Aug. 18, 2014 | Kathleen Doheny
Overall, parent-reported disabilities rose 16 percent -- from almost 5 million children to about 6 million between 2001 and 2011, said study author Dr. Amy Houtrow, associate professor of physical medicine and rehabilitation and pediatrics at the University of Pittsburgh.
"We know that disabilities have been on the rise for decades," Houtrow said. Understanding the trends helps practitioners know where and how to better direct services, the study noted.
Children from poor families are more likely to have a disability than richer kids, but the surge in neurodevelopmental and mental troubles was most notable among wealthier families, the researchers found.
Although the study didn't look at why this is so, Houtrow said there is less stigma about getting help for a disability than in the past. She also speculated that wealthier families have better access to care.
A Florida pediatric neurologist agreed. Dr. Sayed Naqvi, of Miami Children's Hospital, said he's observed a surge in requested services for autism, attention-deficit/hyperactivity disorder (ADHD) and speech delay. Many of those families have easy access to pediatric information on the Internet and a growing awareness that their kids can be helped, he said.
"The more affluent parents come prepared, they know what services are there," Naqvi said. "We spend a lot more time nowadays discussing [treatments]."
For the study, published online Aug. 18 in Pediatrics, Houtrow analyzed data from the U.S. National Health Interview Surveys taken in four time periods between 2001 and 2011.
Parents first reported if their child had a limitation or disability. Next, they chose from a list of limiting physical, developmental or mental health conditions.
Physical conditions included: asthma or breathing problems, vision problems, hearing problems, bone/joint/muscle problems, injury.
Mental/neurodevelopmental conditions included: epilepsy or seizures, speech problems, learning disability, ADHD, mental retardation, other mental/emotional/behavioral problems, and other developmental problems.
Autism spectrum disorders, now thought to affect one in 68 U.S. children, was not one of the specific developmental disorders that parents could report. "Autism probably would have been listed by the parent as either 'other developmental problem,' 'other mental, emotional or behavioral problem' or 'intellectual disability' (also referred to as mental retardation)," Houtrow said.
Birth defects or other impairment problems were considered unclassifiable conditions. Physical disability cases declined almost 12 percent over the decade, the study authors noted.
Significant increases were reported in "other mental, emotional or behavioral problems," which rose 65 percent, and speech problems and mental retardation, each up 63 percent, Houtrow said.
While ADHD increased 22 percent, according to parent reports, learning disabilities dropped 13 percent, the investigators found.
Reports of asthma fell 24 percent, and hearing problems increased 16 percent, the findings showed.
Families earning $89,400 or more in 2011 had the greatest increase in reported disabilities -- nearly 29 percent, the study found. Households earning below the poverty level had a rise of about 11 percent.
Is it healthy or not to label kids as disabled? The study didn't address that, but Houtrow said that "a disability is a normal part of life. We should work to maximize a child's ability."
While there is still some stigma linked with disability, she said, the focus needs to be on understanding a child's limitation and making plans to overcome it.
"The disability doesn't just describe the limitation," she said. "It affects the [child's] interaction with the world."
Acknowledging it and making a plan, she said, "is better than ignoring it."