Children with Limitations
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Headline

Between 2003 and 2004, the percentage of children ages 5 to 17 with one or more limitation increased from 17 percent to 20 percent, the highest percentage reported since 1998, when data were first collected. (See Table 1) These may include limitations in normal physical activities due to health conditions and impairments, difficulty seeing, difficulty hearing, diagnosed learning disabilities, and limitations requiring help with bathing or showering.

Importance

Approximately 20 percent of Americans currently live with one or more limitations or disabilities.¹ Increased birth and survival rates among very low birth weight infants (who have a high risk of disability) and increased diagnosis of Attention Deficit/Hyperactivity Disorder and asthma in recent years have led to a larger population of children classified with a disability.²

One nationally representative study of children ages 5 to 17 with limitations found that children limited in mobility, self-care, communication, or learning were more likely than other children to be exposed to second-hand smoke in their homes, face cost and insurance barriers to medical care, and have low parental reported health status. They lived in homes that had fewer resources (measured by poverty, family structure, and parental education), and were less safe.³

In 1997, among children with limitations, 31 percent were reported to be sad, unhappy, or depressed, compared with only 17 percent of children without limitations.⁴ This increased suffering among children with limitations may reflect, in part, frustration with environmental barriers that limit their ability to fully engage in home, school, community, or social activities, as well as the condition itself.⁵

Trends

The percentage of children and adolescents ages 5 to 17 that are reported by a parent or other household respondent to have at least one limitation remained relatively constant from 1998 to 2003, between 17 percent and 18 percent. However, the percentage increased in 2004 to 20 percent, the highest reported percentage since 1998 (the first year for which such data are available). (See Table 1)

Differences by Gender

Boys are more likely than girls to be reported to have at least one limitation. In 2004, 24 percent of boys were reported to have at least one limitation, compared with 16 percent of girls. (See Figure 1)

Differences by Race and Ethnicity

Non-Hispanic white and non-Hispanic black children are more likely than Hispanic children and children of other races to be described as having at least one limitation. In 2004, 22 percent of non-Hispanic white and 20 percent of non-Hispanic black children and youth were reported as having a limitation, compared with 15 percent of Hispanic children and 13 percent of non-Hispanic children of other races. (See Figure 2)

Differences by Type of Insurance Coverage

Children with public health insurance are more likely than children with private insurance or no insurance coverage to have at least one limitation. Twenty-six percent of children with public health insurance exhibited at least one limitation in 2004, compared with 18 percent of children with private insurance and 17 percent of children with no insurance. (See Figure 3) This difference may reflect educational or economic differences or it may exist because families that have children with limitations and cannot afford private insurance may be more likely than other low-income families to seek out public health insurance in order to gain access to the health care their children need.

Differences by Public Assistance

Children in families with at least one member receiving income from welfare or TANF⁶ are much more likely to have a limitation than children living in families not receiving these benefits (31 percent versus 19 percent, respectively, in 2004). Similarly, 26 percent of children in families where at least one member is eligible to receive food stamps had at least one limitation in 2004, compared with only 19 percent among children in families not eligible to receive food stamps. (See Figure 4)

Related Indicators

Health Care Coverage, Asthma, Children with AIDS, Learning Disabilities

State and Local Estimates

Estimates of the proportion of persons ages five to 20 who are disabled are available at the state and local levels from the 2000 Decennial Census. Users need to specify their state and locality of interest, and then look in Table DP-2. http://censtats.census.gov/pub/Profiles.shtml

International Estimates

None

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National Goals

The Healthy People 2010 initiative has set several goals concerning children and youth with disabilities. These objectives include:

• Eliminating the use of group care facilities for persons aged 21 and under with disabilities;
  
• Increasing the proportion of children and youth with disabilities who spend at least 80 percent of their time in regular education programs to 60 percent (from 45 percent in 1995-96); and
  
• Reducing the percentage of children and adolescents with disabilities who are reported to be sad, unhappy, or depressed from 31 percent (in 1997) to a targeted 17 percent.⁷

What Works: Programs and Interventions that May Influence this Indicator

None available at this time.

Research References

¹McNeil, John. 1997. Disabilities Affect One Fifth of All Americans. Proportion Could Increase in Coming Decades. Census Brief CNBR/97-5. U.S Bureau of the Census. http://www.census.gov/prod/3/97pubs/cenbr975.pdf

²Hogan, Dennis P. and Thomas Wells. "Developing Concise Measures of Childhood Activity Limitations." Maternal and Child Health Journal, Vol. 7, No. 2, June 2003, p.115-126. http://rcgd.isr.umich.edu/nihnetwork/members/articles/wells03.pdf

³Hogan, Dennis P., Rogers, Michelle L., and Msall, Michael E. (2000). "Functional Limitations and Key Indicators of Well-being in Children With Disability". Archives of Pediatric and Adolescent Medicine, 154: 1042-1048. Available at: http://rcgd.isr.umich.edu/nihnetwork/members/articles/hogan00.pdf.

⁴National Health Interview Survey, 1997. As found in U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two Volumes). Washington, DC: January 2000. http://www.health.gov/healthypeople/Document/pdf/Volume1/06Disability.pdf

⁵U.S. Department of Health and Human Services. Healthy People 2010 (Conference Edition, in Two Volumes). Washington, DC: January 2000.
http://www.health.gov/healthypeople/Document/pdf/Volume1/06Disability.pdf

⁶Temporary Assistance for Needy Families (TANF) "provides assistance and work opportunities to needy families by granting states the federal funds and wide flexibility to develop and implement their own welfare programs." Definition from the Department of Health and Human Services, Administration for Children and Families, Office of Family Assistance website at http://www.acf.hhs.gov/programs/ofa/

⁷Ibid.

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Definition

For this indicator, a child is identified as having a limitation if the child exhibits at least one of the following:
1) Difficulty seeing even when wearing glasses or contact lenses;
2) Difficulty hearing without a hearing aid;
3) An impairment or health problem that limits his or her ability to crawl, walk, run or play;
4) Has been identified by a school representative or health professional as having a learning disability
5) Has been identified by a school representative or health professional as having ADD/ADHD; or
6) Needs the help of other persons with bathing or showering.

This list of characteristics is not intended to be exhaustive of all limitations that should be included in the concept of childhood limitation, which may include a variety of chronic health conditions, impairments, developmental delays, and functional limitations. It is, instead, an operational definition that allows researchers to capture the largest group of children with any sort of limitation while using a limited set of identifying questions. For more information, see Hogan, Dennis P. and Thomas Wells. 2002. "Developing Concise Measures of Childhood Limitations." Abstract available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12870627&dopt=Abstract

Data Source

Original analysis by Child Trends of National Health Interview Survey data from 1998-2004. Data are provided by an adult respondent, typically a parent.

Raw Data Source

National Health Interview Survey, 1998-2004
http://www.cdc.gov/nchs/nhis.htm

Approximate Date of Next Update

Winter 2006

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