CSHCN: Conditions and Functional Impact

HRSA’s Maternal and Child Health Bureau defines children with special health care needs (CSHCN) as “those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.” The 2005–2006 National Survey of CSHCN provides information about the prevalence and impact of special health care needs among children in the United States. Children were considered to have special health care needs if their parents answered “yes” to at least one question in each of three categories. Based on this series of questions, 13.9 percent of children under 18 years of age in the United States, or approximately 10.2 million children, were estimated to have special health care needs. Overall, 21.8 percent of U.S. households with children have at least one CSHCN.

The survey asked parents of CSHCN whether their children had any of a list of 16 conditions (the list was not exhaustive and did not include all conditions that CSHCN might have). Overall, 91 percent of CSHCN were reported to have at least one condition on the list, and 57 percent had two or more conditions. Allergies (53 percent) were the health condition most commonly reported by parents of CSHCN. Other commonly reported conditions were asthma (39 percent), attention deficit disorder (30 percent), and emotional problems (21 percent).

One important aspect of special health care needs is how those needs impact the child. Based on parents’ reports, nearly 38 percent of CSHCN were never affected in their ability to do things other children do because of the nature of their health condition or the treatment they receive to manage their conditions. Another 39 percent were moderately affected some of the time. Nearly one quarter (24 percent) are affected usually, always, or a great deal by their conditions.

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