An increasing number of parents—particularly higher-income parents—reported between 2001 and 2011 that their child had a disability, a new study finds. The biggest increase came from households with incomes that were more than 400 percent above the federal poverty level, according to the study in the journal Pediatrics.
Nearly 6 million children were considered to be disabled in the 2010-11 sampling, up by 15.6 percent since 2001-02, said the study, which was published online on Aug. 18. During that decade, there was an almost 12 percent decline in the reported number of disabilities related to physical conditions, and a nearly 21 percent increase in the number of disabilities related to neurodevelopmental or mental health conditions, such as attention deficit hyperactivity disorder (ADHD) or learning disabilities.
Children in poverty were reported to have the highest rates of disabilities—102.6 cases per 1,000 population in the 2010-11 sampling. But children from upper-income families saw the largest increase—28.4 percent in 10 years—in reported disabilities, according to the study.
The study was based on analysis of National Health Interview Survey data, which was collected by the National Center for Health Statistics for about 200,000 children every other year between 2001 and 2011 (in two-year sampling periods—for example, 2001-02 and again in 2004-05).
Dr. Amy Houtrow, lead author of the study and chief of the division of pediatric rehabilitation medicine at the Children’s Hospital of Pittsburgh, said part of that increase comes from people being more open to talking about disabilities and accessing services more readily. Upper-income parents also have better access to health care, she said.
More children are being diagnosed with speech and language problems or ADHD partly because they’re identified as needing special instruction in schools or early intervention, she said.
“Certainly, there’s been a large increase in the number of kids being served by those programs, which is a positive finding,” Houtrow said.
Meanwhile, the decrease in the reported number of disabilities related to physical conditions is not because diagnoses of conditions such as asthma are decreasing, Houtrow said, but rather, because they are managed and treated better and are less likely to result in a disability.
Similarly, she said more prevalent safety measures in the last decade, like bicycle helmets, booster seats, and seatbelts, have contributed to a decrease in disabilities stemming from injuries.
Autism was not included as a specific disability in the NHIS dataset, which was established before autism was widely recognized, Houtrow said. Still, she said cases of autism were captured in other categories, such as “other developmental problems,” which saw an increase.
The study abstract said this is the first time since NHIS began tracking data on childhood disabilities in 1957 that the rise in reports is disproportionately among upper-income families.
“This unexpected finding highlights the need to better understand the social, medical, and environmental factors influencing parent reports of childhood disability,” the abstract reads.