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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:
Children age 0-17 years
Children with special health care needs (CSHCN); Non-CSHCN
Revisions and Changes:
There have been no substantive changes to this item or measure since 2016.
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 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.
C.I. = 95% Confidence Interval.
Percentages and population estimates (Pop.Est.) are weighted to represent child population in US.
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Data Source: National Survey of Children’s Health, Health Resources and Services Administration, Maternal and Child Health Bureau. https://mchb.hrsa.gov/data/national-surveys
Citation: Child and Adolescent Health Measurement Initiative. 2019-2020 National Survey of Children’s Health (NSCH) data query. Data Resource Center for Child and Adolescent Health supported by the U.S. Department of Health and Human Services, Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). Retrieved [mm/dd/yy] from [www.childhealthdata.org].
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U59MC27866,National Maternal and Child Health Data Resource Initiative, $4.5M. This information or content and conclusions are those of the author and should not be construed as the official position of or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.