Survey Results

Survey Items: Screener item numbers (all children): 7, 8, 9, 10, 11 Survey instrument item numbers for children 0-5 years: A3(a-f), A4(a-b), A5-A18(2022), A20-A26(2022), A5-A25(2023), A29(2022), A28(2023), A34(2022), A33(2023); for children 6-11 years: A3(a-d), A4(A4a-e), A5-A18(2022), A20-A26(2022), A5-A25(2023), A31(2022), A30(2023), A34(2022), A33(2023); for children 12-17 years: A3(a-d), A4(a-f), A5-A18(2022), A20-A26(2022), A5-A25(2023), A31(2022), A30(2023), A34(2022), A33(2023)
Variables in public use data file: SC_K2Q10; SC_K2Q11; SC_K2Q12; SC_K2Q13; SC_K2Q14; SC_K2Q15; SC_K2Q16; SC_K2Q17; SC_K2Q18; SC_K2Q19; SC_K2Q20; SC_K2Q21; SC_K2Q22; SC_K2Q23; BREATHING; ALLERGIES_CURR; K2Q40B; AUTOIMMUNE; BLOOD; K2Q61A; CYSTFIB; DIABETES_CURR; DOWNSYN; FASD; GENETIC; K2Q42A; K2Q42B; HEART; HEART_CURR; HEADACHE; HEADACHE_CURR; K2Q38A; K2Q38B; K2Q33A; K2Q33B; K2Q32A; K2Q32B; K2Q34A; K2Q34B; K2Q36A; K2Q36B; K2Q60A; K2Q60B; K2Q37A; K2Q37B; K2Q30A; K2Q30B; K2Q35A; K2Q35B; K2Q31A; K2Q31B; K2Q43B; BLINDNESS COORDINATION; DRESSING; ERRANDALONE; HANDS; MEMORYCOND; PHYSICALPAIN; STOMACH; SWALLOWING; WALKSTAIRS; SC_CSHCN (derived)

Denominator: Children age 0-17 years

Numerator: Meets expanded CSHCN criteria; Does not meet expanded CSHCN criteria

Revisions and Changes: This composite measure was added to the 2022-2023 NSCH Data Query for the first time.
There have been no substantive changes to the CSHCN Screener and functional difficulties asked in the NSCH since 2016. The number of conditions asked about in the NSCH has changed across the survey years. In 2022, two new questions were added to the survey: child has ever been told that they have an autoimmune disease such as Type 1 Diabetes, Celiac, or Juvenile Idiopathic Arthritis; and child has ever been told that they have Fetal Alcohol Spectrum Disorder (FASD). With the addition of the survey item on autoimmune diseases, the existing survey item for diabetes was clarified to specify only children with type 2 diabetes, and the item regarding arthritis was dropped from the survey altogether. In 2023, the questions about a genetic or inherited condition were dropped from the survey. For more information about the changes click here.

Additional Notes: Children with special health care needs (CSHCN) constitute an important population that require additional monitoring and care. One of MCHB’s primary goals is to ensure that Title V programs work to improve care delivery and outcomes for CSHCN. In 2024, MCHB slightly broadened the definition of CSHCN in order to identify more children in need of supportive services. The foundation of the definition remains the validated CSHCN Screener.
The Screener has been in use for more than 20 years and has consistently provided the basis for MCHB’s work in this population. The Screener captures children whose health needs and health consequences are ongoing and expected to last at least 12 months.
The newly added elements are based on longstanding NSCH items - health conditions and functional difficulties. The “Children who meet the expanded special health care needs criteria” measure thus includes those identified by the Screener and/or children with at least one of the 23 (in 2022 NSCH)/22 (in 2023 NSCH) health conditions asked about in the survey AND at least one of the 10 functional difficulties asked about in both surveys. The key to the additional individuals captured by these expanded criteria is that they must have at lease one condition AND at least one functional difficulty, not just one or the other. Please note that throughout the NSCH, all information about children's health conditions is based on parent recollection and is not independently verified.
In the 2022-2023 NSCH dataset, the prevalence of “Children who meet the expanded special health care needs criteria” is 26.2%--79.6% that were identified by the CSHCN Screener and 20.4% that did not meet Screener criteria but met the one condition/one difficulty measures. Therefore the “Children who meet the expanded special health care needs criteria” added 5.4% to the traditional CSHCN measure. Click here to learn more about the expanded CSHCN criteria. More information about CSHCN and the CSHCN Screener can be obtained on the Child and Adolescent Health Measurement Initiative’s website.

Treatment of Unknown Values: Missing values may be due to non-response (i.e. a skipped item) or a “don’t know” response. The way these items are handled can vary by measure. For Title V Maternal and Child Health Services Block Grant Measures, having missing values for all items in an indicator will lead to the case being given a missing value on the overall measure. For some other measures, if there is a missing value on any of the items, the case will be set to missing. How missing values are handled is documented in the "Additional notes" field above when required. Missing values are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the Interactive Data Query results table. In the majority of cases, the proportion of missing values is less than 5%. Exceptions are noted in the form of a Data Alert at the bottom of a results table. The exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). To learn about the impact of the missing values on the population count estimates, click here.

History and Development:
About NSCH
The National Survey of Children’s Health (NSCH), funded and directed by the Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB), is designed to provide annual national and state-level information on the health and well-being of children ages 0-17 years in the United States. The U.S. Census Bureau administers the survey, oversees the sampling, and produces a final data set of survey results. HRSA’s Maternal and Child Health Bureau (MCHB) develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children’s health, federal and state stakeholders, clinicians and researchers. In 2016, the NSCH underwent a significant redesign which combined content from both the NSCH and the National Survey of Children with Special Health Care Needs (NS-CSHCN). Further information on that redesign can be found in “The Design and Implementation of the 2016 National Survey of Children’s Health”.
The NSCH is conducted as a household survey, and one child per household is selected to be the subject for the detailed age-specific questionnaire. The respondent to this questionnaire is a parent or guardian who is living in the home and has knowledge of the sampled child. Survey participants complete either web-based or self-administered paper-and-pencil questionnaires. Data from the NSCH is used for scientific research, federal policy and program development, and state-level planning and performance reporting. Information is collected on factors related to the health and well-being of children, including access to and utilization of health care, receipt of care in a medical home, systems of care for CSHCN, family interactions, parental health, school and after-school experiences, and neighborhood characteristics.
More information about the survey can be found in the “About the National Survey of Children's Health” section of this website and HRSA’s MCHB website.