Children with Special Health Care Needs

Children and youth with special health care needs (CSHCN) “have or are at increased risk for chronic physical, developmental, behavioral or emotional conditions and who also require health and related services of a type or amount beyond that required by children generally.”1

  • Nearly 20% of U.S. children under age 18 years of age have a special health care need.
  • One in five U.S. families have a child with a special health care need.
  • Children and youth with special health care needs and their families often need services from multiple systems – health care, public health, education, mental health, and social services.

What Goals Are We Trying to Accomplish?

The Maternal and Child Health Bureau's (MCHB) vision is for optimal health and quality of life for all children and youth with special health needs and their families. Creating an effective system of care for children and youth with special health care needs to achieve optimal outcomes is one of the most challenging and pressing roles for public health leaders at the national, state and local level. Systems of care for CSHCN depends on ensuring families are partners in care; there is early and continuous screening; children and youth have access to a medical home to provide coordinated care that is community- based; there is adequate insurance and funding to cover services; and families and providers plan for transition to adult care and services.

Individuals and Families diagram

Improving the system of care for CSHCN has potential for maximizing outcomes for women, pregnant women and children in general – what works for the most vulnerable should work for all.

How Do We Accomplish Our Goals?

MCHB accomplishes these goals by providing leadership and resources to the nation in order to improve the quality of life for children with special health needs and their families. MCHB provides support for programs that support states, communities, and organizations to improve systems of care for all CYSHN or, in some cases, for children with specific conditions as required by federal law. MCHB works on the principles that all program are: 1) evidence-base/informed; 2) ensure health equity; 3) are whole-person focused; and 4) are innovative and collaborative.

Learn about our initiatives, on our CSHCN Programs & Initiatives page

1McPherson et al (1998) Pediatrics 102/1.


Date Last Reviewed:  March 2019