Table IV.
Observed prevalence and aPRs of functional indicators, school and social factors, and health care access and service use by TBI category among US children aged 6-17 years—2020 NSCH
| Prevalences | No suspected TBI (ref) |
Suspected TBI, sought care, and diagnosed |
|||||
|---|---|---|---|---|---|---|---|
| No. | Weighted size | % (95% CI) | No. | Weighted size | % (95% CI) | aPR∗ (95%CI) | |
| Functional indicators | |||||||
| Functional disability type† | |||||||
| Deafness or problems with hearing | 351 | 533 080 | 1.2 (1.0-1.4) | 35 | 24 317 | 1.2 (0.7-1.9) | 1.0 (0.6-1.7) |
| Blindness or problems with seeing | 428 | 1 006 585 | 2.2 (1.7-2.7) | 51 | 52 394 | 2.6 (1.7-4.0) | 1.4 (0.8-2.2) |
| Cognitive | 2846 | 4 480 242 | 9.7 (9.0-10.5) | 328 | 353 815 | 17.4 (13.7-21.9) | 1.7 (1.3-2.2) |
| Mobility | 184 | 275 863 | 0.6 (0.5-0.8) | 46 | 92 399 | 4.6 (1.9-10.4)‡ | -§ |
| Self-care | 380 | 669 034 | 1.5 (1.2-1.8) | 54 | 102 719 | 5.1 (2.3-10.7)‡ | 3.8 (1.7-8.9)‡ |
| Activity limitation—past 12 mo¶ | |||||||
| No health conditions | 18 861 | 32 219 526 | 69.7 (68.5-70.9) | 928 | 1 006 163 | 49.4 (44.9-53.9) | 0.8 (0.7-0.8) |
| Daily activities never affected | 4718 | 7 524 252 | 16.3 (15.4-17.2) | 438 | 442 928 | 21.8 (18.4-25.5)‡ | 1.3 (1.1-1.5) |
| Sometimes affected | 3526 | 5 143 091 | 11.1 (10.3-12.0) | 421 | 381 655 | 18.7 (16.1-21.7) | 1.5 (1.3-1.8) |
| Usually or always affected | 888 | 1 344 140 | 2.9 (2.6-3.3) | 146 | 205 650 | 10.1 (6.7-14.9) | 3.2 (2.0-5.3) |
| School and social factors | |||||||
| School engagement∗∗ | |||||||
| Always | 11 551 | 19 861 836 | 43.7 (42.4-45.1) | 676 | 753 606 | 37.6 (33.3-42.1) | 0.9 (0.8-1.0) |
| Usually | 10 979 | 17 022 079 | 37.6 (36.3-38.9) | 769 | 770 329 | 38.5 (34.3-42.8) | 1.0 (0.9-1.1) |
| Sometimes/never | 5018 | 8 482 587 | 18.7 (17.6-19.8) | 466 | 479 406 | 24.0 (19.9-28.5) | 1.2 (1.0-1.4) |
| Repeated grade (ever) | 1346 | 2 958 546 | 6.5 (5.8-7.2) | 102 | 116 944 | 5.8 (3.9-8.4) | 0.8 (0.5-1.2) |
| Missed school days (past 12 mo) | |||||||
| No days missed | 9722 | 18 492 425 | 40.6 (39.3-42.0) | 404 | 451 899 | 22.4 (18.9-26.5) | 0.6 (0.5-0.7) |
| 1-3 d | 11 617 | 17 650 438 | 38.8 (37.5-40.1) | 759 | 759 109 | 37.7 (33.6-42.0) | 1.0 (0.9-1.1) |
| 4-6 d | 3817 | 5 855 668 | 12.9 (12.1-13.7) | 358 | 432 583 | 21.5 (17.3-26.4) | 1.7 (1.4-2.1) |
| 7-10 d | 1478 | 2 086 031 | 4.6 (4.1-5.1) | 191 | 167 954 | 8.3 (6.5-10.7) | 1.7 (1.3-2.3) |
| 11+ d | 910 | 1 416 646 | 3.1 (2.7-3.6) | 201 | 202 551 | 10.1 (8.0-12.6) | 3.0 (2.3-4.0) |
| Difficulty making and keeping friends | |||||||
| No difficulties | 20 928 | 35 554 956 | 77.8 (76.7-78.9) | 1359 | 1 501 904 | 74.1 (70.6-77.4) | 1.0 (0.9-1.0) |
| A little difficulty | 5408 | 8 139 178 | 17.8 (16.8-18.9) | 428 | 409 788 | 20.2 (17.3-23.5) | 1.0 (0.9-1.2) |
| A lot of difficulty | 1308 | 1 981 882 | 4.3 (3.8-4.9) | 131 | 114 079 | 5.6 (4.2-7.5) | 1.1 (0.8-1.5) |
| Health care access and service use | |||||||
| Access to care | |||||||
| Receipt of care in a medical home†† | 14 475 | 20 703 602 | 44.6 (43.3-45.8) | 1052 | 1 096 861 | 53.8 (49.2-58.3) | 1.1 (1.0-1.2) |
| Usual source of sick care in a doctor’s office-clinic-or health center | 22 225 | 33 917 396 | 73.7 (72.4-75.0) | 1708 | 1 781 245 | 87.8 (84.6-90.5) | 1.1 (1.1-1.2) |
| Unmet need for care coordination‡‡ | 4046 | 6 762 134 | 14.7 (13.7-15.7) | 448 | 455 829 | 22.4 (18.6-26.9) | 1.6 (1.3-1.9) |
| Unmet need for mental health care service use | 358 | 610 384 | 1.3 (1.0-1.8) | 45 | 52 765 | 2.6 (1.7-4.0) | 2.0 (1.1-3.4) |
| Service use | |||||||
| Preventive health visit (past 12 mo) | 21 457 | 34 045 852 | 73.6 (72.3-74.8) | 1680 | 1 751 878 | 86.1 (81.2-89.9) | 1.2 (1.1-1.2) |
| Mental health treatment, among those who needed it (past 12 mo)§§ | 4013 | 5 636 861 | 12.2 (11.3-13.1) | 461 | 400 312 | 19.7 (17.0-22.7) | 1.3 (1.1-1.6) |
| Specialist treatment, among those who needed it (past 12 mo)¶¶ | 4220 | 5 729 462 | 12.4 (11.7-13.2) | 584 | 630 722 | 31.1 (26.8-35.8) | 2.1 (1.8-2.5) |
| Special education services (current)∗∗∗ | 3232 | 5 258 715 | 11.4 (10.6-12.2) | 303 | 348 635 | 17.1 (13.4-21.6) | 1.4 (1.1-1.8) |
Prevalence ratios for functional indicators and school and social factors were adjusted for age, sex, and race and ethnicity. The prevalence ratios for meets criteria for health care access and service use were adjusted for age, sex, race and ethnicity, and health insurance type.
The NSCH asked parents to report if their child had “any of the following…Deafness or problems hearing; Blindness or problems with seeing-even when wearing glasses; Serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition (cognitive); Serious difficulty walking or climbing stairs (mobility); or Difficulty dressing or bathing (self-care).” Disability types are not mutually exclusive, ie, children may have more than 1 disability type.
RSE is between 30% and 50%; therefore, estimate should be interpreted with caution.
Estimate suppressed; RSE is >50%.
Respondents were asked, “During the last 12 months, how often have this child’s health conditions or problems affected their ability to do things other children their age do?” Response options included, “This child does not have any health conditions,” “Never,” “Sometimes,” “Usually,” or “Always.”
School engagement was defined as a composite measure based on responses to 2 questions: “How often does this child care about doing well in school?” and “How often does this child do all required homework?”.
Receipt of care in a medical home was defined as a composite measure composed of 5 subcomponents (usual source of sick care, personal doctor or nurse, referral access, receipt of care coordination, and receipt of family-centered care).
Unmet care coordination measure was defined as a composite measure based on responses to questions about communication between doctors when needed, communication between doctors and schools when needed, and getting needed help coordinating care. Children who did not see more than 1 health care provider were coded as not needing care coordination.
Respondents were asked, “During the last 12 months-has this child received any treatment or counseling from a mental health professional?” NSCH defined mental health professionals as psychiatrists, psychologists, psychiatric nurses, and clinical social workers.
Respondents were asked, “During the past 12 months, did this child see a specialist other than a mental health professional?” NSCH defined specialists as doctors like surgeons, heart doctors, allergy doctors, and others who specialize in 1 area of health care.
Respondents were asked, “Has this child EVER had a special education or early intervention plan? Children receiving these services often have an Individualized Family Service Plan (IFSP) or Individualized Education Plan (IEP).” If respondents answered yes, they were then asked, “Is this child CURRENTLY receiving services under one of these plans?”.