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.1 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.2 Parents play a crucial role in informing health professionals about a child's emotional or behavioral difficulties and obtaining mental health services.3

Indicator HEALTH3 Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by age and sex, selected years 2013–2022
Indicator HEALTH3: Percentage of children ages 4–17 reported by a parent to have serious emotional or behavioral difficulties by age and sex, selected years 2013–2022

NOTE: Emotional or behavioral difficulties of children were based on parental responses to the following question on the Strengths and Difficulties Questionnaire4: "Overall, do you think that [child's name] 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 were defined as those whose parent responded "yes, definite difficulties" or "yes, severe difficulties." These difficulties may be similar to but do not equate with the definition of serious emotional disturbance used by the Federal government for planning purposes. In 2019, the National Health Interview Survey (NHIS) questionnaire was redesigned, and other changes were made to weighting and design methodology. Therefore, data for 2019 onward are not strictly comparable with data for 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/about/2019-questionnaire-redesign.html.

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

  • From 2019 to 2022, the percentage of children ages 4–17 who were reported by a parent to have serious difficulties with emotions, concentration, behavior, or getting along with other people increased from 6% to 7%. Prior to this period, the percentage was stable, ranging from 5% to 6% between 2013 and 2018.
  • In 2022, the percentage of children who were reported by a parent to have serious emotional or behavioral difficulties was higher for children ages 8–10 (7%), 11–14 (8%), and 15–17 (8%) than for children ages 4–7 (5%).
  • From 2019 to 2022, the percentage of children ages 4–17 who were reported by a parent to have serious emotional or behavioral difficulties increased for females (from 4% to 6%) but did not significantly change for males (8% in 2022).
  • In 2022, the percentage of children ages 4–17 who were reported by a parent to have serious emotional or behavioral difficulties was higher for males (8%) than for females (6%). This pattern was reflected among children ages 4–7 (7% for males and 3% for females) and 8–10 (9% for males and 6% for females); for children ages 11–14 and 15–17, there was no statistically significant difference between males and females.
  • In 2022, the percentage of children ages 4–17 who were reported to have serious emotional or behavioral difficulties was higher for children living with a relative or guardian who was not a parent (16%) than for children living with a single mother (8%), a single father (7%), and two parents (6%).

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

1 National Academies of Sciences, Engineering, and Medicine. (2019). Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda. The National Academies Press. https://doi.org/10.17226/25201

2 Cuellar, A. (2015). Preventing and treating child mental health problems. The Future of Children, 25(1), 111–134. http://doi.org/10.1353/foc.2015.0005

3 Ogundele, M. O. (2018). Behavioural and emotional disorders in childhood: A brief overview for paediatricians. World Journal of Clinical Pediatrics, 7(1), 9–26. http://dx.doi.org/10.5409/wjcp.v7.i1.9

4 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(5), 791–799. https://doi.org/10.1111/1469-7610.00494

Federal Interagency Forum on Child and Family Statistics

Explore

More Information

Contact