Prevalence of Children Aged 3–17 Years With Developmental Disabilities, by Urbanicity: United States, 2015–2018

Questions for Ben Zablotsky, Ph.D., Health Statistician and Lead Author of “Prevalence of Children Aged 3–17 Years With Developmental Disabilities, by Urbanicity: United States, 2015–2018.”

Q: Why did you decide to focus on urbanicity among children with developmental disabilities?

BZ: Thanks to previous research, we know that children with developmental disabilities typically require more health care and educational services than their typically developing peers, and we also know that children living in rural areas have greater unmet medical needs when compared to children living in urban areas.  For these two reasons, it is possible, that children with developmental disabilities living in rural areas could represent some of the most vulnerable when it comes to receiving a variety of health care services.  This report attempts to answer this question, by exploring the prevalence of selected developmental disability conditions and use of related services in rural and urban areas.  It serves as a follow-up to a previous Pediatrics article written by myself and Lindsey Black, along with colleagues from the National Center for Health Statistics, National Center on Birth Defects and Developmental Disabilities, and the Maternal and Child Health Bureau, titled “Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009-2017”

Q: How did you obtain this data for this report and what is considered a developmental disability?

BZ: Data come from the 2015-2018 National Health Interview Survey, a timely and nationally representative survey.  Developmental disabilities examined in this report were attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, blindness, cerebral palsy, moderate to profound hearing loss, learning disability, intellectual disability, seizures in the past 12 months, stuttering or stammering in the past 12 months, or any other developmental delay. Children whose parents answered that their child had one or more of these conditions were classified as having any “developmental disability.”

Q: Can you summarize how the data varied by types of developmental disabilities and service utilization in rural and urban areas?

BZ: During 2015-2018, children were more likely to be diagnosed with ADHD and cerebral palsy in rural areas than urban areas.  Meanwhile, children with developmental disabilities living in rural areas were less likely to have seen a mental health professional, therapist, or had a well-child check-up in the past 12 months than their urban peers.  Children with developmental disabilities in rural areas were also less likely to be receiving Special Education or Early Intervention Services.

Q: Was there a specific finding in the data that surprised you?

BZ: Children with developmental disabilities often need specialty and mental health services.  It was surprising to see that approximately half of children with developmental disabilities living in rural areas had not seen a mental health professional, specialist, or therapist in the past year.

Q: What is the take home message for this report?

BZ: There was a higher prevalence of children with developmental disabilities in rural areas compared with urban areas. Furthermore, among children with developmental disabilities, those living in rural areas were less likely to use a range of health care and educational services compared with their urban peers.  Additional research exploring the pathways to the diagnosis and treatment of developmental disabilities in both urban and rural areas, with a focus on the availability of resources to pay for services as well as access to trained specialty providers, could provide insight into the disparities seen in this report.