 0-17 years participated in the surveys.
Parents were asked whether their child had any limitations in play or activity, received special education services, needed help with personal care, had difficulty walking without equipment, had difficulty with memory or had any other limitation.
If they answered yes to any of those questions, they were asked whether their child’s limitations were due to a vision or hearing problem; asthma or breathing problem; joint, bone or muscle problem; intellectual deficit or mental retardation; emotional or behavior problems; epilepsy; learning disability; speech problems; attention-deficit/hyperactivity disorder; birth defect; injury or other developmental problem.
Researchers classified conditions into three groups: physical, neurodevelopmental/mental health and other.
Results showed that the prevalence of disability increased 16.3 percent from 2001-2002 to 2009-2010.
While neurodevelopmental and mental health-related disabilities increased, those due to physical conditions decreased. This trend was most notable among children under 6 years of age whose rate of neurodevelopmental disabilities nearly doubled over the study period from 19 cases to 36 cases per 1,000 children.
“The survey did not break out autism, but we suspect that some of the increase in neurodevelopmental disabilities is due to the rising incidence or recognition of autism spectrum disorders,” Dr. Houtrow said.
The data also showed that children living in poverty experienced the highest rates of disability at both time periods but not the highest growth. The largest increase was seen among children living in households with incomes at or above 300 percent of the federal poverty level (about $66,000 a year for a family of four).
“We are worried that those living in poverty may be having problems with being diagnosed and getting services,” Dr. Houtrow said.
Since the study could not pinpoint why the disability rate is increasing, more research is needed, she concluded.
To view the abstract, “Childhood Disability Trends, 2000-2010,” go to http://www.abstracts2view.com/pas/view.php?nu=PAS13L1_2600.3.
The Pediatric Academic Societies (PAS) are four individual pediatric organizations that co-sponsor the PAS Annual Meeting – the American Pediatric Society, the Society for Pediatric Research, the Academic Pediatric Association, and the American Academy of Pediatrics. Members of these organizations are pediatricians and other health care providers who are practicing in the research, academic and clinical arenas. The four sponsoring organizations are leaders in the advancement of pediatric research and child advocacy within pediatrics, and all share a common mission of fostering the health and well-being of children worldwide. For more information, visit http://www.pas-meeting.org. Follow news of the PAS meeting on Twitter at http://twitter.com/PedAcadSoc.
[2600.3] Childhood Disability Trends, 2000-2010
Amy Houtrow, Kandyce Larson, Paul Newacheck, Neal Halfon. Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PS; Pediatrics, University of California, Los Angeles, Los Angeles, CA; Pediatrics and Health Policy, University of California, San Francisco, San Francisco, CA.
BACKGROUND: A century of advances have changed the face of childhood chronic disease and disability. Although numerous studies document changes in prevalence for certain disabling conditions, no recent studies have documented the changing landscape of childhood disability.
OBJECTIVE: The purpose of this study was to evaluate trends in childhood disability over the past decade to assess changes in prevalence and severity in relationship to socio-demographic factors.
DESIGN/METHODS: The National Health Interview Survey datasets from 2001-02 and 2009-10 were used for these analyses. Children aged 0-17 years were included in the analysis (N=102,468). Using questions administered in the household survey, a composite of developmentally appropriate activity limitations were used to identify children with disabilities and to determine prevalence of underlying chronic conditions. Conditions were categorized into 3 groups: physical, neurodevelopmental/mental health, and other. Bivariate and multivariable analyses were conducted to assess socio-demographic disparities.
The prevalence of disability increased 16.3% between 2001/02 and 2009/10. Nearly 6 million children were considered disabled in 2009/10.
Children living in poverty experienced the highest rates of disability but not the highest growth: 92.7 cases/1,000 in 2001/02 and 101.4 cases/1,000 in2009/10.
Only children living in households with incomes 300-399% of the federal poverty level (FPL) and 400% or above the FPL experienced statistically significant increases in disability rates over the study period (28.0% and 23.9%, respectively).
Rates of disability due to physical conditions declined while disability due to neurodevelopmental/mental health conditions increased.
This trend was most pronounced among children under six years who experienced a near doubling of neurodevelopmental/mental health conditions (18.7 to 35.6 cases/1,000, p<0.05).
Disability in childhood is on the rise.
Over the past decade there has been a decline in disability due to physical health conditions but a large increase in disabilities related to neurodevelopmental/mental health problems.
The rise is occurring primarily among socially advantaged families highlighting the importance of focusing on under-recognized social, medical and environmental trends.
Knowing the extent and characteristics of childhood disability is an important first step in refining how we study disability, and how we create and refine services to best meet the needs of children.