Growing numbers of American families say they’re raising a child who has a disability, and the most-prevalent conditions are less and less likely to be physical disorders.

A report released this week by Princeton University and the Brookings Institution found that the top five chronic childhood conditions that limit typical activities are some type of developmental, behavioral or mental problem.

For much of the 1970s, ’80s and ’90s, the most-common cause had been respiratory disease. Now, asthma and breathing problems are No. 6, and deafness and orthopedic impairments don’t even make the list of top conditions.

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The report cites data from the National Health Interview Surveys that put the prevalence of disability for children younger than 18 at about 8 percent in 2009, up from less than 2 percent in the 1960s.

Dr. Robert Kahn, a pediatrician at Cincinnati Children’s Hospital and an editor for the report that appears in The Future of Children, said the trends raise many questions about the incidence of disabilities, how they’re defined and how children get the support they need.

“There’s been a fourfold increase in reported disabilities over the last 50 years,” Kahn said. ” To some extent, we think it’s absolutely real. But, in addition, we also believe there have been different (diagnostic criteria) and more reporting of these conditions.”

He and the report’s co-editor, Janet Currie of Princeton, said the nation lacks consistently collected statistics on childhood disability over time. That makes it “difficult to resolve the controversy over how much of the increase in disability reflects changes in incidence or changes in definition and diagnosis,” they wrote.

According to the report, more than 1 in 5 parents reporting a child with a disability in 2009 cited ADHD — attention-deficit hyperactivity disorder — as an underlying condition.

An additional 19 percent cited other mental, emotional or behavioral problems. Today, ADHD is nearly three times more likely than asthma to contribute to childhood disability, the report said.

And autism affects about 6 percent of all special-education students, up from 2 percent over the past decade.

Kahn said some groups have begun work on proposals for more-uniform definitions of disabilities. But to help children and families now, the nation’s health and education systems should work together better and also put more focus on prevention, he said.

“The lifetime cost of these conditions is huge,” Kahn said. “We need to be thinking of ways to prevent these disorders, not just treat them.”

© 2012 The Columbus Dispatch
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