Unprecedented numbers of U.S. children are being identified with special medical and educational needs, reports the Future of Children’s latest volume, Children with Disabilities. Over the past several decades, predominant childhood disabilities have shifted away from physical disorders toward mental health disorders. Today, ADHD is almost three times more likely than asthma to contribute to reported childhood disability.
The documented increase of mental health disorders in children is particularly important given that research shows that on average, mental health disorders in childhood have larger impacts than childhood physical health problems on adult health, years of schooling, participation in the labor force, marital status, and family income.
Editors Janet Currie, the Henry Putnam Professor of Economics and Public Affairs and director of the Center for Health and Well-Being at Princeton University’s Woodrow Wilson School and Robert Kahn of Cincinnati Children’s Hospital are careful to note that the term “disability” is not standardized, which complicates researchers’ ability to understand increasing disability rates in the U.S.
“In the absence of consistently collected statistics about the incidence of childhood disability over time,” write Currie and Kahn in the volume, “it is difficult to resolve the controversy over how much of the increase in disability reflects changes in incidence or changes in definition and diagnosis… researchers must pay attention to how disability is defined and develop workable definitions that can be implemented in national surveys and maintained over time.”
Still, the high prevalence of mental health problems among children and the potential for these problems to hinder accumulation of human capital are worrisome. Even as mental disabilities make up a growing share of children’s disabilities, the growth in services for these children has not kept pace.
A key goal for society today is to devote resources to preventing, diagnosing, and managing health conditions in children to improve their functioning and trajectories. In fact, as the volume shows, the costs of not doing so may be greater than the costs of many interventions to prevent and reduce childhood disability.
In addition to these findings, the volume also discusses health care for children with disabilities, the complex role that health insurance plays in access to and quality of care, fragmentation of services and recommendations to improve coordination, education services for children and youth transitioning to adulthood, the centrality of families in advocating for a higher quality of care, disparities among children with disabilities, the possible role of environmental factors in increasing disability, and the transformative role that technology can play in reducing disabilities if equitably distributed.
To read the volume and summaries of the chapters, go to: www.futureofchildren.org.
The Future of Children is a collaboration of the Woodrow Wilson School of Public and International Affairs at Princeton University and the Brookings Institution. This volume was supported by a grant from the David & Lucile Packard Foundation.