In the Journals

One in six American children has a developmental disability

Photo of Benjamin Zablotsky
Benjamin Zablotsky

Between 2009 and 2017, approximately one in six children aged 3 to 17 years in the United States had a diagnosed developmental disability, according to updated prevalence estimates published in Pediatrics. Researchers noted increases specifically in the prevalence of ADHD, autism spectrum disorder and intellectual disability.

“Our study did not examine the reasons behind specific increases in the prevalence of ADHD, autism spectrum disorder and intellectual disability; however, previous researchers, who are referenced in our article, have highlighted improved identification of children with these conditions, greater availability of treatments and increased parental awareness and changing provider practices,” Benjamin Zablotsky, PhD, a health statistician at the CDC’s National Center for Health Statistics, told Infectious Diseases in Children.

“In addition, changes in the estimated prevalence may be tied to survey measurement, as changes in question wording to both autism spectrum disorder and intellectual disability in the [National Health Interview Survey] resulted in increases in prevalence.”

According to the researchers, access to current data is necessary to understand the impact that awareness, improvements in diagnosis and changes to diagnostic criteria have on prevalence. Additionally, it can also identify groups that may need targeted interventions to improve diagnosis and limit barriers to care.

The researchers analyzed NHIS data collected between 2009 and 2017. For the survey, parents reported whether their child received a diagnosis of ADHD, autism spectrum disorder, blindness, cerebral palsy, moderate to profound hearing loss, learning disability, intellectual disability, seizures, stuttering or stammering, and other developmental delays. Diagnoses were made by physicians or other health care providers.

The prevalence of any developmental disability increased significantly between 2009 to 2011 and 2015 to 2017 (16.2% to 17.8%; P < .001). The data also showed increases in ADHD (8.5% to 9.5%; P < .01), ASD (1.1% to 2.5%; P < .001) and intellectual disability (0.9% to 1.2%; P < .05). However, the prevalence of any other developmental disability decreased during the study period (4.7% to 4.1%; P < .05). Zablotsky said this could be the result of parents who were less likely to select other categories because more children were diagnosed with another specified condition on the survey.

When Zablotsky and colleagues examined the prevalence of developmental disabilities among specific groups, they observed increased prevalence of any developmental delay among boys, older children, non-Hispanic white and Hispanic children and those covered only by private insurance. Further, increases were noted among children who weighed 2,500 g or more at birth and children born to less-educated mothers who lived in urban environments.

“We indicate in our paper that universal screening by age 18 to 24 months and ongoing monitoring of a child’s development, as recommended by the AAP in 2007, likely accounts for some of the increases seen in prevalence,” Zablotsky said. – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.

Photo of Benjamin Zablotsky
Benjamin Zablotsky

Between 2009 and 2017, approximately one in six children aged 3 to 17 years in the United States had a diagnosed developmental disability, according to updated prevalence estimates published in Pediatrics. Researchers noted increases specifically in the prevalence of ADHD, autism spectrum disorder and intellectual disability.

“Our study did not examine the reasons behind specific increases in the prevalence of ADHD, autism spectrum disorder and intellectual disability; however, previous researchers, who are referenced in our article, have highlighted improved identification of children with these conditions, greater availability of treatments and increased parental awareness and changing provider practices,” Benjamin Zablotsky, PhD, a health statistician at the CDC’s National Center for Health Statistics, told Infectious Diseases in Children.

“In addition, changes in the estimated prevalence may be tied to survey measurement, as changes in question wording to both autism spectrum disorder and intellectual disability in the [National Health Interview Survey] resulted in increases in prevalence.”

According to the researchers, access to current data is necessary to understand the impact that awareness, improvements in diagnosis and changes to diagnostic criteria have on prevalence. Additionally, it can also identify groups that may need targeted interventions to improve diagnosis and limit barriers to care.

The researchers analyzed NHIS data collected between 2009 and 2017. For the survey, parents reported whether their child received a diagnosis of ADHD, autism spectrum disorder, blindness, cerebral palsy, moderate to profound hearing loss, learning disability, intellectual disability, seizures, stuttering or stammering, and other developmental delays. Diagnoses were made by physicians or other health care providers.

The prevalence of any developmental disability increased significantly between 2009 to 2011 and 2015 to 2017 (16.2% to 17.8%; P < .001). The data also showed increases in ADHD (8.5% to 9.5%; P < .01), ASD (1.1% to 2.5%; P < .001) and intellectual disability (0.9% to 1.2%; P < .05). However, the prevalence of any other developmental disability decreased during the study period (4.7% to 4.1%; P < .05). Zablotsky said this could be the result of parents who were less likely to select other categories because more children were diagnosed with another specified condition on the survey.

When Zablotsky and colleagues examined the prevalence of developmental disabilities among specific groups, they observed increased prevalence of any developmental delay among boys, older children, non-Hispanic white and Hispanic children and those covered only by private insurance. Further, increases were noted among children who weighed 2,500 g or more at birth and children born to less-educated mothers who lived in urban environments.

“We indicate in our paper that universal screening by age 18 to 24 months and ongoing monitoring of a child’s development, as recommended by the AAP in 2007, likely accounts for some of the increases seen in prevalence,” Zablotsky said. – by Katherine Bortz

Disclosures: The authors report no relevant financial disclosures.