95 A Comparison of the Developmental Profiles of Individuals with Hemiplegic Cerebral Palsy associated with Middle Cerebral Artery and Periventricular Venous Infarctions

Background and Objective(s): Developmental disabilities are present in a significant proportion of US children. Current prevalence estimates and regular reporting are essential for estimating the costs of programs and policies, and facilitating prioritization and modification in resource allocation to ensure proper supports and services. We examined overall prevalence, prevalence by demographic characteristics, and trends over time for cerebral palsy (CP), intellectual disability (ID), hearing loss, and blindness. Study Design: Cross-sectional study. Study Participants & Setting: Data from the 2009–2016 National Health Interview Survey (NHIS) were analyzed for children 3–17 years of age because many developmental disabilities are not yet diagnosed in younger children (81,133 children were 3–17 years of age out of the 98,196 children in the sample child file). The sample child final response rate ranged from 62% (2016) to 74% (2011). Materials/Methods: Prevalence estimates were based on survey questions regarding parental report of children’s diagnosis of CP, ID, moderate to severe hearing loss, or blindness. Survey question wording was consistent over time for CP, hearing loss, and blindness, but changed in 2011 when “intellectual disability” replaced the term “mental retardation.” While children may have more than one diagnosis, individual prevalence estimates were provided for each disability. Chi-square tests were used to examine demographic differences in prevalence; Wald-F tests were used to assess linear trends over three constructed time periods (2009–2010, 2011–2013, and 2014– 2016). Results: During 2009–2016, the overall prevalence estimates per 1000 children ages 3–17 years for CP, ID, hearing loss, and blindness were 3.2 (95% CI: 2.7, 3.7), 11.2 (95% CI: 10.3, 12.2), 6.4 (95% CI: 5.7, 7.2), and 1.6 (95% CI: 1.2, 2.0), respectively. Older children had a higher prevalence of ID compared with younger children; boys had a significantly higher prevalence of CP and of ID compared with girls. Additionally, disability prevalence was generally higher for children of parents with lower education, and families with income ≤200% of the federal poverty level or with public insurance, and children with low birth weight. Only ID demonstrated a significant trend during the time periods (2009–2010: 7.4 (6.1, 9.1), 2011–13: 12.7 (11.3, 14.4), 2014–16: 12.2 (10.5, 14.0); p=0.0002). Conclusions/Significance: We provide nationally representative prevalence estimates for 4 developmental disabilities. Overall, prevalences of CP, moderate to severe hearing loss, and blindness were stable during the last eight years. Prevalence of ID increased after 2010, coincident with the questionnaire wording change; recent estimates are comparable to those from records-based studies. Regular and timely surveillance of developmental disabilities is crucial for developing and maintaining effective programs and policies, guiding research into risk factors, and informing early intervention efforts to maximize health, well-being and quality of life.