Children with Disabilities
Total Page：16
File Type：pdf, Size：1020Kb
Disabilities www.futureofchildren.org The Future of Children Children with Disabilities VOLUME 22 NUMBER 1 SPRING 2012 3 Children with Disabilities: Introducing the Issue 13 The Changing Landscape of Disability in Childhood 43 Childhood Health: Trends and Consequences over the Life Course 65 The Economic Costs of Childhood Disability Volume 22 Number 1 Spring 2012 Volume 97 Disability and the Education System 123 Health Insurance and Children with Disabilities 149 How Can Quality Improvement Enhance the Lives of Children with Disabilities? 169 Emerging Technologies and Their Impact on Disability 193 Prevention of Disability in Children: Elevating the Role of Environment A COLLABORATION OF THE WOODROW WILSON SCHOOL OF PUBLIC AND INTERNATIONAL AFFAIRS AT A COLLABORATION OF THE WOODROW WILSON SCHOOL OF PUBLIC AND INTERNATIONAL AFFAIRS AT PRINCETON UNIVERSITY AND THE BROOKINGS INSTITUTION PRINCETON UNIVERSITY AND THE BROOKINGS INSTITUTION The Future of Children seeks to translate high-level research into information that is useful Board of Advisors to policy makers, practitioners, and the media. Lawrence Balter Marguerite Kondracke The Future of Children is a collaboration of the Woodrow Wilson School of Public and New York University America’s Promise—The Alliance for Youth International Affairs at Princeton University and the Brookings Institution. Jeanne Brooks-Gunn Rebecca Maynard Columbia University University of Pennsylvania Senior Editorial Staff Journal Staff Judith Feder Lynn Thoman Sara McLanahan Kris McDonald Georgetown University Corporate Perspectives Editor-in-Chief Associate Editor William Galston Heather B. Weiss Princeton University Princeton University Brookings Institution Harvard University Director, Center for Research on Lauren Moore University of Maryland Child Wellbeing, and William S. Tod Amy Wilkins Professor of Sociology and Public Affairs Project Manager Princeton University Kay S. Hymowitz Education Reform Now Ron Haskins Manhattan Institute for Policy Research Senior Editor Brenda Szittya Charles N. Kahn III Brookings Institution Managing Editor Federation of American Hospitals Senior Fellow and Co-Director, Center on Princeton University Children and Families Martha Gottron Christina Paxson Managing Editor Senior Editor Princeton University Princeton University Lisa Markman-Pithers Dean, Woodrow Wilson School of Public Outreach Director and International Affairs, and Hughes-Rogers Princeton University Professor of Economics and Public Affairs Mary Jones Cecilia Rouse Outreach Coordinator Senior Editor Brookings Institution Princeton University Director, Education Research Section, Regina Leidy and Katzman-Ernst Professor in the Communications Coordinator Economics of Education and Professor of Princeton University Economics and Public Affairs Tracy Merone The views expressed in this publication do not necessarily represent the views of the Woodrow Isabel Sawhill Administrator Wilson School at Princeton University or the Brookings Institution. Senior Editor Princeton University Copyright © 2012 by The Trustees of Princeton University Brookings Institution Senior Fellow, Cabot Family Chair, and This work is licensed under the Creative Commons Attribution-NoDerivs 3.0 Co-Director, Center on Children and Families Unported License, http://creativecommons.org/licenses/by-nd/3.0. Authorization to reproduce articles is allowed with proper attribution: “From The Future of Children, a collaboration of the The Future of Children would like to thank the David and Lucille Packard Foundation for its Woodrow Wilson School of Public and International Affairs at Princeton University and the generous support. Brookings Institution.” To purchase a print copy, access free electronic copies, or sign up for our e-newsletter, go to ISSN: 1054-8289 our website, www.futureofchildren.org. If you would like additional information about the ISBN: 978-0-9814705-8-0 journal, please send questions to [email protected]. VOLUME 22 NUMBER 1 SPRING 2012 Children with Disabilities 3 Children with Disabilities: Introducing the Issue by Janet Currie and Robert Kahn 13 The Changing Landscape of Disability in Childhood by Neal Halfon, Amy Houtrow, Kandyce Larson, and Paul W. Newacheck 43 Childhood Health: Trends and Consequences over the Life Course by Liam Delaney and James P. Smith 65 The Economic Costs of Childhood Disability by Mark Stabile and Sara Allin 97 Disability and the Education System by Laudan Aron and Pamela Loprest 123 Health Insurance and Children with Disabilities by Peter G. Szilagyi 149 How Can Quality Improvement Enhance the Lives of Children with Disabilities? by James M. Perrin 169 Emerging Technologies and Their Impact on Disability by Paul H. Wise 193 Prevention of Disability in Children: Elevating the Role of Environment by Stephen A. Rauch and Bruce P. Lanphear www.futureofchildren.org Children with Disabilities: Introducing the Issue Children with Disabilities: Introducing the Issue Janet Currie and Robert Kahn This issue of The Future of Children explores health care quality. The volume concludes childhood disability—its prevalence, nature, with a discussion of the prevention of child- treatment, and consequences. With unprec- hood disability. edented numbers of U.S. children now being identified as having special medical Themes of the Volume and educational needs and with the nation’s Out of the research presented in this volume, resources for addressing those needs increas- five broad themes emerge. These themes are ingly constrained, the topic is timely. related to defining and measuring disability; trends in disability; the growing importance Public discussion of childhood disability, by of mental relative to physical health; the the media, parents, scholars, and advocates importance of families; and the fragmenta- alike, tends to emphasize particular causes of tion of services for children with disabilities. disability, such as autism, asthma, cystic fibro- sis, or attention-deficit/hyperactivity disorder Defining Disability and Other (ADHD). In this volume, however, we focus Measurement Issues not on individual disabilities, but rather on First, it is remarkably difficult to point to cross-cutting themes that apply more broadly a consensus definition of disability. In the to the issue of children with disabilities. opening article of the issue Neal Halfon and Kandyce Larson, both of the University of To this end, we commissioned a group of California–Los Angeles, and Paul Newacheck experts to review research on childhood dis- and Amy Houtrow, both of the University of ability, including its definition (itself a chal- California–San Francisco, make the case for lenge), its prevalence and trends over time a definition that highlights the relationship (likewise), and the costs it imposes both on between health, functioning, and the environ- the individual child and on the child’s fam- ment. Specifically, the authors propose that a ily. Our contributors also consider disability disability be defined as “an environmentally within the context of the nation’s educational, contextualized health-related limitation in health insurance, and medical systems; the a child’s existing or emergent capacity to impact of emerging technologies on the perform developmentally appropriate activi- experience of disability; and the definition of ties and participate, as desired, in society.” Janet Currie is the Henry Putnam Professor of Economics and Public Affairs and the Director of the Center for Health and Wellbeing at Princeton University. Robert Kahn is an associate professor of pediatrics at the Cincinnati Children’s Hospital Medical Center and University of Cincinnati College of Medicine. VOL. 22 / NO. 1 / SPRING 2012 3 Janet Currie and Robert Kahn Defining disability as a limitation rather than the measure of disability. Research based on a health condition per se highlights the social historical data (which analysts use to examine and technological context of the individual. disability over the life course) consists almost In a world with electric wheelchairs, for entirely of information about the presence or example, a child with impaired mobility will absence of specific conditions. Clearly, there be less disabled than he or she would be is little uniformity across time periods or otherwise. It follows then that home and studies in the definition of disability. school environments can shape disability and that new technologies can either mitigate or exacerbate disability, as Paul Wise, of Stan- ford University, discusses in his article on the Defining disability as a role of technology. The definition proposed limitation rather than a by Halfon, Houtrow, Larson, and Newacheck also emphasizes that disability exists along a health condition per se continuum and varies across children’s ages highlights the social and and functional domains. technological context of the Until now empirical work on the prevalence individual. of childhood disability has been based on a variety of simpler and more concrete defini- tions. National surveys that collect informa- Beyond the challenge of defining and tion about childhood disabilities, for example, measuring disability, many of the articles generally ask questions about limitations on in the volume highlight ancillary measure- activities of daily living; they also usually clas- ment issues. For example, Peter Szilagyi, sify children as disabled if they are receiving of the University of Rochester, addresses services for their limitations. Although the the challenge of comparing