Measuring disability in school-age children: Findings from the 2001-2006 National Health Interview Survey

Objectives:

1) Define child disability using the concept of difficulties in performing basic actions,

2) Examine the impact of different operationalizations of basic actions difficulties on estimates of disability prevalence in all school-age children and selected groups of children.

Methods: The 2001-2006 National Health Interview Survey provided nationally representative data on the functional difficulties, health conditions, service use, and sociodemographic characteristics of children aged 5-17 years (n=51,086). Prevalence rates were estimated and differences were evaluated using SUDAAN.

Results: We examined several operationalizations of basic actions difficulty that ranged from a less inclusive or narrow measure based on functional difficulties in two domains: sensory and movement to a more inclusive or broad measure based on functional difficulties in four domains: sensory, movement, cognitive and emotional/ behavioral. Among all school-age children, the prevalence of disability varied from 5% using the narrow definition to 18% using the broad definition. Among children with limitations in activities of daily living (ADLs), 58% were identified as disabled by the narrow definition of disability as compared to 95% by the broad definition of disability. Among children receiving special education services, 16% were identified as disabled by the narrow definition as compared to 82% by the broad definition. Additional analyses will examine specific domains of basic actions difficulties and explore how differences in question wording and context influence prevalence estimates.

Conclusion: Identifying and analyzing differences in child disability measures will contribute to the synthesis of research findings in this important area of child health.