One way of classifying children’s functional status is to group their functional difficulties into categories based on the type of activity that is affected. Overall, the parents of 57 percent of CSHCN report that their child has difficulty with at least one bodily function (such as eating, dressing, or bathing), and half report that their child has difficulty with participation in activities (such as walking or running). Finally, 42 percent report emotional or behavioral difficulties. A child can have difficulties in more than one area.
Another way of looking at functional impact is to create mutually exclusive categories (in which each child falls into only one group). Of these categories, the largest is that of children who have difficulty with their bodily functions only, representing 27 percent of CSHCN. The next largest group is children who are reported to have all three kinds of difficulties (17 percent), followed by those who have difficulty with participation in activities and an emotional or behavioral difficulty (approximately 15 percent of CSHCN). Only 3.4 percent of CSHCN are reported to have emotional or behavioral difficulties without any additional difficulties with bodily functions or participation in activities.
It should be noted that 15 percent of CSHCN are reported as not having any of these types of difficulties as a result of their conditions. In 90 percent of these cases, this is attributable to the treatments and therapies that keep their conditions well-managed.
Children with lower family incomes were more likely to be reported to have each kind of functional difficulty than children with higher family incomes. The difference was most pronounced for emotional or behavioral difficulties: 61 percent of CSHCN in poverty were reported to have difficulties in this area, compared to 30 percent of CSHCN with family incomes of 400 percent of poverty or more.
Non-Hispanic Black and Hispanic children were also more likely than non-Hispanic White and non-Hispanic children of other races to have each type of functional difficulty. Difficulties with bodily functions were most commonly reported among children of all racial and ethnic groups, but the percentage of children who were reported to have these difficulties ranged from 54 percent of non-Hispanic White children to 68 percent of non-Hispanic Black children. There was also a substantial racial/ethnic disparity in the percentage of children reported to have emotional or behavioral difficulties; the proportion ranged from 39 percent of non-Hispanic White children to 49 percent of non-Hispanic Black children.