Survey Results

Survey Items: These items are asked among all children in the initial household screener questionnaire. The screener item numbers: 7,8,9,10,11
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; SC_CSHCN (derived)

Denominator: Children age 0-17 years

Numerator: Children who do not have qualifying responses on any of the five CSHCN Screener criteria; Children with qualifying responses on one or more of the five CSHCN Screener criteria

Revisions and Changes: In 2018 this measure did not change from the 2017 NSCH.

Additional Notes: The NSCH uses the CSHCN Screener to identify children with special health care needs. The Screener is a five item, parent-reported tool designed to reflect the federal Maternal and Child Health Bureau’s consequences-based definition of children with special health care needs. It identifies children across the range and diversity of childhood chronic conditions and special needs, allowing a more comprehensive and robust assessment of children's needs and health care system performance than is attainable by focusing on a single diagnosis or type of special need.
To qualify as having special health care needs, the following criteria must be met: a) the child currently experiences a specific consequence; b) the consequence is due to a medical or other health condition; and c) the duration or expected duration of the condition is 12 months or longer. The first part of each screener question asks whether a child experiences one of five different health consequences:
1) Use or need of prescription medication.
2) Above average use or need of medical, mental health or educational services.
3) Functional limitations compared with others of same age.
4) Use or need of specialized therapies (OT, PT, speech, etc.).
5) Treatment or counseling for emotional or developmental problems.
The second and third parts of each screener question ask those responding “yes” to the first part of the question whether the consequence is due to any kind of health condition and if so, whether that condition has lasted or is expected to last for at least 12 months. All three parts of at least one screener question (or in the case of question 5, the two parts) must be answered “YES” in order for a child to meet CSHCN Screener criteria for having a special health care need.
This instrument has been used in several national surveys including the Promoting Healthy Development Survey, the CAHPS-CCC, the NSCH, the NS-CSHCN, and Medical Expenditure Panel Survey (MEPS). 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 NPMs and NOMs, 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 2%. 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: The Health Resources and Services Administration's (HRSA) Maternal and Child Health Bureau (MCHB) funds and directs the National Survey of Children's Health (NSCH), and 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. The U.S. Census Bureau conducts the survey, oversees the sampling, and produces a final data set of survey results. Respondents' cognitive understanding of the survey questions was assessed during the pretest phase of the survey redesign (in 2015) and reassessed after the 2016 survey; subsequent revisions were made. Previously validated questions and scales are used when available. The manuscript "The Design and Implementation of the 2016 National Survey of Children's Health" provides detailed information about the redesign of the NSCH, administration of the first redesigned survey (2016), and the sampling and administration changes for the 2017 and 2018 NSCH. Prior to 2016, the NSCH and the National Survey of Children with Special Health Care Needs were each conducted three times as interviewer-assisted telephone surveys using random digit dial sampling. In 2016, the two surveys were combined into a single annual self-administered questionnaire. Due to decline in the number of households with landline telephones, the NSCH now utilizes an addressed based sampling method to select participating households, thus all invitations are sent by mail. Participants may choose to complete the survey either online using a secure website or a mailed paper version of the survey. All final data components are verified by the Census Bureau, HRSA/MCHB and CAHMI/DRC staff prior to public release. 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.