Lifetime prevalence of learning disability among US Children age 3 to 17 years in 2003

1. Lifetime prevalence of learning disability among US Children age 3 to 17 years in 2003 Maja Altarac, MD, MPH, PhD [Ma-ya Ahl-tah-rahtz] December 8, 2006

2. Learning disabilities • Characterized by significant difficulties in listening, speaking, reading (either reading skill or reading comprehension), writing, reasoning, mathematics (either in mathematical calculation or mathematical reasoning), foreign languages, coordination, spatial adaptation, memorization and social studies.

3. Children with special health care needs • are defined as those who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally.

4. Objective • to produce estimates of lifetime prevalence of LD in US children <18 years old in 2003 from a large scale nationally representative survey • to examine the LD by socio-demographic and family functioning characteristics, with particular attention paid to the child’s special health care need status.

5. Data source • 2003 National Survey of Children’s Health • This nationwide telephone survey, sponsored by the Maternal and Child Health Bureau of the Health Resources and Services Administration, provides a breadth and depth of data pertaining to the developmental and behavioral health of children in the United States.

6. Measures • Lifetime prevalence of learning disabilities (LD) • “Has a doctor, health professional, teacher or school official ever told you [child] has a learning disability?”. • Answers were available for children ages 3-17.

7. Measures • CSHCN status • Screening questions can be grouped on five definitional criteria: • prescription medication use, • above average services use, • functional limitations, • use of mental health services and • use or need for specialized therapies.

8. Measures • Socio-demographic variables • Family functioning variables

9. Results • Overall lifetime prevalence of LD in US children in 2003 was: • 9.7% (95% CI 9.4 – 10.1) • This translates into an estimated 6 million US children age <18 years ever had LD.

10. LD & demographic characteristics

11. LD & demographic characteristics

12. LD & demographic characteristics • family structure • two-parent 7.5% (7.2 – 7.9) (other than step) • two-parent step 14.0% (12.6 – 15.4) • single mother 12.4% (11.6 – 13.3) (no father present) • other 11.8% (10.3 – 13.5)

13. LD & demographic characteristics • Adopted 20.4% (17.5 – 23.5) • Not adopted 9.3% (9.0 – 9.7) • Smoker in the household • Yes 13.5% (12.7 – 14.2) • No 8.9% (8.5 – 9.4)

14. LD & SHCN status • Overall prevalence 9.7% (9.4 – 10.1) • About 6 million US children • CSHCN 27.8% (26.6 – 29.0) • About 3.3 million US children • Non-CSHCN 5.4% (5.1 – 5.7) • About 2.7 million US children

15. LD & SHCN definitional criterion

16. LD & # definitional criteria met

17. LD among US children • LD is a common chronic condition among US children. • LD affects about 1 in 10 children overall. • LD is more common among CSHCN, affecting about 1 in 4. • LD is a significant morbidity in average developing children as well, affecting about 1 in 20.

18. LD among US children • Among CSHCN, the prevalence of LD increased as the number of definitional criteria for CSHCN a child met increased, from 15.0% for one criterion, to 86.8% for children who met all five. • This indicates that LD is an important co-morbidity among CSHCN, especially those with multiple needs or those who are using multiple kinds of services.

19. LD among US children • Prevalence of LD rises with child’s increasing age, reaching stable levels during adolescence. • LD is also associated with male gender, lower household education, poverty, family structure, being adopted and household smoking.

20. Questions? Thank you.