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Difficulties in Functioning among Children in the United States: 2021-2023. National Health Statistics Reports. Number 218

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Title: Difficulties in Functioning among Children in the United States: 2021-2023. National Health Statistics Reports. Number 218
Language: English
Authors: Julie D. Weeks, Jennifer H. Madans, Lindsey I. Black, Nazik Elgaddal, Benjamin Zablotsky, National Center for Health Statistics (DHHS/PHS)
Source: National Center for Health Statistics. 2025.
Availability: National Center for Health Statistics. 3311 Toledo Road, Hyattsville, MD 20782. Tel: 800-232-4636; e-mail: cdcinfo@cdc.gov; Web site: http://www.cdc.gov/nchs
Peer Reviewed: N
Page Count: 20
Publication Date: 2025
Document Type: Reports - Research
Descriptors: Children, Adolescents, Disabilities, Visual Impairments, Hard of Hearing, Physical Disabilities, Communication Problems, Learning Problems, Play, Psychomotor Skills, Age Differences, Daily Living Skills, Memory, Attention, Adjustment (to Environment), Coping, Interpersonal Competence, Anxiety, Depression (Psychology), Incidence, Gender Differences, Racial Differences, Ethnicity, Rural Urban Differences, Family Income
Assessment and Survey Identifiers: National Health Interview Survey
Abstract: Objectives: This report presents national estimates of difficulties in functioning for children ages 2-17. Methods: 2021-2023 National Health Interview Survey (NHIS) data were used to assess difficulties in functioning among children. NHIS has included the Child Functioning Module, developed jointly by UNICEF and the Washington Group on Disability Statistics, since 2019. The module's questions ask about difficulties in the following functional domains: seeing, hearing, walking, communication, behavior, and learning (for all children ages 2-17); fine motor and playing (for children ages 2-4); and self-care, remembering, concentrating, coping with change, relationships, and affect (anxiety and depression) (for children ages 5-17). Prevalence estimates were calculated for different levels of difficulty (a lot of difficulty, some difficulty, or no difficulty) and are presented for overall functioning, by individual functional domain, and by number of functional domains where difficulties were reported. Differences in functioning by age, sex, race and Hispanic origin, urbanization level, and family income are also presented. Results: In 2021-2023, about one-quarter (24.9%) of children ages 2-4 experienced difficulties in functioning (4.1% experienced a lot of difficulty in one or more domains and 20.8% experienced some difficulty). Among children ages 5-17, just over one-half (50.8%) experienced functioning difficulties (13.0% experienced a lot of difficulty and 37.8% experienced some difficulty). The prevalence of functioning difficulties varied by sex, with boys being more likely than girls to experience a lot of difficulty in at least one domain, but differences across other characteristics varied. Functioning difficulties were most prevalent in the domains of communication, learning, behavior, and playing among children ages 2-4. For those ages 5-17, the most prevalent domains were anxiety, accepting change, behavior, depression, and making friends. Among children who experienced functioning difficulties, most had difficulty in only one functional domain.
Abstractor: As Provided
Entry Date: 2025
Accession Number: ED676211
Database: ERIC
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  Data: Difficulties in Functioning among Children in the United States: 2021-2023. National Health Statistics Reports. Number 218
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  Data: <searchLink fieldCode="AR" term="%22Julie+D%2E+Weeks%22">Julie D. Weeks</searchLink><br /><searchLink fieldCode="AR" term="%22Jennifer+H%2E+Madans%22">Jennifer H. Madans</searchLink><br /><searchLink fieldCode="AR" term="%22Lindsey+I%2E+Black%22">Lindsey I. Black</searchLink><br /><searchLink fieldCode="AR" term="%22Nazik+Elgaddal%22">Nazik Elgaddal</searchLink><br /><searchLink fieldCode="AR" term="%22Benjamin+Zablotsky%22">Benjamin Zablotsky</searchLink><br /><searchLink fieldCode="AR" term="%22National+Center+for+Health+Statistics+%28DHHS%2FPHS%29%22">National Center for Health Statistics (DHHS/PHS)</searchLink>
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  Data: National Center for Health Statistics. 3311 Toledo Road, Hyattsville, MD 20782. Tel: 800-232-4636; e-mail: cdcinfo@cdc.gov; Web site: http://www.cdc.gov/nchs
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  Data: <searchLink fieldCode="DE" term="%22Children%22">Children</searchLink><br /><searchLink fieldCode="DE" term="%22Adolescents%22">Adolescents</searchLink><br /><searchLink fieldCode="DE" term="%22Disabilities%22">Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+Impairments%22">Visual Impairments</searchLink><br /><searchLink fieldCode="DE" term="%22Hard+of+Hearing%22">Hard of Hearing</searchLink><br /><searchLink fieldCode="DE" term="%22Physical+Disabilities%22">Physical Disabilities</searchLink><br /><searchLink fieldCode="DE" term="%22Communication+Problems%22">Communication Problems</searchLink><br /><searchLink fieldCode="DE" term="%22Learning+Problems%22">Learning Problems</searchLink><br /><searchLink fieldCode="DE" term="%22Play%22">Play</searchLink><br /><searchLink fieldCode="DE" term="%22Psychomotor+Skills%22">Psychomotor Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Age+Differences%22">Age Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Daily+Living+Skills%22">Daily Living Skills</searchLink><br /><searchLink fieldCode="DE" term="%22Memory%22">Memory</searchLink><br /><searchLink fieldCode="DE" term="%22Attention%22">Attention</searchLink><br /><searchLink fieldCode="DE" term="%22Adjustment+%28to+Environment%29%22">Adjustment (to Environment)</searchLink><br /><searchLink fieldCode="DE" term="%22Coping%22">Coping</searchLink><br /><searchLink fieldCode="DE" term="%22Interpersonal+Competence%22">Interpersonal Competence</searchLink><br /><searchLink fieldCode="DE" term="%22Anxiety%22">Anxiety</searchLink><br /><searchLink fieldCode="DE" term="%22Depression+%28Psychology%29%22">Depression (Psychology)</searchLink><br /><searchLink fieldCode="DE" term="%22Incidence%22">Incidence</searchLink><br /><searchLink fieldCode="DE" term="%22Gender+Differences%22">Gender Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Racial+Differences%22">Racial Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Ethnicity%22">Ethnicity</searchLink><br /><searchLink fieldCode="DE" term="%22Rural+Urban+Differences%22">Rural Urban Differences</searchLink><br /><searchLink fieldCode="DE" term="%22Family+Income%22">Family Income</searchLink>
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  Data: Objectives: This report presents national estimates of difficulties in functioning for children ages 2-17. Methods: 2021-2023 National Health Interview Survey (NHIS) data were used to assess difficulties in functioning among children. NHIS has included the Child Functioning Module, developed jointly by UNICEF and the Washington Group on Disability Statistics, since 2019. The module's questions ask about difficulties in the following functional domains: seeing, hearing, walking, communication, behavior, and learning (for all children ages 2-17); fine motor and playing (for children ages 2-4); and self-care, remembering, concentrating, coping with change, relationships, and affect (anxiety and depression) (for children ages 5-17). Prevalence estimates were calculated for different levels of difficulty (a lot of difficulty, some difficulty, or no difficulty) and are presented for overall functioning, by individual functional domain, and by number of functional domains where difficulties were reported. Differences in functioning by age, sex, race and Hispanic origin, urbanization level, and family income are also presented. Results: In 2021-2023, about one-quarter (24.9%) of children ages 2-4 experienced difficulties in functioning (4.1% experienced a lot of difficulty in one or more domains and 20.8% experienced some difficulty). Among children ages 5-17, just over one-half (50.8%) experienced functioning difficulties (13.0% experienced a lot of difficulty and 37.8% experienced some difficulty). The prevalence of functioning difficulties varied by sex, with boys being more likely than girls to experience a lot of difficulty in at least one domain, but differences across other characteristics varied. Functioning difficulties were most prevalent in the domains of communication, learning, behavior, and playing among children ages 2-4. For those ages 5-17, the most prevalent domains were anxiety, accepting change, behavior, depression, and making friends. Among children who experienced functioning difficulties, most had difficulty in only one functional domain.
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      – SubjectFull: Children
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      – SubjectFull: Adolescents
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      – SubjectFull: Disabilities
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