- The Washington Times - Wednesday, February 19, 2020

A new study shows that U.S. children in rural areas are more likely to be diagnosed with a developmental disability than children in urban areas, yet less likely to receive specialized treatment and services.

Researchers found that 19.8% of children in rural areas, compared to 17.4% of children in urban areas, were likely to be diagnosed with a developmental disability, according to a report by the Centers for Disease Control and Prevention.

The national health statistics report, published Wednesday, specifically points to the difference in the number of children diagnosed with attention-deficit/hyperactivity disorder (ADHD) and cerebral palsy. It concludes that rural children were more likely than urban kids to be diagnosed with ADHD (11.5% versus 9.2%) and cerebral palsy (0.5% versus 0.2%).

“Children living in rural areas are more likely to experience family adversity, potentially in the form of poor parental mental health and financial difficulties,” said Benjamin Zablotsky, an epidemiologist at the CDC’s National Center for Health Statistics and the senior author of the study, citing previous research. “We also know that this, in combination with lack of individual and community level resources for treatment in rural areas, might be leading to these higher rates of persistent behavioral problems.”

The study also highlights that rural children were less likely to have seen a mental health professional (26.4% versus 33.1%) or a therapist (22.4% versus 26.7%), or had a health checkup visit in the last year compared to their urban counterparts (83.4% versus 87.4%).

Also, only 37.7% of children with developmental disabilities in rural areas were likely to receive special educational or early intervention services, compared to 44.2% of children in urban areas.

“Across the country, state Developmental Disabilities Councils have found gaps in the way we collect prevalence data,” said Donna Meltzer, CEO of the National Association of Councils on Developmental Disabilities and who was not involved in the study. “Unquestionably, these data gaps have a negative impact on rural communities where it can be more difficult to access services that make it possible for people with disabilities to live fully in the community.”

The study’s researchers said children in rural areas often lack resources, which is compounded with accessibility problems such as reliable transportation that might play a key role in accessing health care services.

Pulling data from the 2015-2018 National Health Interview Survey, which included nearly 34,000 interviews, the researchers looked at specialized services for children and the prevalence of 10 developmental disability diagnoses reported by parents or guardians: ADHD, autism spectrum disorder, blindness, cerebral palsy, hearing loss, learning disability, intellectual disability, seizures, stuttering or stammering and other developmental delays.

For the report, the researchers defined urban areas as spaces consisting of 50,000 or more people and clusters of 2,500 to 49,999 individuals. All other areas were defined as rural.

“Diagnostic information is valuable, but it really is dependent on whether parents bring their children in for diagnosis,” said Margaret Nygren, executive director of American Association on Intellectual and Developmental Disabilities. “What I see or think when I hear this kind of data is that rural parents are getting better at bringing their kids in for diagnosis … It may reflect there is an increased awareness and access to clinicians who can diagnose for conditions in rural areas.”

She also noted that it’s not surprising that children in rural areas are less likely to receive specialized treatment since these services are more readily available in urban areas.

“What’s really important with this data is that we are seeing an increased awareness of what developmental disabilities are and a decrease in shame associated with that and a real interest in providing support for those children so they can have the best possible outcomes in life,” said Ms. Nygren. “That’s a real big change from say 40 or 50 years ago.”

The CDC estimates that about one in six, or 17%, of U.S. children aged 3 to 17 years old have one or more developmental disabilities.

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