Le. Westbrook et al., IMPLICATIONS FOR ESTIMATES OF DISABILITY IN CHILDREN - A COMPARISON OF DEFINITIONAL COMPONENTS, Pediatrics, 101(6), 1998, pp. 1025-1030
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.