America's Children: Key National Indicators of Well-Being, 2007
Emotional and Behavioral Difficulties
Good emotional and behavioral health enhances a child's sense of well-being, leads to satisfying social relationships at home and with peers, and leads to achievement of full academic potential.116 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 and can lead to lifelong disability, are usually noticed first by parents.117 Parents' reports are crucial to alerting doctors about their child's emotional and behavioral difficulties and to obtaining mental health services.118
Indicator HEALTH3: Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by gender, 2001–2005
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): "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: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey.
- In 2005, slightly less 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.
- From 2001–2005, the percentage of children with serious emotional or behavioral difficulties remained stable at about 5 percent.
- From 2001–2005, the percentage of children with serious emotional or behavioral difficulties differed by gender and age. More males than females were reported by a parent to have difficulties. Children ages 15–17 generally had the highest rates of serious emotional or behavioral difficulties.
- In 2005, 7 percent of children living below the poverty level had serious emotional or behavioral difficulties, compared with 5 percent of children in near-poor families (those with family incomes of 100–199 percent of the poverty level) and 4 percent of children in non-poor families (those with family incomes of 200 percent or more of the poverty level).119
- Among the parents of children with serious (definite or severe) difficulties, 81 percent reported contacting a health care provider or school staff about their child's difficulties, 40 percent reported their child was prescribed medication for their difficulties, and 47 percent reported their child had received treatment or help other than medication.120
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116 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.
117 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.
118 Dulcan, M.K., Costello, E.J., Costello, A.J., Edelbrock, C., Brent, D., and Janiszewski, B.S. (1990). The pediatrician as gatekeeper to mental health care for children: Do parents' concerns open the gate? Journal of the American Academy of Child and Adolescent Psychiatry, 29, 453–458.
119 Poverty level is based on family income and reflects family size and composition. It is adjusted each year using the annual average Consumer Price Index level. For more detail, see U.S. Census Bureau, Series P-60, no. 219. Near-poor children are children living in families with incomes 100–199 percent of the poverty threshold. Non-poor children are children living in families with incomes 200 percent of the poverty level or greater.
120 Data for service contact and type of service or treatment for emotional or behavioral difficulties are from new service questions asked directly after the Strengths and Difficulties Questionnaire (SDQ) questions, first used in the 2005 National Health Interview Survey (NHIS).