The screening questions used in the survey to identify CSHCN included five major components. In addition to the existence of a condition that has lasted or is expected to last at least 1 year, the respondent must report that the condition had at least one of the following consequences for the child:
- The use of or need for prescription medication;
- The use of or need for more medical care, mental health services, or education services than other children of the same age;
- An ongoing emotional, developmental, or behavioral problem that requires treatment or counseling;
- A limitation in the child’s ability to do the things most children of the same age do;
- The use of or need for special therapy, such as physical, occupational, or speech therapy.
Of these five qualifying criteria, the need for prescription medication is by far the most common, reported for more than three-fourths of CSHCN. The next most frequently reported consequence is the use of or need for extra medical, mental health, or educational services (39 percent of CSHCN), followed by the use of or need for emotional, behavioral, or developmental problems (28 percent), limitation in activities (21 percent), and the use of specialized therapies (18 percent). The percentages do not add to 100 because each child may experience more than one consequence of his or her condition(s).
The proportion of CSHCN experiencing each consequence varies across income levels. While the need for prescription medication is the most common consequence among all income groups, the percentage of CSHCN who currently need or use prescription drugs ranges from 72 percent of CSHCN with family incomes below the poverty level to 83 percent of CSHCN with family incomes of 400 percent of poverty or more. Among CSHCN living in poverty, the parents of 38 percent report an emotional, behavioral, or developmental problem, compared to 22 percent of CSHCN in the highest-income families. The prevalence of limitations in activities also varies by income: the parents of 28 percent of poor children report this consequence, compared to 16 percent of children in high-income families.
