National Survey Of Children's Health Research Articles

Trauma in Schools: A Review of the Impact of Childhood Trauma and Assessment of a Potential Intervention

According to the National Survey of Children’s Health (NSCH), nearly 30 million children in the United States have experienced one or more types of significant childhood trauma. In the average public school, this statistic translates to as many as half of the students in a given teacher’s classroom. Children exposed to the toxic stress of trauma often experience negative consequences that affect their academic, psychological, socioemotional, and behavioral health. To aid educators in addressing this reality, trauma-informed care practices have increasingly begun to be translated into professional development opportunities for educators. Using the theoretical frameworks of trauma theory and transformational learning theory, this review of the literature provides a brief overview of trauma theory, the short- and long-term effects on children, the mechanisms involved in how trauma affects developmental outcomes, and the relevance of trauma in an educational setting. It also reviews the implementation of trauma-informed care as professional development in educational settings, examines research on educators’ awareness of beliefs and attitudes, and reviews how/whether knowledge and change in attitudes affect behavioral change.

Association of general anxiety and pediatric dental preventive examination utilization, National Survey of Children's Health, 2021.

Many factors influence preventive dental health service access for children. The objective of this research was to examine one factor, general anxiety, in accessing at least one preventive dental examination in the past 12 months in children with special healthcare needs (CSHCN) and children without special healthcare needs (CWSHCN). National Survey of Children's Health (NSCH) 2021 were obtained for this cross-sectional research. Chi-square and logistic regression analyses were used to determine association of anxiety and past 12-month preventive dental examinations. The sample included 10493 CSHCN, and 35675 CWSHCN. Overall, 72.7% had past 12-month preventive dental examinations, and 9.9% had a healthcare provider indicate they had general anxiety. CSHCN with anxiety, CWSHCN with anxiety, and CSHCN without anxiety were more likely to have a past 12-month preventive dental examination visit than CWSHCN without anxiety (Adjusted Odds Ratios: 1.86, 1.39, 1.32, respectively). Our results suggest children with general anxiety (both CSHCN and CWSHCN) are more likely to have had at least one regular preventive dental visit within the past 12 months than CWSHCN and without general anxiety. There is a need for further understanding the relationship of general anxiety and dental health to improve the health of all children. CWSHCN without anxiety need individualized, comprehensive care with enough time, attention, instruction, and rewards to demonstrate to parents/guardians the importance of making routine preventive dental examinations a priority for their child.

Children With Special Health Care Needs: An Analysis of National Survey of Children's Health Database.

Background Children with Special Health Care Needs (CSHCN) represent a diverse pediatric population requiring healthcare services beyond typical childhood needs. This study analyzes data from the 2016-2020 National Survey of Children's Health Database to elucidate demographic patterns, prevalence rates, and nuanced factors influencing the health and well-being of CSHCN. Methods This retrospective observational study focuses on children aged 0-17 who are identified as CSHCN based on Maternal and Child Health Bureau criteria. A comprehensive analysis of the National Survey of Children's Health (NSCH) database examines key variables, including health outcomes, healthcare utilization, parental-reported health status, and socio-demographic factors. Stratified random sampling ensures national representation. Results The study encompassed 40,335 patients, revealing that 14.6% (CI: 14.0-15.3, n=6,445) of CSHCN received care in a well-functioning system. Across age groups, 19.1% (CI: 14.0-15.3, n=6,445) of CSHCN aged 0-5 received ongoing treatment, contrasting with 5.7% (CI: 5.2-6.2, n=1,599) in the 12-17 years group. Males exhibited a prevalence of 15% (CI: 14.1-15.9, n=3,674), and females had 14.2% (CI: 13.2-15.2, n=2,771). Racial disparities were noted; non-Hispanic Native Hawaiian/Other Pacific Islander children had a 3% (CI: 1.1-8.1, n=6) prevalence. Across Federal Poverty Level categories, prevalence ranged from 12.5% (CI: 11.5-13.6, n=1,753) to 17.7% (CI: 16.6-18.9, n=2,856). Notably, 18.5% (CI: 17.4-19.7, n=3,515) of children without adverse experiences were CSHCN. Among CSHCN in two-parent currently married households, 15.9% (CI: 15.0-16.8, n=4,330) received treatment, while those in unmarried households had a prevalence of 12.9% (CI: 10.5-15.7, n=335). CSHCN with parents born in the United Statesshowed a prevalence of 15.4% (CI: 14.7-16.1, n=5,257). Conclusion This study provides valuable insights into the prevalence and demographic patterns of CSHCN. Limitations include potential recall bias and the retrospective study design. Despite these constraints, the findings lay a foundation for future research and targeted interventions, fostering a deeper understanding of the evolving landscape of pediatric healthcare in the United States.

Dental Caries and Preventive Dental Visits Among Children in the U.S.: The Impact of Race/Ethnicity and Immigration

Introduction: National data on dental caries and dental service use among immigrant children in US is limited. It is not known whether race/ethnicity would interact with immigration status to increase these disparities. Using a national representative sample, we assessed the interaction effects of immigrant generation status and race/ethnicity on dental caries and dental visits among children in the US. Methods: Data were from the 2020 and 2021 National Survey of Children's Health (NSCH). All data were self-reported by parents/guardians. The two outcomes were (1) dental caries (yes/no) in the past 12 months, and (2) preventive dental visits (yes/no) in the past 12 months. Racial/ethnic groups included non-Hispanic White, Black, Hispanics, and Asian Americans. The analytical sample included 66,167children ages 2-17 years, including 1,243 first generation, 11,017 second generation immigrant children, and 53,907 non-immigrant children. We ran separate multiple logistic regression models for the two outcome variables. All analyses accounted for the survey design of NSCH. Results: First generation immigrant children were more likely to have dental caries than non-immigrant children (AOR=1.44). The interaction of race/ethnicity and immigrant generation status was significant (P =0.04) in the preventive dental visits model, indicating increased challenges in getting dental visits among minority immigrant children in comparison with non-Hispanic White immigrant children, especially among first generation immigrant children of Asian Americans (AOR=0.41) and non-Hispanic Black (AOR=0.37) immigrant children. Conclusions: We found that first generation immigrant children were less likely to see a dentist and more likely to have dental caries than non-immigrants. Moreover, first generation immigrant children from minority racial/ethnic groups were the least likely to seek dental services. To further reduce disparities in oral health and dental use among children in the U.S., culturally sensitive health promotion is warranted to improve oral health literacy and reduce barriers to dental care for immigrants, especially immigrant children of the minority groups.

ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment

ABSTRACT Objective To provide updated national prevalence estimates of diagnosed attention-deficit/hyperactivity disorder (ADHD), ADHD severity, co-occurring disorders, and receipt of ADHD medication and behavioral treatment among U.S. children and adolescents by demographic and clinical subgroups using data from the 2022 National Survey of Children’s Health (NSCH). Method This study used 2022 NSCH data to estimate the prevalence of ever diagnosed and current ADHD among U.S. children aged 3–17 years. Among children with current ADHD, ADHD severity, presence of current co-occurring disorders, and receipt of medication and behavioral treatment were estimated. Weighted estimates were calculated overall and for demographic and clinical subgroups (n = 45,169). Results Approximately 1 in 9 U.S. children have ever received an ADHD diagnosis (11.4%, 7.1 million children) and 10.5% (6.5 million) had current ADHD. Among children with current ADHD, 58.1% had moderate or severe ADHD, 77.9% had at least one co-occurring disorder, approximately half of children with current ADHD (53.6%) received ADHD medication, and 44.4% had received behavioral treatment for ADHD in the past year; nearly one third (30.1%) did not receive any ADHD-specific treatment. Conclusions Pediatric ADHD remains an ongoing and expanding public health concern, as approximately 1 million more children had ever received an ADHD diagnosis in 2022 than in 2016. Estimates from the 2022 NSCH provide information on pediatric ADHD during the last full year of the COVID-19 pandemic and can be used by policymakers, government agencies, health care systems, public health practitioners, and other partners to plan for needs of children with ADHD.

Recovery from substance use disorder among adolescents: Roles of adverse and positive childhood experiences

AbstractThis study examines the roles of positive childhood experiences (PCEs) and adverse childhood experiences (ACEs) on the recovery from substance use disorder (SUD) among adolescents ages 12–17, utilizing data from the 2016–2019 National Survey of Children's Health (NSCH). On a sample of 256 adolescents who have had SUD, a hierarchical binary logistic regression analysis demonstrated that the cumulative PCEs significantly increased the odds of SUD recovery, whereas the cumulative ACEs did not decrease the odds.

Aluminum Adjuvants and Childhood Disease Prevalence

This study investigated the relationship between aluminum adjuvant vaccines and the prevalence of 4 childhood diseases (Autism, Allergies, Asthma, ADD/ADHD) using data from the 2020-2021 National Survey of Children's Health (NSCH) [1] and the Centers for Disease Control National Immunization Survey (CDC NIS) [2]. The study found an association with aluminum adjuvant dosage and the prevalence of each disease studied (Autism, Allergies, Asthma, ADD/ADHD) through a weighted regression analysis of disease prevalence against the summed likelihood of aluminum adjuvant vaccine uptake.

Comparing bullying to ACEs in the national survey of children's health: Examining 2016–2019 prevalence trends among children and adolescents

ObjectivesTo estimate adverse childhood experience (ACE) prevalence among children and adolescents aged 6–17 years in the United States, to examine factors influencing the prevalence of ACEs over the time period 2016–2019, and to examine the difference in bullying trends compared to ACEs in the NSCH. Participants and settingThe National Survey of Children's Health (NSCH) is a cross-sectional survey. Participants included respondents who completed the separate surveys for ages 6–11 and 12–17 from 2016 to 2019. MethodsCumulative ACEs were analyzed to determine the change in prevalence of having at least one ACE, overall and stratified by age group. ResultsOverall prevalence was highest among income difficulties (16–26 %); parent/guardian divorced or separated (29–31 %); and bullying (21–48 %). There was a significant time trend for income difficulties (decreased; p < 0.001), lived with anyone with a mental illness (increased; p = 0.004), racial/ethnic mistreatment (increased; p = 0.004), and bullying (increased; p < 0.001). Cumulative prevalence trends without bullying decreased significantly from 2016 to 2019 while prevalence trends for bullying increased significantly during this time frame. Sex, age, and race/ethnicity were significantly associated with some of the ACEs. ConclusionsTrend of ACEs varies as prevalence of some ACEs increased while decreasing for others over time. Also, ACEs appear to affect children and adolescents differently according to sex, age group, and racial/ethnic background, which warrants the need to prioritize efforts to decrease the exposure to ACEs.

Flourishing and Functional Difficulties among Autistic Youth: A Confirmatory Factor Analysis.

The International Classification of Functioning, Disability, and Health for Children and Youth outlines body structures and functions and activities and participation to fully describe elements that support or detract from participation. While flourishing has gained attention in recent literature, research also points to the role of functional difficulties among autistic youth in influencing participation. Clearly, function is a multi-dimensional and complex construct and likely consists of both indicators of flourishing and functional difficulties. We used data from the National Survey of Children's Health (NSCH) from 2016 to 2020 to identify aspects of flourishing functional difficulties to achieve the following aims: (1) Investigate the factor structure of flourishing and functional difficulties among autistic youth ages 10-17 years; and (2) examine the extent to which child variables (i.e., sex, age, race, ethnicity, autism severity, poverty) are associated with flourishing and functional difficulties. Autistic children (n = 2960) between the ages of 10 and 17 years were included. We used confirmatory factor analysis followed by a multivariate general linear model (GLM) to examine the association between child variables and factors. Results indicated a six-factor structure (medical conditions, instrumental activities of daily living, activities of daily living, social competence, behavioral control, and school motivation) with good model fit (root mean square error of approximation = 0.08 [p = 0.926], comparative fit index = 0.94, Tucker-Lewis index = 0.91). Multivariate GLM showed that child factors were differentially and significantly associated with factors of functional difficulties and flourishing. Current findings suggest that 16 items measured by the NSCH result in a six-factor structure of flourishing and functional difficulties among autistic youth. A comprehensive approach to capture function among autistic youth must assess aspects of flourishing and difficulties.

Associations of meeting 24-hour movement behavior guidelines with prescribed eyeglasses/contact lenses among children and adolescents

BackgroundVision health is crucial for many aspects of life especially in developing populations such as children and adolescents. However, there is a high proportion of children and adolescents who suffer from visual impairments. Notably, accumulating evidence indicates that meeting the 24-hour movement behaviors (24-HMB) guidelines is associated with positive physical and mental health outcomes in children and adolescents. However, the relationship between being prescribed eyeglasses/contact lenses and meeting the 24-HMB guidelines has yet to be investigated. Thus, this study aimed to address this gap in the existing literature by using the 2021 National Survey of Children's Health (NSCH) dataset. MethodsIn this cross-sectional study, data was retrieved from the 2021 NSCH. A total of 14,193 U.S. children and adolescents aged between 6 and 17 years were included for data analyses. We used items of the NSCH concerning the 24-HMB guidelines (i.e., physical activity, screen time, and sleep duration) and prescription of eyeglasses/contact lenses that were answered by the legal guardian of the children. Binary logistic regression was performed to investigate whether meeting the 24-HMB guidelines is associated with prescription eyeglasses/contact lenses and whether wearing eyeglasses/contact lenses predicts adherence to the 24-HMB guidelines among children and adolescents. ResultsMore than half of the participants (59.53%) wore eyeglasses/contact lenses and only 8.40% of them met all three of the 24-HMB guidelines. Compared to meeting none of the 24-HMB guidelines, meeting one (OR = 0.76, 95% CI = 0.62–0.93, p = 0.008), two (OR = 0.54, 95% CI = 0.43–0.67, p < 0.001), and all three 24-HMB guidelines (OR = 0.47, 95% CI = 0.34–0.64, p < 0.001) were associated with a lower risk of being prescribed eyeglasses/contact lenses among children and adolescents. ConclusionsThe findings of the current study provided evidence that the prevalence of U.S. children and adolescents aged between 6 and 17 years who wore eyeglasses/contact lenses was relatively high. Furthermore, meeting the 24-HMB guidelines was associated with a lower risk of being prescribed eyeglasses/contact lenses. Future studies focusing on the effects of 24-HMB interventions on vision health among children and adolescents are needed to better inform public health actions.

Association and disparities of food insecurity and exposure to violence: analysis of the National Survey of Children's Health.

Lack of access to food is a significant concern for child well-being, and it creates many health disparities and adverse social outcomes. Food insecurity and its many associated risk factors increase parental stress, which are strongly correlated with an increased risk of child abuse and maltreatment. Research now identifies being witness to domestic abuse as a form of child maltreatment, and exposure to violence in the community has been shown to result in similar long-term impacts. Given the potential for lifelong adverse effects from experiencing adverse childhood events involving violence and food insecurity, our primary objective was to assess the relationship between the two and disparities among demographic factors. We conducted an observational study utilizing data from the National Survey of Children's Health (NSCH) 2016-2021. The NSCH is a United States nationally representative survey completed by primary caregivers of one child per home aged 0-17 years. We determined population estimates (n=216,799; n=83,424,126) and rates of children experiencing food insecurity and parent-reported exposure to violence. We then constructed logistic regression models to assess associations, through odds ratios (ORs), between food security and exposure to violence including demographic factors. Among the sample, 5.42 % of children experienced low food security and 7.4 % were exposed to violence. The odds of exposure to violence are 5.19 times greater for children with low food security compared to food-secure children (95 % confidence interval [CI]: 4.48-6.02). Indigenous and Black children were 7.8 and 6.81 times more likely to experience or witness violence when food insecure compared to food secure White children, respectively (95 % CI: 3.18-19.13, 5.24-8.86 respectively). Food insecurity was associated with increased odds of children experiencing and/or witnessing violence compared to those who were food secure. The interaction between exposure to violence and food insecurity also disproportionately impacts children with specific demographic factors, notably race/ethnicity including multiracial, Indigenous, and Black children. By developing and adapting strategies to improve food security, it is possible to indirectly reduce the rates of childhood exposure to violence and the long-term impacts that result.

School Readiness Among United States Children: Results From the 2022 National Survey of Children’s Health

ObjectiveProvide the latest national and state estimates and correlates of the proportion of young children who are healthy and ready to learn (HRTL) using a revised measure from the National Survey of Children’s Health (NSCH). MethodsData were analyzed for 11,121 children ages 3 to 5 years from the 2022 NSCH, an address-based, parent-completed survey on the health and well-being of children in the United States. A total of 27 items across 5 domains (early learning skills, social emotional development, self-regulation, motor development, and health) were used to calculate domain-specific assessments scored as “on track,” “emerging,” or “needs support” according to age-appropriate developmental expectations. Children “on track” in 4 to 5 domains with no domain that “needs support” were considered HRTL. ResultsIn 2022, 63.6% of 3- to 5-year-old children were HRTL. The proportion of children “on track” ranged from just over two thirds for early learning skills and motor development to 88.9% for health. One million children, or 9.0%, needed support in multiple domains. Being HRTL was associated with child, family, community factors including participation in early childhood education, special health care needs status/type, male sex, reading/singing/storytelling by family members, adverse childhood experiences, parental mental health and education, food insufficiency, outdoor play, household language, neighborhood amenities, rural residence, medical home access. ConclusionsNearly two thirds of young children are reported to be HRTL, meeting the Title V National Outcome Measure for School Readiness. Using a revised measure, modifiable factors are identified which offer a range of intervention opportunities at the child, family, and community levels.

Sexual orientation/gender identity discrimination and chronic pain in children: A national study

This study provides national estimates of parental perceived child sexual orientation or gender minority (SGM) discrimination and examines associations between SGM discrimination and chronic pain in children. Cross-sectional analysis of the 2020 and 2021 National Survey of Children's Health (NSCH) (N=47,213). Caregivers of children ages 6-17 years old reported whether their child had ever been treated or judged unfairly (i.e., discrimination) because of their SGM identity. Chronic pain in children was defined as frequent or chronic difficulty with repeated or chronic physical pain during the past 12 months, as reported by caregivers. Weighted prevalence estimates for discrimination were calculated for the whole sample and sociodemographic subgroups. Associations between SGM discrimination and chronic pain were estimated using multivariable Poisson regression models adjusting for sociodemographic factors. Analyses were conducted 2022-2023. Within this nationally representative sample, parents reported 1.4% (95% CI: 1.2-1.6%) of children have experienced SGM-related discrimination. The prevalence was higher among adolescents, females at birth, and those living in suburban areas. Children who experienced discrimination had a higher prevalence of chronic pain (20.2%) compared to those who did not (7.0%, p<0.0001), with an adjusted prevalence rate ratio (aPR) of 2.0 (95% CI: 1.5-2.5, p<0.0001). Based on parent report, about 0.6 million children in the U.S. have experienced SGM-based discrimination; these children are twice as likely to have chronic pain. Findings highlight the importance of assessment and intervention for chronic pain in children who may experience marginalization and discrimination due to their sexual orientation and gender identity.

Family-Centered Care and Delayed or Missed Pediatric Preventive Care due to the COVID-19 Pandemic

ObjectiveTo examine the association between family-centered care and its components with delayed or missed preventive care due to the COVID-9 pandemic among US children. MethodsThis is a cross-sectional study using nationally representative data from the 2021 National Survey of Children’s Health (NSCH). Children were eligible if they received health care services in the past 12 months (n = 42,649; 79.3%). We excluded children with missing data, for a final sample of 40,511 (93.7% of the eligible sample). Children were deemed to have received family-centered care if caregivers responded “always” or “usually” to all five measures of family-centered care. Poisson regression was used to ascertain weighted prevalence ratios (PRs) and 95% confidence intervals (CIs). Predisposing, enabling, and need factors of health care services use were evaluated as potential confounders. ResultsApproximately 86.7% of children received family-centered care during the pandemic, with significant racial and ethnic differences, findings consistent with pre-pandemic data. In multivariable analyses adjusted for the child’s race and age, family-centered care was associated with a 30% reduced likelihood of delayed or missed preventive care (95% CI: 0.64–0.78). Individual components of family-centered care were associated with a 26%−43% reduced likelihood of delayed or missed preventive care. ConclusionsFamily-centered care and its components were associated with a reduced likelihood of delayed or missed pediatric preventive care. Our findings highlight the important role of health care providers in curbing the negative effects of the COVID-19 pandemic on pediatric preventive care utilization and emphasize the need to expand family-centered care among racial and ethnic minority groups.

Parenting Stress, Community Support, and Unmet Health Care Needs of Children in the US.

In 2018, approximately 2.3million children in the United States had unmet healthcare needs (UHCN). To date, studies examining associations between UHCN and parent stress and support have had limited generalizability. This study aimed to investigate the relationship between children's UHCN and parenting stress and support using a nationally representative sample. Additionally, this study aimed to assess associations between unmet mental health needs and these parental well-being measures. Households with children ages 0-17 and complete data on UHCN in the combined 2016, 2017, 2018, and 2019 cohorts of the National Survey of Children's Health (NSCH) met inclusion criteria. Logistic regressions were used to evaluate associations between overall UHCN and outcome measures of parental coping, aggravation, emotional support, and neighborhood support. Associations between mental UHCN and these outcome measures were analyzed in a subset limited to children with mental health conditions. Regressions were adjusted for potential confounders, including demographics, household income, medical home status, and health insurance (adequacy/type). In our sample of 131,299 children, overall UHCN were associated with poorer parental coping (aOR = 5.35, 95% CI: [3.60, 7.95]), greater parental aggravation (aOR = 3.35, 95% CI: [2.73, 4.12]), and non-supportive neighborhood (aOR = 2.22, 95% CI: [1.86, 2.65]). Mental UHCN were similarly associated with parental coping and aggravation and neighborhood support in the mental health subset. Healthcare professionals must address the needs of children with UHCN and collaborate with community organizations and child advocates to promote coordinated and comprehensive care and adequately support caregivers.

Change in screen time and overuse, and their association with psychological well-being among US-wide school-age children during the COVID-19 pandemic: analysis of the National Survey of Children’s Health (NSCH) years 2018–21

BackgroundPrevious studies on screen use and children’s mental health during the Coronavirus Disease 2019 (COVID-19) pandemic focused only on the timeframe during the pandemic, on children between narrow age ranges, only among a subset of children who have previously reported COVID-related severe family economic hardship or worries, or did not distinguish between instructive versus recreational device usage. Thus, in this study, we analyzed trends, specifically related to recreational screen use, and associations with psychological well-being (PWB) in the years before versus during the COVID-19 pandemic, among a wide range of school-aged children, widely across the nation.MethodsUsing the National Survey of Children’s Health (NSCH) years 2018–21, we analyzed a large random sample of school-aged children (6–17 years old) across the US (n = 88,823). We developed PWB issue scores (PWBIS) using self-reported measures relevant to this age group, and constructed regression models to assess the magnitude of the contribution of the pandemic on recreational screen use and PWB.ResultsThe prevalence of recreational screen overuse and PWBIS increased significantly during the pandemic, compared to prior years. We also detected a notable effect of the pandemic on increased PWBIS, as well as its interaction term finding that it strengthened the association between screen time and PWBIS (p < 0.01 across all regression models).ConclusionsAccordingly, our results demonstrate the importance of the pandemic itself as an independent adverse factor and effect measure modifier for screen overuse and PWB more generally among all school-age children widely across the US. Our study used the most current data available, and future studies to evaluate whether these effects are persistent in the years after the pandemic are important.

Associations of social determinants of health and childhood obesity: a cross-sectional analysis of the 2021 National Survey of Children's Health.

Childhood obesity is a growing health problem in the United States, with those affected having an increased likelihood of developing chronic diseases at a younger age. Social determinants of health (SDOH) are known to influence overall health. Families who are of low socioeconomic status (SES) have also been shown to be more likely to experience food insecurity. Our primary objective was to utilize the National Survey of Children's Health (NSCH) 2021 data to determine the current associations between childhood obesity and SDOH. Secondarily, we estimated the prevalence of select SDOH among children with obesity. We conducted a cross-sectional analysis of 2021 NSCH to extract data related to the SDOH domains. We extracted sociodemographic variables to utilize as controls and constructed logistic regression models to determine associations, via odds ratios, between SDOH and childhood obesity. Within the binary regression models, children with obesity (≥95th percentile) were more likely than children without obesity to experience SDOH in all domains. After controlling for sociodemographic variables, children with obesity were significantly more likely to experience food insecurity when compared to children without obesity (adjusted odds ratio [AOR]=1.39; 95 % confidence interval [CI]: 1.13-1.17). In line with the current American Academy of Pediatrics (AAP) Clinical Practice Guidelines (CPG), improving policies for nutrition programs and addressing the lack of access to nutritious foods may alleviate some food insecurity. Ensuring that children have access to sufficient nutritious foods is critical in addressing childhood obesity and thus decreasing risk of chronic disease.

Patterns of Adverse Childhood Experiences and Psychiatric Disorders Among Adolescents with ADHD: A Latent Class Analysis.

There is limited existing research on whether specific combinations of Adverse Childhood Experiences (ACEs) are associated with different psychiatric disorders among adolescents with ADHD. This study aimed to address this gap by identifying classes of ACEs and examining their association with behavioral problems, anxiety, and depression in adolescents with ADHD aged 11-17 (n = 1,806), using data from the 2018 National Survey of Children's Health (NSCH). A latent class analysis revealed a four-class solution: (1) low-risk ACEs (61.6%), (2) moderate-risk ACEs (25.2%), (3) high discrimination and neighborhood violence exposure (7.6%), and (4) high-risk ACEs (5.6%). The "high-risk ACEs" and the "high discrimination and neighborhood violence exposure" class showed a higher likelihood of behavioral problems and depression, and anxiety and depression respectively. These findings provide some insight into the ACE patterns that are more likely to be associated with mental health problems among adolescents with ADHD.

Understanding 24-hour movement guideline adherence and links to school achievement, social-behavioural problems, and emotional functioning among children and adolescents with learning disabilities

ABSTRACTThis cross-sectional study examined the associations between adherence to 24-hour movement behaviour (24-HMB) guidelines and indicators of school achievement, social-behavioural problems, and emotional functioning among a nationally representative sample of US children and adolescents with learning disabilities (LD). Data were retrieved from the 2020–2021 National Survey of Children's Health (NSCH), including 4999 children and adolescents (aged between 6 and 17 years) with LD. Multivariate logistic regressions were conducted to estimate odds ratios (OR) with 95% confidence intervals (95%CI), adherence to 24-HMB guidelines was considered as independent variables (Model 1: continuous variable; Model 2: categorical variable), and indicators of school achievement, social-behavioural problems, and emotional functioning as dependent variables. Covariates included age, sex, race, overweight status, the severity of learning disability, educational intervention, parental education, and household poverty level. Overall, 2156 participants (41.47%) met one of the three 24-HMB recommendations, 1289 (26.04%) met two 24-HMB recommendations, and 336 participants (6.62%) met all three 24-HMB recommendations. Positive associations between adherence to 24-HMB guidelines and most of the assessed outcomes were observed. Those who adhered to at least two of the three 24-HMB guidelines (PA + SL, PA + ST, SL + ST, and PA + SL + ST) had better school achievement and fewer social-behavioural problems. Additionally, adherence to PA + SL or SL + ST guidelines was linked with improved emotional functioning. This study provides evidence that adherence to 24-HMB guidelines is associated with superior school achievement, social-behavioural problems, and emotional function, and thus suggests future public health efforts should promote adequate levels of PA, limited ST, and sufficient SL among children and adolescents with LD.

Variation in identifying children and adolescents with disability and developmental disability in population-based public health surveys

BackgroundThe term “developmental disability” (DD) is inconsistently defined and applied depending on purpose and across sources, including in legislation. ObjectiveThis project aimed to identify existing definitions of disability and DD and to determine the extent to which each definition could be operationalized to produce prevalence estimates using data from U.S. national surveys. MethodsUsing data among children <18 years from the 2016–2018 National Health Interview Survey (NHIS) and National Survey of Children's Health (NSCH), we estimated the prevalence of two definitions of disability (Washington Group Short Set on Functioning, American Community Survey) and seven definitions of DD [Health and Human Services (ever/current), Developmental Disabilities Assistance and Bill of Rights Act of 2000 (1+, 2+, or 3+ components), and Diagnostic and Statistical Manual of Mental Disorders, 5th ed (ever/current)]. Complex sample design variables and weights were used to calculate nationally representative prevalence. ResultsDisability (NHIS: 5.2–6.3%; NSCH: 9.2–11.9%) and DD prevalence (NHIS: 0.6–18.0% and NSCH: 0.2–22.2%) varied depending on the definition and data source. For the same definition, NSCH prevalence estimates tended to be higher than NHIS estimates. ConclusionsThe substantial variability in estimated prevalence of disability and DD among children in the United States may be in part due to the surveys not representing all components of each definition. Different or additional questions in national surveys may better capture existing definitions of disability and DD. Considering the data collection goals may help determine the optimal definition to provide useful information for public health action.