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Children and Youth With Special Health Care Needs. Sarah Thorson, BSW Minnesota Children with Special Health Needs 11/18/2004. Who Are The Children?.
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Children and Youth With Special Health Care Needs Sarah Thorson, BSW Minnesota Children with Special Health Needs 11/18/2004
Who Are The Children? • Children (from birth to age 21) 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.
Prevalence • 160,946 (<18yrs) in Minnesota (12.4%) • Estimated 198,927<21yrs • 1 in 5 families with children has a child with special health care needs (147,551 families) • CYSHCN are more likely to be male (56.3% v. 43.7%) • Varies by race and ethnicity (national) highest in Native American and mixed race children. Significantly lower in Asian children Source: National Survey of CSHCN 2001
Prevalence By Age in MN (%) Source: MN Data National Survey of CSHCN 2001
Type of Special Health Care Need • Ongoing need for prescription medications (123,000) • Increased need for medical care, mental health care or educational services (81,000) • Emotional, developmental or behavioral needs (47,000) Source: MN Data National Survey of CSHCN 2001
Type of Special Health Care Need • Functional limitation that prevents them from doing things most other children their age are able to do. (29,000) • Need specialized therapy, such as physical, occupational or speech therapy. (24,000) Source: MN Data National Survey of CSHCN 2001
Categories of Special Health Care Needs • Physical disabilities • Sensory impairments • Developmental disabilities • Chronic illnesses • Mental health disorders
Impact Impact on the Child Service Use / Needs Impact on the Family
Child • How often do children’s special needs impact their daily lives? • 18.6% the condition usually or always affects ability to do things other children their age do. • To what extent? • A great deal (17.5%) • To some extent (50.2%) • How severe are the health conditions? • Mild (33.8%) • Moderate (51%) • Severe (15.2%) Source: MN Data National CSHCN Survey
Mental Health Service Needs • Mental health care (29.3%) • Substance abuse treatment (4.1% 8-17y.o.) Source: MN Data National Survey of CSHCN 2001
Unmet Service Needs • 22,700 children have at least one unmet service need (14.1%) • Highest percentage of unmet needs in the five state area • Lower than national average (17.7%) • Mental health care (13.6%) • Substance abuse treatment (9.8%) MN Data National Survey of CSHCN
Unmet Service Needs • Only 40% of children with disabilities with poor psycho-social adjustment received treatment • 70-80% received that care in school settings. Source: 1994-95 National Health Interview Survey Disability Supplement
Health is more than not being sick. Health is a resource for everyday life – the ability to realize hopes, satisfy needs, change or cope with life experiences, and participate fully in society. Health has physical, mental, social and spiritual dimensions.
CYSHCN: Social Isolation • More likely to be dissatisfied with their personal lives than their same aged peers. (29.1% v. 17.1%). • More likely to believe their friends don’t care about them to any great extent. (16.5% v. 9.1%). • Nationally, 40% of people with severe disabilities are not at all involved with their communities. Source: MN Student Survey 2001 National Organization on Disabilities, 2000
CYSHCN: Victimization • More likely than their same aged peers to be victims of school violence • Twice as likely to skip school because they feel threatened; • More likely to have carried a weapon at school;
CYSHCN: Victimization • Preliminary data suggests that 40% of substantiated cases of maltreatment (by adults) in school involve students receiving special education services • At three times the risk of non-familial sexual abuse than their healthy peers; Source: MN Dept of Education, 2004 MN Student Survey 2001
CYSHCN: Depression • 35% of children and adolescents with disabilities age 4 to 17 years are reported to be unhappy, sad or depressed (national data). • Rural children and poor children at even higher risk • 48% of the CYSHCN had thought about suicide compared to 26% of peers without special needs (MN). Source: National Health Interview Survey 2001 MN Student Survey 2001
CYSHCN: Suicide attempts • 20% of CYSHCN attempted suicide compared to 7% of their peers. • 27% of non-white CYSHCN had attempted suicide compared to 10% of non-white students without special health needs. Source: MN Student Survey 2001
Victims of Physical Violence at Home Source: MN Student Survey 2001
National Agenda for CYSHCN • Provide and promote family-centered, community-based, coordinated care for children with special health care needs and to facilitate the development of community-based systems of services for such children and their families.