IMPLICATIONS FOR ESTIMATES OF DISABILITY IN CHILDREN - A COMPARISON OF DEFINITIONAL COMPONENTS

Objective. To test how prevalence estimates and characteristics of chi ldren vary by the way that disability is defined. Specifically, to det ermine 1) the proportions of children identified as disabled by one pa rticular operationalization of disability based on parental reports of three types of consequences tie, functional limitations [FL]), depend ence on compensatory mechanisms (CD), and service use or need beyond r outine [SU/N]), and 2) whether children identified as disabled by thes e three types of consequences differ by type of disorder or condition, age, socioeconomic status, or race. Method. We analyzed a national da taset representing a random sample of 712 households with 1388 childre n. The Questionnaire for Identifying Children with Chronic Conditions (QuICCC) was used to identify children with disabling conditions. We d ivided the QuICCC items into three discrete sets, reflecting three def initional components of disability, and compared the proportions and c haracteristics of children fitting these components separately and in combination. Results. Using the, QuICCC definition of disability, SU/N identified the largest proportion of children (72%), followed by CD ( 55%) and FLs (49%). Forty-four percent of children were identified by only one component, 36% by two components in any combination, and 20% by all three components. The type of disorder or condition generally d id not vary by the three definitional components, although the FL comp onent may be more effective at identifying children with sensory impai rments. Children identified by two or more components were more likely to have multiple conditions and had more pervasive disorders than tho se identified by only one component. The youngest children (0 to 3 yea rs old) may be less likely to be identified as disabled than children of other ages, especially by FLs. FLs also were more likely to identif y children from the poorest and least educated families. Conclusions. Although the specific findings reported here pertain to a single-defin itional approach (the QuICCC), the data highlight that who will be cla ssified as disabled land who will not) may be dependent on how disabil ity is defined. The implications of using different definitions and de finitional components on both the prevalence and the characteristics o f children with disabilities need to be considered before data can be applied responsibly and appropriately.