Health Care Use and Health and Functional Impact of Developmental Disabilities Among US Children, 1997-2005

Abstract

To present nationally representative estimates of health-related limitations, needs, and service use among US children with and without developmental disabilities (DDs).Design: Retrospective analysis of data from a sample of US households from the 1997-2005 National Health Interview Surveys.Participants: Children aged 3 to 17 years (n =95 132).Main Outcome Measures: Parents or other knowledgeable adults reported on their children's DDs, health needs, and use of health and education services. Developmental disabilities included attention-deficit/ hyperactivity disorder, autism, blindness, cerebral palsy, deaf/a lot of trouble hearing, learning disability, mental retardation, seizures, stuttering/stammering, and other developmental delay.Results: Among children with 1 or more DDs, prevalence estimates for limitations in movement (6.1%), needed help with personal care (3.2%), needed special equipment (3.5%), received home health care (1.4%), and regularly took prescription medication(s) (37.5%) were 4 to 32 times higher than for children without DDs. Children with DDs were 2 to 8 times as likely to have had more than 9 health care visits (14.9%), received special education (38.8%), had a surgical or medical procedure (7.5%), and recently visited a medical specialist (23.9%), mental health professional (26.6%), therapist/allied health professional (19.6%), and/or emergency department (10.3%). Effects were generally stable during the study interval and independent of age, race, sex, and family income. Cerebral palsy, autism, mental retardation, blindness, and deafness/a lot of trouble hearing were associated with the highest levels of health and functional impact indicators.Conclusions: Developmental disabilities profoundly affect children's health and functioning. These data can inform evidence-based targeted prevention strategies for minimizing functional limitations and lifetime disability. Additional study of unmet needs and access to care is needed.

Factors Associated With Physical Therapy Services Received for Individuals With Cerebral Palsy in an Outpatient Pediatric Medical Setting

“…6,8,12 Our results are in disagreement with the findings of 2 studies, 8,12 in which severity of functional limitation was associated with increased use of health services. Parkes et al 8 grouped severity of functional limitation into moderate (having abnormal gait) and severe (no walking ability), whereas Boulet et al 12 defined severe as answering "yes" to at least 2 or more functional limitation questions in their survey.…”

Types and correlates of school absenteeism among students with intellectual disability

“…The high rates of absences due to illness (32.0% of students) and medical and allied health appointments (24.2%) in this study are to be expected. Children with ID have higher rates of chronic and multiple health conditions and subsequent health care utilisation than children without disabilities (Boulet et al 2009). The current findings are consistent with two other studies.…”

Developmental stages and estimated prevalence of coexisting mental health and neurodevelopmental conditions and service use in youth with intellectual disabilities, 2011–2012

“…Studies have shown multiple comorbidities associated with having ADHD (Larson et al 2011) and autism (Close et al 2012); however, few studies have examined comorbidities among youth with ID. Our findings are consistent with previous literature regarding higher rates of mental health and neurodevelopmental conditions and service use among youth with ID (Boulet et al 2009;Schieve et al 2012). Our study, however, extends these studies by identifying the prevalence of coexisting conditions across three developmental stages during childhood.…”

“…Specifically, the prevalence rates of medication use in youth with ID compared with youth without ID was higher for preschool aged youth (4.7% vs. 0.4%), school aged youth (18% vs. 1.9%) and adolescents (19.6% vs. 4.1%).This finding is consistent with other research showing youth with ID are more likely than youth without ID to utilise medication (Boulet et al 2009;Schieve et al 2012). Specifically, the prevalence rates of medication use in youth with ID compared with youth without ID was higher for preschool aged youth (4.7% vs. 0.4%), school aged youth (18% vs. 1.9%) and adolescents (19.6% vs. 4.1%).This finding is consistent with other research showing youth with ID are more likely than youth without ID to utilise medication (Boulet et al 2009;Schieve et al 2012).…”

“…Specifically, the prevalence rates of medication use in youth with ID compared with youth without ID was higher for preschool aged youth (4.7% vs. 0.4%), school aged youth (18% vs. 1.9%) and adolescents (19.6% vs. 4.1%).This finding is consistent with other research showing youth with ID are more likely than youth without ID to utilise medication (Boulet et al 2009;Schieve et al 2012). In one study, which combined IDs with developmental disabilities, 37.5% of youth with ID used medication, compared with 8.8% without ID (Boulet et al 2009). Another study reported 44.7% of youth with ID regularly took prescription medication, compared with 9.7% of youth without ID (Schieve et al 2012).…”