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Different Definitions of Developmental Disability and Implications for Outcomes.
1Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
JAMA Health Forum
|February 3, 2026
Summary
The definition of developmental disability (DD) significantly impacts prevalence estimates and service needs. A narrower definition may better identify individuals at higher risk for segregation and public service utilization.
Area of Science:
- Public Health
- Health Services Research
- Disability Studies
Background:
- Varying definitions of developmental disability (DD) lead to different population characteristics.
- Understanding these differences is crucial for effective policy analysis and service planning.
Purpose of the Study:
- To analyze the distributive implications of four distinct definitions of developmental disability (DD).
- To utilize data from the 2023 Survey of Income and Program Participation (SIPP) and the Residential Information Systems Project (RISP).
Main Methods:
- Cross-sectional study using 2023 SIPP data, including institutionalized individuals.
- Four DD definitions based on self-reported diagnoses and screener questions.
- Analysis of prevalence, long-term services and supports (LTSS) utilization, residential settings, income support, employment, and impairment characteristics.
Main Results:
- Developmental disability (DD) prevalence varied widely, from 4.17% to 15.93% in children/young adults and 1.24% to 8.10% in adults, depending on the definition used.
- Broader definitions correlated with increased employment but decreased LTSS eligibility, congregate setting placement, and income support receipt.
- Narrower definitions identified populations with higher LTSS eligibility and congregate setting placement.
Conclusions:
- The choice of developmental disability (DD) definition significantly influences prevalence estimates and population relevance for services.
- A narrower definition may more accurately identify individuals at higher risk of segregation and those most likely to need publicly funded DD services.
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