Children and Youth With Special Health Care Needs

1
Children and Youth With Special Health Care Needs

• Sarah Thorson, BSW
• Minnesota Children with
• Special Health Needs
• 11/18/2004

2
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.

3
Prevalence

• 160,946 (lt18yrs) in Minnesota (12.4)
• Estimated 198,927lt21yrs
• 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
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Prevalence By Age in MN ()
Source MN Data National Survey of CSHCN 2001
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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
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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
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Categories of Special Health Care Needs

• Physical disabilities
• Sensory impairments
• Developmental disabilities
• Chronic illnesses
• Mental health disorders

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Impact

• Impact on the Child
• Service Use / Needs
• Impact on the Family

9
Child

• How often do childrens 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
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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
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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
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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
13
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.
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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 dont 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
15
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

16
(No Transcript)
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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
18
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
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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
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Victims of Physical Violence at Home
Source MN Student Survey 2001
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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.