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Summary
Pages 1-18

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From page 1...
... Less than 1 percent of children in the United States are recipients of SSI benefits for a mental disorder. There has been considerable and recurring interest in the growth and sustainability of the SSI program for children.
From page 2...
... b In the context of current trends in child health and development, and in pediatric and adolescent medicine. c Including disorders such as attention deficit and hyperactivity disorder, autism and other developmental disorders, intellectual disability, learning disorders, and mood and conduct disorders.
From page 3...
... NATIONAL TRENDS IN THE SSI PROGRAM FOR CHILDREN WITH DISABILITIES The committee conducted a review of the trends in the number and proportion of all children in the United States who were allowed and received SSI disability benefits nationally, from 2004 to 2013. This analysis included a review of the trends in the number of children who received SSI disability benefits for all causes as well as reviews of the trends in childhood disability attributed to 10 major mental disorders, both individually and in aggregate.
From page 4...
... 3. After taking child poverty into account, the increase in the percentage of chil dren in low-income households receiving SSI benefits for mental disorders, (from 1.88 percent in 2004 to 2.09 percent in 2013)
From page 5...
... The percentage of all U.S. children who were recipients of SSI disability benefits for the 10 major mental disorders grew from 0.74 percent in 2004 to 0.89 percent in 2013.
From page 6...
... For each year from 2004 to 2013, the ADHD category was the largest in terms of the numbers and proportions of child SSI disability allow ances and recipients. STATE-TO-STATE VARIATION OBSERVED IN THE SSI PROGRAM FOR CHILDREN WITH MENTAL DISORDERS The data requested from the SSA by the committee included the numbers of SSI child disability benefit allowances and recipients for mental disorders within each state.
From page 7...
... • The number of families with an SSI recipient who are living below the FPL when SSI benefits are not included in calculating income increased by 46 percent between 2002 and 2010. In 2010 more than 45 percent of those families were raised above the FPL after
From page 8...
... • Allowance and recipient rates per 100,000 children were higher for families below the FPL than for those above, and they increased with progressively more severe levels of poverty. CLINICAL CHARACTERISTICS OF MENTAL DISORDERS IN CHILDREN Pursuant to the statement of task, the committee conducted focused reviews of the clinical characteristics and treatment of the six selected mental disorders, chosen due to their prevalence and the severity of disability attributed to those disorders within the SSI disability program.
From page 9...
... The co occurrence of these disorders with other mental disorders causes significant functional impairment in many children who are SSI recipients. • Early preventive interventions show promise for reducing ODD occurrence.
From page 10...
... • As a diagnostic category, IDs include individuals with a wide range of intellectual functional impairments and difficulties with daily life skills. The levels of severity of intellectual impairment and the need for support can vary from profound to mild.
From page 11...
... Severe impairments in functioning are very common and frequently persist, even with treatment. PREVALENCE OF MENTAL DISORDERS IN CHILDREN As prescribed in the task order, the committee completed focused reviews of prevalence estimates for six major mental disorders from SSI data, from the general population of youth, and from Medicaid childhood populations.
From page 12...
... • Based on 2012 estimates of the number of children below 200 per cent of the FPL and the prevalence of moderate to severe ADHD in children nationally, it appears that only a small proportion of chil dren who were potentially eligible for SSI benefits due to ADHD were in fact recipients. Findings • Prevalence estimates for ADHD in the general population of youth fall into the 5 percent or greater range, depending on the source of the estimate and survey methodology.
From page 13...
... Depending on the prevalence estimate, only 20 to 50 percent of potentially eligible children received SSI benefits. However, unlike the case with other mental disorders, the evidence shows higher rates of ASD identification in children in middle- and high-income households, and lower rates of identification among children in low-income households.
From page 14...
... The yearly prevalence estimates of ASD diagnoses among children enrolled in Medicaid were similar to estimates based on special education child counts, but lower than ASD prevalence estimates from surveillance and survey data for the general population. Prevalence of IDs Conclusion • Rough estimates of the number of children in low-income house holds with moderate to severe ID suggest that less than 60 percent of children who are likely eligible for SSI benefits due to ID are recipients of these benefits.
From page 15...
... Prevalence of Mood Disorders Conclusion • Conservative estimates of the prevalence of moderate to severe depression among children and adolescents (i.e., 1 percent) applied to the population of these children and adolescents who are below 200 percent of the FPL suggest that only a small proportion, ap proximately 3 percent, of those who are potentially eligible for SSI benefits on the basis of mood disorders are actually recipients.
From page 16...
... The trends in the prevalence of pediatric bipolar disorder remain unknown. • From 2004 to 2013 the allowance rates for SSI benefits for mood disorders decreased, while the percentage of children in low-income households who were recipients of SSI benefits for mood disorders increased modestly.
From page 17...
... • The rates of treatment with medication, psychotherapy, or combi nations of the two varied depending on the specific mental disorder diagnosis. • All Medicaid enrollees with ADHD experienced increased rates of treatment with medications, psychotherapy, or a combination of the two.


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