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Thursday, September 26, 2019

Increasing Prevalence of Developmental Disabilities

In The Politics of Autism, I write:
The number of people with a stake in the issue is going to mount. I am not saying that there will be a true increase in the prevalence of autism. As we saw in chapter 3, it is unclear how much of the apparent change involves awareness and diagnostic standards. Even if there has been a true increase in recent decades, there is no way of knowing whether it will go on. But the rise in the number of autism diagnoses and educational determinations will translate into a growing population of people who have lived with the autism label, and who think of themselves as autistic.
Nearly 18% of children have developmental disability, a figure that has continued to rise over the past two decades, according to a new study.
Researchers from the Centers for Disease Control and Prevention and the Health Resources and Services Administration used data from the National Health Interview Survey to look at the prevalence of 10 developmental disabilities among children ages 3-17 years.
The overall rate was 17.8% in 2015-’17, up from 16.2% in 2009-’11 and 12.8% in 1997-’99, according to “Prevalence and Trends of Developmental Disabilities among Children in the U.S: 2009-2017,” (Zablotsky B, et al. Pediatrics. Sept. 26, 2019, https://doi.org/10.1542/peds.2019-0811). From 2015-’17, the most prevalent developmental disabilities were
  • attention-deficit/hyperactivity disorder (ADHD) (9.5%),
  • learning disability (7.9%),
  • other developmental delay (4.1%),
  • autism spectrum disorder (2.5%),
  • stuttering or stammering, past 12 months (2.1%),
  • intellectual disability (1.2%),
  • seizures, past 12 months (0.8%),
  • moderate/profound hearing loss (0.6%),
  • cerebral palsy (0.3%) and
  • blindness (0.2%).
Authors attributed increases in the overall rate of developmental disabilities since 2009 to increases in ADHD, autism and intellectual disability. Since that time, ADHD prevalence rose from 8.5% to 9.5%, autism rose from 1.1% to 2.5% and intellectual disability rose from 0.9% to 1.2%. In the meantime, there was a decline in children deemed as having an unspecified developmental delay from 4.65% to 4.1%, which the authors said may have been due to children being given a more specific diagnosis.
Children who were in their teens, male, had public health insurance, had low birthweight, those living in poverty and those in rural areas had the highest rates of developmental disabilities. From 2009-’17, rates rose significantly for children who were in their teens, male, white, Hispanic and those with private insurance.
Rate increases likely are due to a mix of better identification of children with developmental disabilities, changes in diagnostic criteria and changes in survey wording, according to the report.
“Given this growth, additional research may help to better understand the characteristics of children with developmental disabilities, the complex risk factors associated with developmental disabilities, and the accessibility of services and interventions which have been shown to improve long-term outcomes for those diagnosed with a developmental disability,” authors wrote.
Maureen S. Durkin, Ph.D., Dr.Ph., wrote in a related commentary, the rising rates may be a sign of progress. Children who were born preterm or with a congenital disorder are living longer, screening is improving and disabilities are more socially accepted. She called for long-term investments in early childhood education and other pediatric services.
“With the publication of these findings,” she wrote, “the need for expanded services and training to meet the needs of children with developmental disabilities cannot be ignored.”