Child Neurodevelopmental and Mental Health Disabilities Are on the Rise
More children have disabilities now than a decade ago, and the greatest increase is among children of higher-income families, according to a new study.
The study also showed that while disabilities due to neurodevelopmental and mental health problems have increased sharply, disabilities related to physical health conditions have decreased. This trend was most note-worthy among children under 6, whose rate of neurodevelopmental disabilities nearly doubled during the study, from 19 cases per 1,000 children to 36 cases per 1,000 children.
“Nearly six million kids were considered disabled in 2009 and 2010—almost one million more than in 2001 and 2002,” said Amy Houtrow, MD, PhD, MPH, lead author of the study and chief of the Division of Pediatric Rehabilitation Medicine at Children’s Hospital of Pittsburgh.
The researchers studied data from the National Health Interview Survey conducted by the U.S. Centers for Disease Control and Prevention from 2001 to 2002 and from 2009 to 2010. Participants included more than 102,000 parents of children up to age 17.
The research team assembled a composite of disability indicators to identify disabled children and their associated underlying chronic conditions. Conditions were categorized into three groups: physical, neurodevelopmental/mental health, and other.
The overall rate of disability for children under age 18 increased 16.3 percent between the 2001 to 2002 study period and the 2009 to 2010 study period.
Children living in poverty represented the largest numbers of overall children with disability in both time periods, but not the highest growth rates. The largest increase in growth rates of disabilities was seen among children living in households with incomes at or above 300 percent of the federal poverty level—about $66,000 a year for a family of four in 2010.
“We are worried that children living in lower income families may be having problems accessing diagnostic and treatment services,” Houtrow said. The study did not pinpoint why the disability rate is increasing.
Nearly one in five children and teens found to be at risk for suicide report that there are guns in their homes, and 15 percent of those at risk for suicide with guns in the home know how to access both the guns and the bullets, according to a new study.
Suicide is the second leading cause of death among young people ages 10 to 24 in the United States, according to data from the Centers for Disease Control and Prevention. Nearly half of youths who die by suicide use a firearm (see adjacent graph).
Most Common Suicide Methods
Researchers used the study findings to create a screening tool that health-care professionals in emergency departments (EDs) could use to determine which youths need further mental health evaluation to keep them from harming themselves. As part of that study, researchers asked youths about access to guns in or around their home and about storage of guns and ammunition.
Study participants included 524 patients ages 10 to 21 who were seen for medical/surgical or psychiatric complaints at one of three pediatric EDs. They were asked to fill out a 17-item questionnaire that the researchers used to develop the Ask Suicide-Screening Questions (ASQ), a four-question screening tool that can be used for all pediatric patients visiting the ED. The ASQ has been validated against a longer, more in-depth suicide-assessment tool.
“For more than 1.5 million adolescents, the ED is their primary point of contact with the healthcare system, which makes the ED an important place for identifying youth at risk for suicide,” said Stephen J. Teach, MD, MPH, FAAP, associate chief in the Division of Emergency Medicine at Children’s National Medical Center in Washington, DC, and co-author of the study.
“Nearly all of the kids in our study were in favor of suicide-screening in the ED,” said Lisa M. Horowitz, PhD, MPH, staff scientist/pediatric psychologist at the National Institute of Mental Health, National Institutes of Health, Bethesda, Md. “Our study shows that if you ask kids directly about suicide, they will tell you what they are thinking.”
Of the patients who completed the screening tools, 151 (29 percent) were found to be at risk for suicide, and 17 percent of them reported guns in or around the home. Of those at risk for suicide and reporting guns in the home, 31 percent knew how to access the guns, 31 percent knew how to access the bullets, and 15 percent knew how to access both the guns and the bullets.
“This study highlights the importance of parents understanding the risks of having guns in their homes,” said co-author and youth suicide expert Jeffrey A. Bridge, PhD, principal investigator at The Research Institute at Nationwide Children’s Hospital and associate professor of pediatrics at The Ohio State University. “Being at risk for suicide and having access to firearms is a volatile mix. These conversations need to take place in the ED with families of children at risk for suicide.”
“Up to 40 percent of youths who kill themselves have no known mental illness,” said “Therefore, it is important to screen all children and adolescents for suicide, regardless of the reason they are visiting the ED,” Bridge said
Source: American Academy of Pediatrics press release. View the abstract for, “Access to Firearms Among Patients Screening Positive for Suicide Risk in Pediatric Emergency Departments.”
How Universal Is Optimism?
Research into optimism has found that the Irish and Brazilians are the most hopeful for the future, while people in Egypt and Lebanon are the least sanguine. The study analyzed 150,048 individuals from 142 countries to examine relationships between optimism, subjective well-being, perceived health, and hopes for the future.
After ranking nations in a scale of optimism, the countries with the five highest mean expectations for the future were Ireland, Brazil, Denmark, New Zealand, and the United States. The countries with the five lowest mean expectations for the future were Zimbabwe, Egypt, Haiti, Bulgaria, and Lebanon.
The findings show that most individuals in most countries worldwide are optimistic and that higher levels of optimism are associated with improved subjective well-being and perceived health worldwide.
“Our study provides compelling evidence that optimism is a universal phenomenon, that optimism is associated with improved perceptions of physical health and improved subjective well-being worldwide,” said Matthew Gallagher. a doctoral student in psychology at the University of Kansas and lead researcher of the study.. “Optimism is not merely a benefit of living in industrialized nations, but reflects a universal characteristic that is associated with and potentially may serve to promote improved psychological functioning worldwide.”
Source: Journal of Personality. First published online April 12, 2013, in the Wiley Online Library. View the abstract.