Rising Trends in Childhood Disabilities: Costs, Fragmentation, and Solutions

1. Children with Disabilities Future of Children Woodrow Wilson School of Public and International Affairs and the Brookings Institution Janet Currie and Robert Kahn, Issue Editors Spring 2012

6. Measurement and trends in disability • Rising importance of mental/behavioral/developmental problems relative to all others. • Lack of consensus on the fraction of the measured increase which may be due to changes in diagnosis/rise of new diagnoses due to lack of data that consistently measures disability over time.

7. Costs of Disability: • To children • To families • To society

14. Overview

15. The fragmentation of services (especially between medical and educational system). • The importance of families for care co-ordination.

19. Directions for Improvement: • Emphasize functioning in important domains of the child’s life. • Evaluate quality of care in terms of how it improves functioning vs. only physical symptoms. • Greater focus on prevention.

23. An important note regarding prevalence and prevention • Many of the factors that have been shown to be linked to childhood disability (maternal smoking, exposure to lead) have been falling not rising over time, so cannot explain increasing trends in measured disability.

24. Summary • Rising measured disability, importance of mental health/development. • Significant costs of disability to individuals, families, and society. • Fragmentation of services, burden on families as care coordinators. • Ideas for improvement: • Medical home • Emphasis on functioning • Importance of prevention

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