One purpose of the NS-CSHCN was to estimate the prevalence of CSHCN in the population nationally and in each State. CSHCN were identified by asking parents if their child used more medical care, mental health services, or educational services than is usual for most children of the same age; if the child used specialized therapies, mental health counseling, or prescription medications; and/or if the child was limited or prevented in any way in his or her ability to do things that most children of the same age can do because of a medical, behavioral, or other health condition that is expected to last at least one year. Children were considered to have special health care needs if their parents answered “yes” to at least one question in each of these three categories. These questions are part of the CSHCN Screener, which was developed by researchers, practitioners, family advocates, and policy makers to identify CSHCN in household surveys.
Based on the series of screening questions, 13.9 percent of children under 18 years of age in the United States, or approximately 10.2 million children, are estimated to have special health care needs. Overall, 21.8 percent of U.S. households with children have at least one child with special health care needs.
Each of these figures represents an increase since the last survey in 2001: at that time, 12.8 percent of children were estimated to have special health care needs, and 20.0 percent of households with children had a child with special health care needs. A variety of factors may have contributed to this increase, including increased access to diagnostic services, better recognition of children’s conditions on the part of parents and physicians, or a true increase in the prevalence of chronic conditions in the population. More information on this issue can be found at the HRSA’s MCHB Data Resource Center for Child and Adolescent Health.
1Bethell CD, Read D, Stein RE, Blumberg SJ, Wells N, Newacheck PW. Identifying children with special health care needs: Development and evaluation of a short screening instrument. Ambulatory Pediatrics, 2002 Jan-Feb; 2(1):38–48.