Racial and Ethnic Differences in the Prevalence of Attention-deficit/Hyperactivity Disorder and Learning Disabilities Among U.S. Children Aged 3–17 Years

March 4, 2020

Attention-deficit/hyperactivity disorder (ADHD) and learning disabilities are the most commonly diagnosed neurodevelopmental disorders in children and often coexist.

Previous research has suggested that the prevalence of these conditions may differ by race and Hispanic origin.

Using timely, nationally representative data, this report examines the reported prevalence of ADHD and learning disabilities by race and ethnicity and select demographic characteristics that are associated with the diagnosis of these conditions.

Findings: 

  • In 2016–2018, nearly 14% of children aged 3–17 years were reported as ever having been diagnosed with either attention-deficit/hyperactivity disorder (ADHD) or a learning disability; non-Hispanic black children were the most likely to be diagnosed (16.9%).
  • Among children aged 3–10 years, non-Hispanic black children were more likely to have ever been diagnosed with ADHD or a learning disability compared with non-Hispanic white or Hispanic children.
  • Diagnosis of ADHD or a learning disability differed by federal poverty level for children in all racial and ethnic groups.
  • Diagnosis of ADHD or a learning disability differed by parental education among non-Hispanic white children only.

Prevalence of Children Aged 3–17 Years With Developmental Disabilities, by Urbanicity: United States, 2015–2018

February 19, 2020

Questions for Ben Zablotsky, Ph.D., Health Statistician and Lead Author of “Prevalence of Children Aged 3–17 Years With Developmental Disabilities, by Urbanicity: United States, 2015–2018.”

Q: Why did you decide to focus on urbanicity among children with developmental disabilities?

BZ: Thanks to previous research, we know that children with developmental disabilities typically require more health care and educational services than their typically developing peers, and we also know that children living in rural areas have greater unmet medical needs when compared to children living in urban areas.  For these two reasons, it is possible, that children with developmental disabilities living in rural areas could represent some of the most vulnerable when it comes to receiving a variety of health care services.  This report attempts to answer this question, by exploring the prevalence of selected developmental disability conditions and use of related services in rural and urban areas.  It serves as a follow-up to a previous Pediatrics article written by myself and Lindsey Black, along with colleagues from the National Center for Health Statistics, National Center on Birth Defects and Developmental Disabilities, and the Maternal and Child Health Bureau, titled “Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017


Q: How did you obtain this data for this report and what is considered a developmental disability?

BZ: Data come from the 2015-2018 National Health Interview Survey, a timely and nationally representative survey.  Developmental disabilities examined in this report were attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, blindness, cerebral palsy, moderate to profound hearing loss, learning disability, intellectual disability, seizures in the past 12 months, stuttering or stammering in the past 12 months, or any other developmental delay. Children whose parents answered that their child had one or more of these conditions were classified as having any “developmental disability.”


Q: Can you summarize how the data varied by types of developmental disabilities and service utilization in rural and urban areas?

BZ: During 2015-2018, children were more likely to be diagnosed with ADHD and cerebral palsy in rural areas than urban areas.  Meanwhile, children with developmental disabilities living in rural areas were less likely to have seen a mental health professional, therapist, or had a well-child check-up in the past 12 months than their urban peers.  Children with developmental disabilities in rural areas were also less likely to be receiving Special Education or Early Intervention Services.


Q: Was there a specific finding in the data that surprised you?

BZ: Children with developmental disabilities often need specialty and mental health services.  It was surprising to see that approximately half of children with developmental disabilities living in rural areas had not seen a mental health professional, specialist, or therapist in the past year.


Q: What is the take home message for this report?

BZ: There was a higher prevalence of children with developmental disabilities in rural areas compared with urban areas. Furthermore, among children with developmental disabilities, those living in rural areas were less likely to use a range of health care and educational services compared with their urban peers.  Additional research exploring the pathways to the diagnosis and treatment of developmental disabilities in both urban and rural areas, with a focus on the availability of resources to pay for services as well as access to trained specialty providers, could provide insight into the disparities seen in this report.


Prevalence and Trends of Developmental Disabilities Among U.S. Children

September 26, 2019

A new study from Pediatrics shows looks the national prevalence of 10 developmental disabilities in US children aged 3 to 17 years and explore changes over time by associated demographic and socioeconomic characteristics, using National Health Interview Survey data.

The study found that from 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability (16.2%–17.8%), attention-deficit/hyperactivity disorder (8.5%–9.5%), autism spectrum disorder (1.1%–2.5%), and intellectual disability (0.9%–1.2%), but a significant decrease for any other developmental delay (4.7%–4.1%).

The prevalence of any developmental disability increased among boys, older children, non-Hispanic white and Hispanic children, children with private insurance only, children with birth weight less than 2500 g, and children living in urban areas and with less-educated mothers.

For more information, please click on the link


Chronic School Absenteeism Among Children With Selected Developmental Disabilities: National Health Interview Survey, 2014–2016

September 26, 2018

Lindsey Black, NCHS Health Statistician

Questions for Lindsey Black, Health Statistician and Lead Author of “Chronic School Absenteeism Among Children With Selected Developmental Disabilities: National Health Interview Survey, 2014–2016

Q: Why did you decide to focus on chronic school absenteeism among U.S. children with developmental disabilities for this report?

LB: DDs encompass a range of conditions that may have lifelong impacts on the functioning and wellbeing of children. In particular, developmental disabilities (DDs) can affect school adjustment, attendance and academic performance. Previous research has explored the relationships of DDs and school outcomes but have generally been limited in sample size and use aggregate mental health measures, rather than specific conditions.

This study aims to describe chronic school absenteeism among a nationally representative sample of children with selected DDs of autism spectrum disorder, intellectual disability, other developmental delay and attention-deficit/hyperactivity disorder (ADHD), in order to identify groups that may need additional supports.


Q: What is meant by chronic school absenteeism?

LB:  School absenteeism was categorized based on the survey question, “During the past 12 months, about how many days did (sample child) miss school because of illness or injury?” Responses of 15 or more days were categorized as chronic school absenteeism based on the U.S. Department of Education definition.


Q: How did the findings vary among the selected developmental disabilities?

LB: In this nationally representative sample of children aged 5–17 years, children with ADHD, autism spectrum disorder, and intellectual disability were more likely to have had chronic school absenteeism compared with children who did not have these conditions even after controlling for demographic and selected physical health conditions.

Similarly, as the number of DDs increased, the DDs of chronic school absenteeism increased. These findings show that both the type and number of DDs are associated with school attendance.


Q: What methods did you use to conduct this analysis?

LB: We calculated the weighted percentage of children who had chronic school absenteeism for each of the selected developmental disability groups. Next, separate unadjusted logistic regressions for each of the selected DDs as the dependent variable (and chronic absenteeism as the outcome) were calculated. Multivariate logistic regressions were also used to assess the association between children with selected DDs and chronic school absenteeism, adjusted by selected demographic characteristics and co-occurring physical health conditions.


Q: Is there any comparable trend data on this topic from previous National Health Interview Service data?

LB: This is the first report that specifically looks at chronic school absenteeism among developmental disabilities.  Data on number of school days missed due to illness or injury has been collected among children consistently since 1997.


Q: What is the take home message in this report?

LB: Children with DDs had higher chronic school absenteeism. Associations remained, controlling for demographics and co-occurring physical health conditions.


Estimated Prevalence of Children With Diagnosed Developmental Disabilities in the United States, 2014–2016

November 29, 2017

Questions for Ben Zablotsky, Ph.D., Health Statistician and Lead Author of “Estimated Prevalence of Children with Diagnosed Developmental Disabilities in the United States, 2014-2016.”

Q: Why did you decide to analyze children with diagnosed developmental disabilities?

BZ: We decided to analyze children with diagnosed developmental disability because children diagnosed with developmental disabilities typically require a substantial number of services and treatment to address both behavioral and developmental challenges.  Measuring the prevalence of children with these conditions aids in assessing the adequacy of available services and interventions that may improve long-term outcomes.


Q: Can you explain the differences between the diagnosed developmental disabilities studied in this report?

BZ: The three conditions studied in this report included autism spectrum disorder, intellectual disability, and any other developmental delay.  All three conditions are considered to be developmental disabilities.  Autism spectrum disorder refers to a group of neurodevelopmental disorders characterized by impairments in social communication and the presence of repetitive or restricted interests.  Intellectual disability is a term used when there are limits to a child’s ability to learn at an expected level and function in daily life.  Other developmental delay serves as a catch-all for children who are delayed for various developmental milestones, for example taking first steps, smiling for the first time, and speaking.


Q: What do you think is the most interesting demographic finding among your new study’s findings?

BZ: I found the fact that the prevalence of any developmental disability was lowest among Hispanic children compared with all other race and ethnicity groups to be the most interesting finding.  The prevalence of any developmental disability among Hispanic children was 4.69% compared to 7.04% for non-Hispanic white children, 6.20% for non-Hispanic black children, and 6.16% for non-Hispanic other children.


Q: Are there any previous reports released from NCHS on diagnosed developmental disabilities in children?

BZ: Yes, this report can be viewed as a follow-up to a National Health Statistics Report (No. 87) from 2015, where the prevalence of any developmental disability in 2014 was also reported (5.76%).  The current report shows this prevalence subsequently increased to 6.99% in 2016.


Q: Can you explain the methodology used for this analysis?

BZ: Children with developmental disabilities were identified through a series of survey questions within the child component of the National Health Interview Survey (NHIS) from 2014 to 2016.  Characteristics of these children were examined, including whether differences exist in prevalence by survey year.


Q: What do you think is the take home message from this report?

BZ: There was a notable increase in the prevalence of developmental disabilities between 2014-2016, which is largely the result of an increase in the prevalence of children diagnosed with developmental delay other than autism spectrum disorder or intellectual disability.