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Editorial |

Being Specific About Being Special:  Defining Children's Conditions and Special Health Care Needs

Matthew M. Davis, MD, MAPP; Jeffrey P. Brosco, MD, PhD
Arch Pediatr Adolesc Med. 2007;161(10):1003-1005. doi:10.1001/archpedi.161.10.1003.
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Should there be a single definition of child illness? Should what qualifies as a chronic condition of childhood be defined in absolute or relative terms?

Over the past 2 decades, many research and policy groups have recommended different approaches to conceptualizing, defining, and measuring child illness and wellness. Scholars disagree on almost every dimension of child health status: whether to define health status based on specific diagnoses, functional state, or health care use or need; how to account for the severity of a condition; whether to include children at risk but not yet diagnosed; and whether to limit definitions to traditionally medical (as separate from behavioral) conditions. There is even debate about the amount of time a child experiences a certain condition before it should be categorized as chronic: 3 months, 6 months, or 12 months—or expected to last that long.

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Figure.

National estimates of prevalence of childhood chronic conditions, children with a special health care need (SHCN), and functional limitations from the National Survey of Children's Health, 2003-2004.14 Data are our estimates (rounded to the nearest hundred) based on analyses weighted for stratified probability sampling of the data set.

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