HEALTH3.A Emotional and behavioral difficulties: Percentage of children ages 4–17 reported by a parent to have serious or minor difficulties with emotions, concentration, behavior, or getting along with other people by selected characteristics, 2001–2019

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Characteristic 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Serious difficulties
Age and gender
Total ages 4–17 5.2 5.5 4.8 5.4 4.6 5.0 5.2 5.4 5.3 6.0 5.3 5.2 5.2 5.2 5.8 5.1 5.6 5.6 5.6
Ages 4–7 3.6 3.2 3.3 4.2 2.8 4.0 3.8 4.0 3.1 4.1 3.5 3.7 3.6 3.9 3.9 4.3 4.3 3.7 4.4
Ages 8–10 5.9 5.9 5.5 5.8 4.8 4.9 4.4 7.1 6.3 7.2 6.2 6.3 6.9 6.6 6.0 5.4 6.5 6.2 6.8
Ages 11–14 6.0 6.8 4.9 6.2 4.9 5.6 6.0 5.0 5.6 6.8 5.8 5.5 5.4 6.2 7.6 5.5 6.0 6.2 5.7
Ages 15–17 5.2 6.5 6.1 5.4 6.2 5.6 6.8 5.9 6.5 6.6 6.3 5.7 5.4 4.5 5.8 5.5 6.0 6.7 6.0
Males ages 4–17 6.2 7.5 6.3 5.8 5.4 6.6 6.4 7.1 6.6 7.3 6.6 6.7 6.5 6.9 7.2 6.7 7.1 6.7 6.8
Ages 4–7 3.8 4.3 4.8 4.0 3.0 5.3 5.1 5.4 4.1 5.0 4.9 5.0 4.5 5.4 5.4 5.9 5.2 4.1 6.3
Ages 8–10 8.2 8.0 7.3 7.0 5.5 6.7 6.3 10.4 8.2 9.4 8.2 7.8 8.6 8.5 7.6 7.8 8.3 7.0 7.8
Ages 11–14 7.4 10.0 6.5 7.0 6.3 7.4 7.5 6.5 7.1 7.7 7.2 7.8 7.3 8.2 9.4 7.6 7.5 7.8 7.5
Ages 15–17 5.6 7.6 6.9 5.6 6.9 7.1 6.9 6.7 7.7 7.6 6.6 6.2 5.7 5.7 6.2 5.4 7.8 8.2 5.6
Females ages 4–17 4.1 3.5 3.3 4.8 3.8 3.3 3.9 3.6 3.9 4.8 4.0 3.8 3.9 3.5 4.4 3.5 4.1 4.5 4.4
Ages 4–7 3.4 2.0 1.8 4.4 2.5 2.6 2.4 2.7 2.1 3.1 2.1 2.3 2.6 2.3 2.3 2.7 3.4 3.3 2.4
Ages 8–10 3.5 3.6 3.5 4.5 4.2 3.0 2.3 3.4 4.4 5.0 4.1 4.8 5.2 4.8 4.6 2.9 4.6 5.3 5.7
Ages 11–14 4.6 3.5 3.2 5.3 3.4 3.8 4.5 3.4 4.1 5.8 4.5 3.2 3.5 4.0 5.6 3.1 4.4 4.6 3.9
Ages 15–17 4.9 5.2 5.2 5.1 5.4 3.9 6.6 5.1 5.3 5.5 5.9 5.3 5.0 3.3 5.3 5.5 4.2 5.3 6.5
Poverty statusa
Below 100% poverty 7.4 9.2 6.4 7.2 7.1 6.6 7.0 9.7 8.2 10.1 7.6 7.9 7.8 7.6 7.6 7.3 8.3 8.2 8.6
100%–199% poverty 6.7 6.3 5.2 5.8 4.8 5.6 7.3 5.8 6.5 5.7 5.4 5.8 5.1 5.8 6.8 6.2 7.3 7.1 5.1
200% poverty and above 4.0 4.3 4.2 4.7 3.8 4.2 3.9 4.0 3.7 4.6 4.4 4.0 4.2 4.1 4.8 3.9 4.2 4.4 5.0
Race and Hispanic originb
White, non-Hispanic 5.3 5.6 5.2 6.0 4.8 5.5 5.6 5.8 5.4 6.7 5.9 5.5 6.0 5.9 6.2 5.4 6.4 6.3 6.5
Black, non-Hispanic 5.6 8.5 4.7 5.8 5.1 4.5 5.9 7.1 6.2 6.1 6.4 5.8 5.2 4.7 6.5 6.9 5.4 5.2 5.4
Hispanic 3.9 3.7 3.7 3.3 4.0 3.6 3.7 3.0 4.1 4.2 3.9 4.2 3.6 4.5 6.0 4.0 5.7 5.0 4.6
Family structurec
Two parents 4.0 4.2 4.0 4.4 3.7 4.0 4.2 4.1 4.1 4.4 3.9 4.2 4.2 4.4 4.3 4.1 4.1 4.0 4.6
Mother only 8.1 9.2 7.0 7.8 6.9 7.8 7.1 8.0 8.2 9.6 8.3 8.0 8.1 7.1 9.9 7.9 8.9 9.5 7.9
Father only 5.0 5.4 3.6 5.3 4.2 4.8 5.5 5.5 5.1 5.5 3.1 3.6 3.5 4.0 7.1 7.4 4.2
No parents 10.6 9.6 8.8 9.4 9.8 7.0 11.5 13.1 7.3 12.5 10.1 6.0 7.8 9.8 9.6 8.6 11.3 10.0 8.6
Minor difficulties
Age and gender
Total ages 4–17 17.1 18.0 15.4 15.4 16.2 15.5 14.4 14.4 13.7 16.1 14.4 14.1 13.0 15.0 15.8 15.3 15.9 18.1 21.6
Ages 4–7 14.9 15.2 13.8 12.2 14.0 13.9 12.5 11.0 11.6 14.2 11.1 12.9 11.4 12.5 13.1 13.6 14.1 16.2 21.9
Ages 8–10 18.1 20.2 15.5 16.4 18.4 14.4 16.4 17.1 15.6 16.9 16.3 14.6 13.3 16.9 16.4 16.6 16.9 18.0 21.0
Ages 11–14 18.7 19.4 16.0 17.3 17.0 15.8 15.8 16.7 14.3 17.4 16.1 14.3 15.3 16.9 16.6 15.0 16.9 20.2 21.8
Ages 15–17 17.1 17.5 16.4 15.9 15.7 18.0 13.1 13.2 14.0 16.1 14.7 15.2 11.9 13.8 17.7 16.7 15.9 18.0 21.6
Males ages 4–17 20.1 20.1 17.3 17.2 17.9 16.9 16.1 16.7 16.3 18.0 16.4 16.3 14.8 17.5 17.6 17.1 17.7 20.6 24.8
Ages 4–7 16.9 18.3 15.8 15.2 15.3 15.5 13.3 12.0 13.8 15.2 12.4 15.6 14.0 16.0 16.5 14.5 15.6 18.4 25.4
Ages 8–10 21.9 23.0 17.8 18.0 22.2 15.9 18.1 20.0 19.4 19.3 19.7 17.7 14.8 20.2 18.1 19.5 20.4 19.9 25.9
Ages 11–14 22.7 20.2 18.1 18.8 18.6 17.8 19.1 20.7 17.0 22.1 17.9 16.5 18.0 19.7 18.8 17.8 18.4 22.9 25.2
Ages 15–17 19.0 19.0 17.4 17.1 16.4 18.4 14.0 14.2 15.9 15.1 16.4 15.5 11.3 14.1 16.9 17.4 16.8 21.3 22.3
Females ages 4–17 14.0 15.9 13.4 13.4 14.4 14.0 12.6 12.0 11.0 14.1 12.3 11.9 11.2 12.3 14.0 13.4 14.1 15.5 18.3
Ages 4–7 12.6 12.0 11.9 9.1 12.7 12.1 11.6 10.0 9.1 13.2 9.8 9.9 8.7 8.8 9.7 12.6 12.7 13.9 18.4
Ages 8–10 14.1 17.1 12.9 14.7 14.7 12.7 14.6 14.0 11.7 14.5 12.6 11.4 11.8 13.6 14.7 13.7 13.3 15.9 15.4
Ages 11–14 14.5 18.6 13.8 15.7 15.4 13.8 12.3 12.4 11.5 12.4 14.3 12.0 12.4 14.0 14.3 12.0 15.3 17.5 18.3
Ages 15–17 15.1 15.9 15.3 14.6 14.9 17.6 12.2 12.2 12.1 17.2 13.0 14.8 12.6 13.4 18.4 16.1 15.0 14.6 20.8
Poverty statusa
Below 100% poverty 20.3 21.2 17.4 18.1 19.4 17.1 17.7 16.1 18.1 20.7 18.4 16.2 16.8 17.3 19.5 18.1 18.2 18.2 21.5
100%–199% poverty 18.9 19.4 17.8 17.3 17.6 16.7 16.3 15.5 14.5 15.6 14.7 15.1 13.7 15.2 17.3 16.4 15.8 19.3 22.9
200% poverty and above 15.7 16.7 13.9 13.9 14.8 14.4 12.7 13.5 11.9 14.6 12.7 12.9 11.3 13.9 14.0 13.9 15.3 17.6 21.2
Race and Hispanic originb
White, non-Hispanic 16.6 18.2 15.6 16.0 16.5 16.3 15.2 14.7 13.8 16.4 15.0 15.5 14.0 16.5 17.3 16.6 16.9 19.6 23.9
Black, non-Hispanic 22.7 22.4 17.2 16.6 18.4 14.3 16.5 18.3 17.8 18.6 16.2 16.1 16.0 17.0 19.1 19.1 16.5 18.5 22.4
Hispanic 15.1 14.5 14.0 13.0 14.8 13.6 12.1 11.7 12.0 14.0 12.4 10.3 10.6 11.2 10.3 15.0 13.7 15.7 20.6
Family structurec
Two parents 15.0 15.3 14.1 13.5 14.4 13.9 12.2 13.0 11.9 13.8 11.8 12.2 10.8 13.1 13.1 12.5 19.0 21.0 19.6
Mother only 22.9 23.9 19.0 19.6 20.6 18.4 19.5 16.7 17.3 21.0 19.7 17.8 18.0 18.8 21.1 21.4 18.0 15.2 24.0
Father only 19.1 22.7 12.8 19.0 19.9 19.0 18.2 16.6 17.5 16.9 18.9 16.0 12.2 16.9 22.7 18.4 14.4 16.8 25.2
No parents 24.0 29.6 22.1 22.9 22.5 22.1 19.9 24.7 19.7 24.1 21.2 22.7 23.8 21.2 24.1 26.2 21.5 30.7 34.4
‡ Reporting standards not met; estimate is considered unreliable.
a Missing family income data were imputed for 15%–25% of children ages 4–17 for the years 2001–2019.
b The revised 1997 U.S. Office of Management and Budget standards for race were used for the 2001–2013 race-specific estimates. A person's race is described by one or more of five racial groups: White, Black or African American, American Indian or Alaska Native, Asian, or Native Hawaiian or Other Pacific Islander. Data on race and Hispanic origin are collected separately but combined for reporting. Included in the total but not shown separately are American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and Two or more races due to the small sample size for each group. Persons of Hispanic origin may be of any race.
c "Two parents" includes two married or unmarried parents. The terms "mother" and "father" can include biological, adoptive, step, or foster relationships. "No parents" can include children cared for by other relatives or a legal guardian. In 2019, family structure was categorized based on a series of questions that establish presence of parents, marital status of parent, and relationship to other adults in the household. Family structure could not be determined for about 7% of sample children in 2019.
NOTE: Emotional or behavioral difficulties of children were based on parental responses to the following question on the Strengths and Difficulties Questionnaire1 in the Sample Child Survey: "Overall, do you think that (child) has difficulties in one or more of the following areas: emotions, concentration, behavior, or being able to get along with other people?" Response choices were (1) no, no difficulties; (2) yes, minor difficulties; (3) yes, definite difficulties; and (4) yes, severe difficulties. Children with serious emotional or behavioral difficulties are defined as those whose parent responded "yes, definite" or "yes, severe." These difficulties may be similar to but do not equate with the Federal definition of serious emotional disturbance, used by the Federal government for planning purposes. Children with minor emotional or behavioral difficulties are defined as those whose parent responded "yes, minor difficulties." In 2019, the National Health Interview Survey (NHIS) questionnaire was redesigned and other changes were made to weighting and design methodology. Data for 2019 have not been fully evaluated for comparability with earlier years. Starting in 2019, questions based on the Strength and Difficulties Questionnaire are included in the 3-year rotating core. For more information on the 2019 NHIS redesign, see: https://www.cdc.gov/nchs/nhis/2019_quest_redesign.htm.
SOURCE: National Center for Health Statistics, National Health Interview Survey.
1 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.