Approximately 1 of every 7 children younger than 18 years in the United States, or ∼10.2 million children, can be classified as having special health care needs. Children with special health care needs (CSHCN) are defined as those children who have or are at increased risk for a chronic physical, developmental, behavioral, or emotional condition and who also require health and related services of a type or amount beyond that required by children generally. Besides any limitations from their conditions, they are at greater risk for unmet health care needs, poorer dental health, and behavioral problems. Expenditures for their care are ∼3 times higher than for other children, accounting for ∼42% of all medical care costs for children.

Until the 2001 National Survey of Children With Special Health Care Needs (NS-CSHCN), little was known about this population. The 2001 NS-CSHCN was the first large-scale...

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