The prevalence of disability among children: Paradigms and estimates

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Across all these measures and estimates, some general conclusions can be drawn. There appears to be a consensus across those who study the prevalence of disability in children that the preferred measures are not those based upon a child's medical diagnosis, but those that identify disability in terms of activity or functional limitations, role performance, or support and service use. There are, however, variations in the components that comprise the other measures for disability identification. The most oft-quoted prevalence rate is that 6.5% of U.S. noninstitutionalized children have a disability, based upon the activity limitation paradigm. This should probably be considered the lower bound of disability prevalence in children, because other measures indicate a higher prevalence. Two groups of researchers have invested considerable effort to develop alternative measures that are independent of condition diagnoses and that are based upon theoretical models of disability and a deeper analysis of what are appropriate manifestations of disability in children. The first group has refined the measurement of functional limitation based upon the National Center for Medical Rehabilitation Research model through use of the larger number of indicators available in the NHIS-D [3]. Their most recent work is aimed at identifying a more parsimonious set of indicators to produce a nearly equivalent measurement of disability among children [14]. With their measure, in excess of 10.6% of all children are found to experience limitations. The second group consists of the researchers who have developed and tested the QuICCC [5,8,9]. The QuICCC rates children in terms of functional limitation, compensatory dependence, or service use beyond routine, and finds that 14.8% have disabilities. Although this scale may be especially useful for identifying children eligible for services under the Title V program for Children with Special Health Care Needs, some might argue that it defines disability too broadly. Both of these measures merit attention.

Original languageEnglish (US)
Pages (from-to)775-792
Number of pages18
JournalPhysical Medicine and Rehabilitation Clinics of North America
Issue number4
StatePublished - Nov 1 2002

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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