The screening questions used in the survey to identify CSHCN included five major components. In addition to the presence of a condition that has lasted or is expected to last at least one year, the respondent must report at least one of the following consequences for the child:

  • The use of or need for prescription medication;
  • The use of or need for more medical care, mental health services, or education services than other children of the same age;
  • An ongoing emotional, behavioral, or developmental (EBD) problem that requires treatment or counseling;
  • A limitation in the child’s ability to do the things that most children of the same age do;
  • The use of or need for special therapy, such as physical, occupational, or speech therapy.

Of these five qualifying criteria, the need for prescription medication is by far the most common, reported by more than three-fourths of CSHCN. The next most frequently reported consequence is the use of or need for extra medical, mental health, or educational services (42.1 percent of CSHCN), followed by need for or use of services for ongoing emotional, behavioral, or developmental problems (31.8 percent), limitation in activities (23.5 percent), and the use of specialized therapies (21.5 percent). The percentages do not add to 100 because each child may experience more than one consequence of his or her condition(s).

Younger children are more likely than older children to need specialized therapies to address their conditions, while older children are more likely to rely on prescription medication or treatment or counseling for an emotional, behavioral, or developmental condition. Variation is also evident by sex: boys are more likely than girls to be reported to use elevated levels of services, have emotional or behavioral problems, or to use specialized therapies. Family income also appears to be related to the consequences of children’s health conditions, as children in low-income families are more likely to be reported to have all consequences except the use of prescription medications, which is more commonly reported among children in higher-income families.

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