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America's Children: Key National Indicators of Well-Being, 2019

Emotional and Behavioral Difficulties

Positive 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.124 Children with emotional or behavioral difficulties may experience problems managing their emotions, focusing on tasks, interacting with family and peers, or controlling their behavior. These difficulties, which may persist throughout a child's development, can lead to lifelong problems.125 Parents play a crucial role in informing health professionals about a child's emotional and behavioral difficulties and obtaining mental health services.126

Indicator HEALTH3: Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by age and gender, 2001–2017
Indicator HEALTH3: Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by age and gender, 2001–2017

NOTE: Emotional or behavioral difficulties of children were based on parental responses to the following question on the Strengths and Difficulties Questionnaire:127 "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. 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.

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

  • In 2017, based on parent reported data, 6% of parents reported that their child ages 4–17 displayed serious difficulties with emotions, concentration, behavior, or getting along with other people. This percentage has been stable at 5%–6% since 2001.
  • The percentage of children whose parents reported serious emotional or behavioral difficulties in 2017 was lowest among children ages 4–7 (4%), compared with children ages 8–10 (6%), children ages 11–14 (6%), and adolescents ages 15–17 (6%).
  • In 2017, parents were more likely to report serious emotional or behavioral difficulties for males than for females among those ages 8–10 (8% versus 5%), 11–14 (8% versus 4%), and 15–17 (8% versus 4%). The percentages for children ages 4–7 by gender were not statistically significantly different.
  • Among males ages 11–17, the prevalence of serious emotional and behavioral difficulties has remained consistently higher since 2001, compared with younger males ages 4–10.
  • Among children living in two parent households, the percentage of children reported as having serious emotional or behavioral difficulties increased from 4% in 2016 to 9% in 2017.

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124 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

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

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

127 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.