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America's Children: Key National Indicators of Well-Being, 2013

Emotional and Behavioral Difficulties

Good emotional and behavioral health is an integral part of healthy development and enhances a child's sense of well-being, supports rewarding social relationships with family and peers, and facilitates achievement of full academic potential.117 Children with emotional or behavioral difficulties may have problems managing their emotions, focusing on tasks, and/or controlling their behavior. These difficulties, which may persist throughout a child's development, can lead to lifelong problems.118 Parents play a crucial role in informing health professionals about a child's emotional and behavioral difficulties and obtaining mental health services.119

Indicator Health3: Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by gender, 2001–2011
Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by gender, 2001–2011

NOTE: Children with serious emotional or behavioral difficulties are defined as those whose parent responded "yes, definite" or "yes, severe" to the following question on the Strengths and Difficulties Questionnaire (SDQ):120 "Overall, do you think that (child) has difficulties in any of the following areas: emotions, concentration, behavior, or being able to get along with other people?" Response choices were: (1) no; (2) yes, minor difficulties; (3) yes, definite difficulties; (4) yes, severe difficulties. These difficulties may be similar to but do not equate with the Federal definition of serious emotional disturbances (SED), used by the Federal government for planning purposes.

SOURCE: National Center for Health Statistics, National Health Interview Survey.

  • In 2011, a little more than 5 percent of children ages 4–17 were reported by a parent to have serious difficulties with emotions, concentration, behavior, or being able to get along with other people.
  • Between 2001 and 2011, the percentage of children with serious emotional or behavioral difficulties remained at about 5 percent.
  • In 2011, the percentage of children with serious emotional or behavioral difficulties differed by gender. More males (7 percent) than females (4 percent) ages 4–17 were reported by a parent to have such difficulties.
  • In 2011, about 8 percent of children living below the poverty level had serious emotional or behavioral difficulties, compared with 5 percent of children in families with incomes 100–199 percent of the poverty level and 4 percent of children with family incomes 200 percent or more of the poverty level.
  • In 2011, the percentage of children with serious difficulties was twice as high among those from single-mother families (8 percent) than among those from two-parent families (4 percent).
  • Among the parents of children with serious difficulties, 28 percent reported that their child received special education services for emotional or behavioral difficulties, 46 percent reported that they had contacted a general doctor about their child's emotional or behavioral difficulties, and 53 percent reported that they had contact with a mental health professional about their child's difficulties.
  • In 2011, more White, non-Hispanic children (6 percent) and Black, non-Hispanic children (6 percent) had serious emotional or behavioral difficulties compared with Hispanic children (4 percent).

table icon HEALTH3.A HTML Table, HEALTH3.B HTML Table

117 U.S. Department of Health and Human Services. (1999). Mental health: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health. Retrieved from http://www.surgeongeneral.gov/library/mentalhealth/home.html.

118 New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final Report (DHHS Pub. No. SMA-03-3832). Rockville, MD: Department of Health and Human Services.

119 Sayal, K. (2006). Annotation: Pathways to care for children with mental health problems. Journal of Child Psychology and Psychiatry, 47, 649–659.

120 Goodman, R. (1999). The extended version of the Strengths and Difficulties Questionnaire as a guide to child psychiatric caseness and consequent burden. Journal of Child Psychology and Psychiatry, 40, 791–799.