Affiliations: Division of Developmental Pediatrics, Department of
Pediatrics, University of Virginia School of Medicine, Charlottesville, VA,
USA | Division of Translational Research and Applied
Statistics, Department of Public Health Sciences, University of Virginia School
of Medicine, Charlottesville, VA, USA
Note: [] Corresponding author: James A. Blackman, Kluge Children's
Rehabilitation Center, University of Virginia, 2270 Ivy Road, Charlottesville,
VA 22901, USA. Tel.: +1 434 924 0245; Fax: +1 434 924 0297; E-mail: jab5u@virginia.edu
Abstract: AIMS: Estimate the prevalence of specific developmental,
emotional, and behavioral (DEB) problems across selected chronic health
conditions; examine the relationship of chronic health conditions to functional
activities and participation; determine the potential confounding effect of
sociodemographic factors on the prevalence of DEB problems. METHODS: The 2007 National Survey of Children's Health, conducted by the Centers for
Disease Control and Prevention, served as the primary data source for this
study. A total of 91.642 interviews (66.6% response rate for identified
households with children) were performed. Population-based estimates were
obtained for variables of interest by assigning sampling weights to each child
for whom an interview was completed. RESULTS: Parents were two to 30 times more likely to report DEB problems, such as Attention
Deficit/Hyperactivity Disorder, depression, learning problems, and challenging
behaviors, for children with chronic health conditions. These children had a
greater number and range of difficulties with social interaction and school
functioning as well as a lower rate of participation in community activities.
Although highest rates of DEB problems were reported for those conditions
involving the nervous or sensory systems, children with asthma, diabetes, and
musculoskeletal conditions also had a higher rate of problems than children
without the conditions. The higher prevalence of DEB problems remained after
statistical adjustment for socio-demographic factors. CONCLUSIONS: Children with a spectrum of chronic health conditions are at high risk for DEB
problems that affect learning, behavior, and emotional well-being. As part of a
comprehensive approach to the management of chronic health conditions, children
should be screened for these problems and referred for appropriate further
evaluation and remediation. Attention to these common co-morbidities will not
only result in enhanced quality of life but will also promote better adherence
to medical recommendations and, thereby, optimal disease control.
Keywords: Chronic health condition, development, behavior, emotional problems, co-morbidities
