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Published on: September 27, 2020
Developmental, emotional and behavioral co-morbidities across the chronic health condition spectrum
James A Blackman1, Mark R Conaway
1Division of Developmental Pediatrics, Department of Pediatrics, University of Virginia School of Medicine, Charlottesville, VA 22901, USA. jab5u@virginia.edu
Insights
Children with chronic health conditions face a significantly higher risk of developmental, emotional, and behavioral (DEB) problems, impacting their daily lives. Early screening and intervention are crucial for improving their well-being and managing their health.
Area of Science:
- Pediatric Health
- Developmental Psychology
- Public Health
Background:
- Chronic health conditions in children are associated with various challenges.
- Developmental, emotional, and behavioral (DEB) problems are common co-morbidities.
- Understanding the prevalence and impact of DEB problems is essential for comprehensive care.
Purpose of the Study:
- To estimate the prevalence of DEB problems in children with chronic health conditions.
- To examine the link between chronic conditions and functional/participation limitations.
- To assess the influence of sociodemographic factors on DEB problem prevalence.
Main Methods:
- Utilized data from the 2007 National Survey of Children's Health (n=91,642).
- Employed population-based estimates with sampling weights.
- Analyzed parent-reported DEB problems and chronic health conditions.
Main Results:
- Children with chronic conditions were 2-30 times more likely to have DEB problems (e.g., ADHD, depression).
- These children experienced greater social and school functioning difficulties and reduced community participation.
- Higher DEB problem rates persisted across various conditions, including asthma and diabetes, even after adjusting for sociodemographics.
Conclusions:
- Children with chronic health conditions are at high risk for DEB problems affecting learning and well-being.
- Routine screening and timely referral for DEB problems are vital components of chronic condition management.
- Addressing these co-morbidities enhances quality of life, medical adherence, and disease control.
Aims:
Estimate the prevalence of specific developmental, emotional, and behavioral (DEB) problems across selected chronic health conditions; examine the relationship of chronic health conditions to functional activities and participation; determine the potential confounding effect of sociodemographic factors on the prevalence of DEB problems.
Methods:
The 2007 National Survey of Children's Health, conducted by the Centers for Disease Control and Prevention, served as the primary data source for this study. A total of 91.642 interviews (66.6% response rate for identified households with children) were performed. Population-based estimates were obtained for variables of interest by assigning sampling weights to each child for whom an interview was completed.
Results:
Parents were two to 30 times more likely to report DEB problems, such as Attention Deficit/Hyperactivity Disorder, depression, learning problems, and challenging behaviors, for children with chronic health conditions. These children had a greater number and range of difficulties with social interaction and school functioning as well as a lower rate of participation in community activities. Although highest rates of DEB problems were reported for those conditions involving the nervous or sensory systems, children with asthma, diabetes, and musculoskeletal conditions also had a higher rate of problems than children without the conditions. The higher prevalence of DEB problems remained after statistical adjustment for socio-demographic factors.
Conclusions:
Children with a spectrum of chronic health conditions are at high risk for DEB problems that affect learning, behavior, and emotional well-being. As part of a comprehensive approach to the management of chronic health conditions, children should be screened for these problems and referred for appropriate further evaluation and remediation. Attention to these common co-morbidities will not only result in enhanced quality of life but will also promote better adherence to medical recommendations and, thereby, optimal disease control.
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