1

Draft PROOF 

The National Survey of Children’s Health
 

The Mental 

and Emotional 

Well-Being of 

Children: 

A Portrait of States 

and the Nation 

2007 

June 2010 

U.S. Department of Health and Human Services 

Health Resources and Services Administration 
Suggested citation: 

U.S. Department of Health and Human Services, 

Health Resources and Services Administration, 

Maternal and Child Health Bureau.
 

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007.
 

Rockville, Maryland: U.S. Department of 

Health and Human Services, 2010.
 

Individual copies of this report are available 

at no cost from the HRSA Information Center, 

P.O. Box 2910, Merrifield, VA 22116; 

1-888-ASK-HRSA; or ask@hrsa.gov. 

The publication is also available online at 

www.mchb.hrsa.gov and www.cdc/nchs/slaits.htm 

Readers are free to duplicate and use all or part of the information contained in this publication; however, the photographs are 

copyrighted and permission may be required to reproduce. 

Note: These data are based entirely on parental reports and have not been independently verified. In addition, they only 

include children whose parents reported that they have been told that they have one of these conditions by a doctor or other 

health care provider.
 

All photos are credited to iStockphoto, except page 7, to Renee Schwalberg.
 
The National Survey of Children’s Health 

State Data	 31 

Alabama 32 

Alaska 32 

Arizona 33 

Arkansas 33 

California 34 

Colorado 34 

Connecticut 35 

Delaware 35 Table of Contents 

District of Columbia	 36 Introduction		 4 

Florida 36 

Mental Health Status 7 Georgia 37 

Mental Health Status 8	 Hawaii 37 

Characteristics of Children with Emotional, Behavioral, or 

Developmental Conditions 10 

Overlap Among Emotional, Behavioral, or Developmental Conditions 11 

Overlap with Learning Disabilities 12 

Overlap with Physical Health Conditions 13 

Mental Health Services	 15 

Idaho 38 

Illinois 38 

Indiana 39 

Iowa 39 

Kansas 40 

Kentucky 

Louisiana 

40 

41 

Use of Mental Health Services 16	 Maine 41 

Maryland 42 Health Insurance Coverage 17 

Massachusetts 42 Adequacy of Health Insurance Coverage		 18 

Michigan		 43

Medical Home	 19 Minnesota 43 

School and Activities 21 Mississippi 44 

Repeating a Grade and School Engagement 22	 Missouri 44 

Social Skills 23	 Montana 45 

Nebraska 45 Problem Social Behaviors 24 

Nevada 46

Activities Outside of School	 25 New Hampshire		 46 

The Child’s Family	 27 New Jersey 47 

Parenting Stress 28 New Mexico 47 

Parents’ Health Status 29	 New York 48 

North Carolina 48 Child Care	 30 

North Dakota 49 

Ohio 49 

Oklahoma 50 

Oregon 50 

Pennsylvania 51 

Rhode Island		 51 

South Carolina 52 

South Dakota 52 

Tennessee 53 

Texas 53 

Utah 54 

Vermont 54 

Virginia 55 

Washington 55 

West Virginia 56 

Appendix A: Technical Appendix 59 Wisconsin 56 

Appendix B: Survey Questions 60 Wyoming 57 

3 
The National Survey of Children’s Health
 

Introduction 

Children, like adults, may have 

mental health problems, including 

depression and anxiety. They may 

also have behavioral conditions, 

such as conduct disorders; cognitive 

disorders, such as autism spectrum 

disorder; or neurological conditions, 

such as Tourette Syndrome. Children 

may also be affected by delays in 

their physical, cognitive, or emotional 

development. 

The 2007 National Survey of Children’s Health asked parents whether 

their children had ever been diagnosed with, and currently had, any of 

these seven conditions. (The exact 

wording of the questions asked in the 

survey is presented in Appendix B.) 

This chartbook addresses the health 

and well-being of the population of 

children whose parents reported 

that their children had at least one 

of these conditions. Note, however, 

that these data are based entirely on 

parental reports and have not been 

independently verified; in addition, 

they only include children whose 

parents reported that they have been 

told that they have one of these conditions by a doctor or other health 

care provider. 

The seven conditions included 

here—depression, anxiety, Attention 

Deficit Disorder/Attention Deficit 

Hyperactivity Disorder (ADD/ADHD), 

conduct disorders, autism spectrum 

disorders, developmental delay, and 

Tourette Syndrome—may be grouped 

together as emotional, behavioral, or 

developmental conditions. Overall, 

these conditions affect 11.3 percent 

of children in the United States, or 

nearly 7.4 million children. Of these 

children, nearly two-thirds (65.7 

percent) are boys, more than half 

(51.1 percent) are between the ages 

of 12 and 17 years, and nearly onequarter (24.8 percent) have family 

incomes below the Federal poverty 

level. Boys, adolescents, and children 

from low-income families are all disproportionately represented among 

children with reported emotional, 

behavioral, or developmental conditions compared to the population of 

children in general. 

Many children have more than 

one of these seven diagnoses: 40.3 

percent of children with at least one 

emotional, behavioral, or developmental condition have more than one 

of the seven conditions. These conditions also frequently overlap with 

learning disabilities. Of children at 

least 3 years of age with at least one 

emotional, behavioral, or developmental condition, 45.8 percent also 

had learning disabilities, compared to 

2.7 percent of children without these 

conditions. In addition, one-third of 

children with emotional, behavioral, 

or developmental conditions also had 

at least one of seven physical health 

conditions addressed in the survey 

(asthma; diabetes; bone, joint, or 

muscle problems; hearing problems; 

vision problems; epilepsy or seizure 

disorder; and brain injury or concussion). 

Children with emotional, behavioral, or developmental conditions are 

no more likely than other children to 

be uninsured or to have gaps in their 

health coverage. However, they are 

more likely to be insured through 

public programs: 43.7 percent of 

children with these conditions have 

public insurance, compared to 26.2 

percent of children without these 

conditions. They are also more likely 

to have insurance that does not adequately meet their needs. Parents of 

insured children were asked whether 

their out-of-pocket costs were reasonable, whether the plan offered 

benefits or covered services that met 

their child’s needs, and whether their 

child was allowed to see the providers he or she needed. Of children 

with emotional, behavioral, or developmental conditions with insurance, 29.4 percent were reported to 

have insurance that did not usually 

or always meet all of these criteria, 

compared to 23.8 percent of children 

without these conditions. 

A “medical home,” or a consistent 

source of medical care that meets 

criteria of accessibility, continuity, 

comprehensiveness, coordination, 

compassion, and cultural sensitivity, 

is particularly critical for any child 

with a chronic condition, including 

emotional, behavioral, or developmental conditions. Unfortunately, 

only 40.2 percent of children with 

these conditions were reported to get 

their care through a medical home, 

compared to 58.5 percent of other 

children. 

Children with emotional, behavioral, or developmental conditions 

can benefit from a variety of services 

and therapies, including counseling 

and medications. However, not all 

children with these conditions are 

reported to receive these services. 

Overall, 45.6 percent of children with 

at least one of the seven conditions 

4 
The National Survey of Children’s Health
 

received needed mental health services, according to their parents, and 

just half (50.1 percent) took medications for their conditions in the past 

year. This finding implies that mental 

health services for children remains 

an area of great unmet need. 

Having an emotional, behavioral or 

developmental condition may affect 

a variety of important developmental 

and social processes during childhood and adolescence. Children with 

at least one of the seven conditions 

are more likely than other children 

to repeat a grade in school, and are 

less likely to be engaged in school, 

according to their parents. They 

are less likely to consistently exhibit 

positive social skills, and more likely 

to show problematic behaviors such 

as bullying or arguing. However, it 

should be noted that these differences are not necessarily attributable 

to the children’s conditions; other 

factors, such as the family’s situation 

and the child’s neighborhood environment, may be involved as well. 

The health of a child and the health 

of the entire family are interdependent. The parents of children with 

emotional, behavioral, or developmental conditions are more likely 

than the parents of children without 

these conditions to report that they 

usually or always feel at least one 

form of parenting stress (30.9 and 

8.2 percent, respectively.) Parents’ 

physical and mental health is also 

closely related to that of their children, and both mothers and fathers 

of children with emotional, behavioral, or developmental conditions 

are less likely to report that they are 

in excellent or very good physical 

and mental health than parents of 

children without these conditions. 

Finally, child care can present substantial challenges in any family with 

young children, and these challenges 

only increase when children have 

emotional, behavioral, or developmental conditions. Of children aged 

2 to 5 years with at least one of these 

conditions, 62.5 percent received 

some form of nonparental child care. 

The parents of 46.2 percent reported 

having at least one problem with 

child care, including having to make 

different child care arrangements in 

the past month due to circumstances 

outside their control, or having to 

quit a job, not take a job, or greatly 

change their job in the past year 

because of child care problems. 

This chartbook presents a range of 

indicators on the health and well-being of children who have been diagnosed with emotional, behavioral, or 

developmental conditions on the national level. For each state, we show 

the prevalence of the seven conditions (grouped together) and the 

major demographic characteristics 

of children who have at least one of 

the conditions. Together, these data 

paint a picture of a large and diverse 

population of children with multiple, 

complex needs. These children and 

their families may need services— 

including mental and physical health 

care, special education, and social 

services and support—from a variety 

of systems and providers. These 

analyses provide a useful first step in 

delineating the relationships among 

these conditions, children’s socioeconomic characteristics, and access to 

health care. However, much more research is needed to fully understand 

these complex relationships. 

The NSCH is sponsored by the 

Health Resources and Services 

Administration’s Maternal and 

Child Health Bureau. The Technical 

Appendices at the end of this book 

presents information about the survey methodology and sample and the 

specific questions that were asked 

about emotional, behavioral, and 

developmental conditions. For more 

in-depth information about the survey and its findings, other resources 

are available. For more detailed 

analyses of the survey’s findings, the 

Data Resource Center on Child and 

Adolescent Health web site provides 

online access to the survey data. The 

interactive data query feature allows 

users to create their own tables and 

to compare survey results at the national and state levels and by relevant 

subgroups such as age, race/ethnicity, and household income. The Child 

& Adolescent Health Measurement 

Initiative (CAHMI) leads the Data Resource Center (DRC) in partnership 

with state and family leaders, including Title V leaders, Family Voices, 

other family organizations and public 

and private sector child health data 

experts. The web site for the DRC 

is: http://www.nschdata.org. More 

complex analyses can be conducted 

using the public use data set available 

from the National Center for Health 

Statistics at: http://www.cdc.gov/ 

nchs/about/major/slaits/nsch.htm. 

5 
The National Survey of Children’s Health
 

The Mental and Emotional 

Well-Being of Children:
 

A Portrait of the Nation
 

7 
The National Survey of Children’s Health
 

Mental Health Status 

The survey asked parents of children aged 2-17 years whether their 

child had been diagnosed with, and 

still had, any of 16 specific conditions, 7 of which were related to 

emotions, behavior, or development. 

For each condition, the survey asked 

parents whether a doctor had told 

them that their child had the condition and whether the child still had 

the condition. 

• Attention Deficit Disorder 

(ADD)/Attention Deficit Hyperactivity Disorder (ADHD). Children with these syndromes may 

have difficulty paying attention, 

be easily distracted and forgetful, 

have trouble listening and following directions, be impatient, and 

have trouble sitting still. Some of 

these children, those with ADD, 

only have difficulty with attention 

and organization. Others primarily have symptoms involving 

hyperactivity and impulsivity, and 

others have both. ADD/ADHD is 

the most common of the emotional, behavioral, and developmental 

conditions included in the survey: 

the parents of 6.4 percent of children reported that their children 

currently have this condition. 

• Anxiety Problems. While 

all children may feel anxiety in 

specific situations, some children experience anxiety disorChildren Aged 2-17 Years with at Least 

One of Seven Emotional, Behavioral, 

or Developmental Conditions 

No conditions 

88.7% 

One condition 6.7% 

ders, including panic disorder, 

obsessive-compulsive disorder, 

post-tramatic stress disorder, and 

phobias. Symptoms may include 

constant worry, obsessions, fear 

of making mistakes, and lack of 

self-confidence. The parents of 2.9 

percent of children reported that 

their children currently have these 

problems. 

• Depression. Like adults, children 

may experience sadness at times. 

Children may also experience 

debilitating depression, although 

this condition may express itself 

differently in children than in 

adults. Symptoms of depression in 

children include persistent sadness or an anxious or empty mood, 

decreased interest in their favorite 

activities, inability to concentrate, 

frequent complaints of headaches 

and stomachaches, and increased 

irritability, anger, or hostility. The 

parents of 2.0 percent of children 

report that their children have 

been diagnosed with and currently 

have depression. 

Two conditions 2.6% 

Three or more 

conditions 1.9% 

• Oppositional Defiant Disorder 

(ODD)/Conduct Disorder. Children with ODD show a pattern of 

uncooperative, defiant, and hostile 

behavior, especially toward adult 

authority figures. Children with 

ODD may have frequent tantrums, 

argue excessively with adults and 

question rules, and deliberately 

attempt to annoy or upset others. 

Children with conduct disorder 

also have difficulty following rules 

and behaving in socially acceptable ways. The parents of 3.3 percent of children report that their 

children currently have behavioral 

or conduct problems. 

• Autism Spectrum Disorders 

(ASDs) includes a range of 

diagnoses, including Asperger’s 

Syndrome, autism, and Pervasive 

Developmental Disorder (PDD). 

Children with autism have delays 

in language, communication, and 

social skills. Children with Asperger’s disorder have impaired social 

skills but do not have speech or 

language delays. They often have 

The Mental and Emotional Well-Being of Children > Mental Health Status 

8 
The National Survey of Children’s Health
 

continued 

an intense interest in a single 

subject or topic. Children with 

pervasive developmental disorder 

have severe and persistent delays 

in language, communication, and 

social skills. The parents of 1.0 

percent of children report that 

their children had ASDs at the 

time of the survey. 

• Developmental Delay includes 

major delays in motor, language, 

social, or thinking skills. The 

parents of 3.2 percent of children 

reported that their child had a 

developmental delay at the time of 

the survey. 

• Tourette Syndrome. Children may have body tics (quick, 

repeated involuntary movements) or vocal tics (involuntary 

speech or sounds), but those with 

Tourette Syndrome have both, and 

may also have difficulties with 

attention and learning or develop 

obsessions and compulsions. The 

parents of 0.1 percent of children 

report that their children currently have Tourette Syndrome. 

In total, 11.3 percent of children 

aged 2-17 years were reported to 

have at least one of these seven conditions at the time of the survey. 

Prevalence of Diagnosed Emotional, 


Behavioral, or Developmental Conditions 


Among Children Aged 2-17 Years
 

ADD/ADHD 

ODD/ 

Conduct Disorder 

Developmental

 Delay 

Anxiety 

Depression 

Autism Spectrum

 Disorder 

Tourette

 Syndrome 

3.3 

3.2 

2.9 

0.1 

1.0 

2.0 

6.4 

1 2 3 4 5 6 7 8 

Percent of Children 

The Mental and Emotional Well-Being of Children > Mental Health Status 

9 
 

The National Survey of Children’s Health
 

Characteristics of 

Children with 

Emotional, Behavioral, 

or Developmental 

Conditions 

The population of children with 

emotional, behavioral, or developmental conditions differs from that 

of children without these conditions 

in many ways. Boys are disproportionately likely to be diagnosed 

with these conditions (65.7 percent 

of children with one of the seven 

conditions is male, compared to 49.2 

percent of children without one of 

the conditions). Children with these 

conditions are more likely to be in 

the older age groups (because these 

conditions may not be diagnosed 

until middle childhood): of children 

with an emotional, behavioral, or developmental condition, 51.1 percent 

were 12 to 17 years old, compared to 

37.3 percent of children with none of 

the conditions. In addition, children 

with these conditions are more likely 

to have low family incomes than children without them: of children with 

at least one emotional, behavioral, 

or developmental condition, 24.8 

percent had family incomes below 

the Federal poverty level, compared 

to 17.1 percent of children without 

one of these conditions. 

Children Aged 2-17 Years Children Aged 2-17 Years 

with Emotional, Behavioral, or without Emotional, Behavioral, or 

Developmental Conditions, by Sex Developmental Conditions, by Sex 

Female 

50.8% 

Male 

49.2% 

Female 

34.3% 

Male 

65.7% 

Children Aged 2-17 Years Children Aged 2-17 Years 

with Emotional, Behavioral, or without Emotional, Behavioral, or 

Developmental Conditions, by Age Developmental Conditions, by Age 

Age 12-17 

37.3% 

Age 6-11 

36.3% 

Age 2-5 

26.5% 

Age 12-17 

51.1% 

Age 6-11 

39.3% 

Age 2-5 

9.6% 

Children Aged 2-17 Years with Children Aged 2-17 Years without 

Emotional, Behavioral, or Developmental Emotional, Behavioral, or Developmental 

Conditions, by Poverty Status* Conditions, by Poverty Status* 

400% or 

More FPL 

30.4% 

200-399% FPL 

31.8% 100-199% FPL 

20.7% 

<100% FPL 

17.1% 

400% or 

More FPL 

24.4% 

200-399% FPL 

27.3% 

100-199% FPL 

23.5% 

<100% FPL 

24.8% 

*Federal poverty level was $20,650 for a family of four in 2007. Percentages may not add to 100 due to rounding. 

The Mental and Emotional Well-Being of Children > Characteristics of Children with Emotional, 

 Behavioral, or Developmental Conditions 10 
The National Survey of Children’s Health 

Overlap Among 

Emotional, Behavioral, 

or Developmental 

Conditions 

Children may have more than one 

of the seven emotional, behavioral, or 

developmental conditions addressed 

in the survey. Overall, 40.3 percent 

of children with at least one of the 7 

emotional, behavioral, or developmental conditions were reported to 

have more than one of these diagnoses. Children with ADD/ADHD 

were the most likely to have only one 

emotional, behavioral, or developmental diagnosis, while the majority 

of children with the other six conditions had more than one condition. 

Number of Emotional, Behavioral, 


or Developmental Conditions among 


Children with at Least One Condition*
 

Three or more 

conditions 

16.9% 

Two conditions 

23.4% 

One condition 

59.7% 

*Including only the seven conditions asked about in the survey. 

Overlap Within Emotional, Behavioral, 


and Developmental Diagnoses*
 

This condition 

Only this This condition plus two or

condition plus one other more others 

ADD/ADHD 

Developmental


 Delay
 

Tourette


 Syndrome
 

Anxiety 

ODD/Conduct


 Disorder
 

Depression 

Autism Spectrum

 Disorder 

10 20 30 40 50 60 70 80 90 100 

37.7 27.2 35.1 

30.1 18.3 51.6 

28.7 26.6 44.7 

14.1 34.6 51.3 

21.2 32.3 46.5 

23.6 33.3 43.1 

52.2 23.9 23.9 

Percent of Children 

*Including only the seven conditions asked about in the survey. 

The Mental and Emotional Well-Being of Children > Overlap Among Emotional, Behavioral,

 or Developmental Conditions 11 
The National Survey of Children’s Health
 

Prevalence of Learning Disabilities 


Among Children Aged 3-17 Years 


with Emotional, Behavioral, 


or Developmental Conditions
 

Does not have 

learning 

disabilities 

54.2% 

Has learning 

disabilities 

45.8% 

Overlap with Learning 

Disabilities 

Children with emotional, behavioral or developmental conditions 

may also have learning disabilities. 

Learning disabilities may be caused 

by problems with the nervous system 

that interfere with the child’s ability 

to receive, process, and communicate 

information. These disabilities are 

generally distinct from emotional, 

behavioral, and developmental conditions, but may overlap with ADD/ 

ADHD or other conditions. The 

survey asked whether parents of children who were at least 3 years old 

had been told by a doctor, health care 

provider, teacher, or school official 

that their child had learning disabilities. Overall, 45.8 percent of children 

with at least one of the seven emotional, behavioral, or developmental 

conditions also have a learning disability; among children without emotional, behavioral, or developmental 

conditions, the prevalence of learning 

disabilities was 2.7 percent. 

Of the seven emotional, behavioral, and developmental conditions 

addressed here, the condition that is 

most likely to overlap with learning 

disabilities is developmental delay; 

82.9 percent of children with developmental delay were also reported to 

have learning disabilities. A majority (76.0 percent) of children with 

autism spectrum disorders have 

learning disabilities as well. 

Prevalence of Learning Disabilities among 


Children Aged 3-17 Years with Emotional, 


Behavioral, or Developmental Conditions
 

Developmental

 Delay 82.9 

Autism Spectrum

 Disorder 76.0 

ODD/Conduct

 Disorder 48.1 

ADD/ADHD 47.6 

Tourette

 Syndrome 44.4 

Anxiety 42.1 

Depression 41.2 

10 

Percent of Children 

20 30 40 50 60 70 80 90 100 

The Mental and Emotional Well-Being of Children > Overlap with Learning Disabilities 

12 
The National Survey of Children’s Health
 

Overlap with Physical 

Health Conditions 

Children with emotional, behavioral, and developmental conditions 

may have chronic physical conditions 

as well. The survey asked parents 

whether their children had been 

diagnosed with any of seven physical 

health conditions: asthma; diabetes; 

bone, joint, or muscle problems; 

hearing problems; vision problems; epilepsy or seizure disorder; 

and brain injury or concussion. Of 

children who have an emotional, 

behavioral, or developmental condition, 33.3 percent have at least one 

of these physical health conditions 

as well. Among children aged 2-17 

years without an emotional, behavioral, or developmental diagnosis, 

11.7 percent have one of these physical health conditions. 

Prevalence of Chronic Physical Conditions* 


Among Children with Emotional, 


Behavioral, or Developmental Conditions
 

Does not have 

one of 7 

chronic physical 

conditions 

66.7% Has one of 7 

chronic physical 

conditions 

33.3% 

*Of the 7 conditions asked about in the survey: asthma; diabetes; 

bone, joint, or muscle problems; hearing problems; vision problems; 

epilepsy or seizure disorder; and brain injury or concussion 

The Mental and Emotional Well-Being of Children > Overlap with Physical Health Conditions 

13 
The National Survey of Children’s Health
 

Mental Health Services
 Mental health screening and treatment services, including behavioral therapies, talk therapy, and medications, can be essential in helping children with emotional and behavioral problems to lead productive lives. This section examines children’s 

health insurance coverage and access to needed services and to the medical homes that can help to assure that their care is 

coordinated and that specialty care is accessible. 

The Mental and Emotional Well-Being of Children 

15 
The National Survey of Children’s Health
 

Children with Emotional, Developmental, Children with Emotional, Developmental, 

or Behavioral Conditions Receiving or Behavioral Conditions Taking 

Needed Mental Health Services, Medications, by Number of Conditions 

by Number of Conditions 

100 100

90 90

50.1 

41.1 

53.1 

80 80 77.6

71.5 

56.0 

45.6 

34.2 

70 70

Percent of Children

Percent of Children

Use of Mental Health 

Services
 

A range of services, including 

60 60

50 50

40 40

30 30

counseling, therapies, and medica- 20 20 

tions, can help children with emo- 10 10 

tional, behavioral, or developmental 

conditions. However, not all children 

who have these conditions receive 

treatment for them. Overall, of children with one or more emotional, 

behavioral, or developmental conditions, 45.6 percent received treatment or counseling from a mental 

health professional. This percentage 

was higher for children with more 

than one condition, but even among 

children with three or more conditions, more than one quarter (28.5 

percent) did not receive any mental 

health services. 

Medications can be particularly 

helpful in stabilizing emotions, improving concentration, and regulating behavior in children with emotional, behavioral, or developmental 

conditions. A substantial percentage 

of children with these conditions 

took medications for their conditions 

in the past year, with percentages 

ranging from 41.1 percent of children 

with one condition to 77.6 percent of 

children with three or more conditions. 

One or more One Two Three or more One or more One Two Three or more 

conditions condition conditions conditions conditions condition conditions conditions 

The Mental and Emotional Well-Being of Children > Use of Mental Health Services 

16 
The National Survey of Children’s Health
 

Health Insurance 

Coverage
 

Overall, children with emotional, 

behavioral, or developmental conditions are slightly more likely than 

the general population of children 

to have current health insurance. 

However, children with these conditions are more likely than children 

without them to have public insurance, including Medicaid and the 

Children’s Health Insurance Program 

(CHIP). Among children with emotional, behavioral, or developmental 

conditions, 43.7 percent have public 

insurance, compared to 26.2 percent 

of children without these conditions, 

while 49.7 percent had private insurance, compared to 64.0 percent of 

children without these conditions. 

Current Health Insurance Coverage Current Health Insurance Coverage 

Among Children with Emotional, Among Children without Emotional, 

Behavioral, or Developmental Behavioral, or Developmental 

Conditions, by Type of Coverage Conditions, by Type of Coverage 

Uninsured 

6.6% 

Public 

Insurance 

43.7% 

Private 

Insurance 

49.7% 

*Percentages may not add to 100 due to rounding. 

Uninsured 

9.8% 

Public 

Insurance 

26.2% 

Private 

Insurance 

64.0% 

*Percentages may not add to 100 due to rounding. 

The Mental and Emotional Well-Being of Children> Health Insurance Coverage 

17 
The National Survey of Children’s Health
 

Adequacy of Health Insurance Coverage Adequacy of Health Insurance Coverage 

Among Currently Insured Children: Among Currently Insured Children: 

Children with Emotional, Behavioral, Children without Emotional, Behavioral, 

or Developmental Conditions or Developmental Conditions 

Health Insurance 

is not Adequate 

23.8% 

Adequate 

Health Insurance 

76.2% 

Health Insurance

 is not Adequate 

29.4% 

Adequate 

Health Insurance 

70.6% 

Adequacy of Health 

Insurance Coverage
 

Insurance coverage may not always be adequate to meet children’s 

needs. Parents whose children were 

currently insured were asked three 

questions regarding the services and Children Lacking Adequate Health Children Aged 2-17 Years with 

costs associated with their child’s Insurance Coverage, by Number of Emotional, Behavioral, or 

Emotional, Developmental, Developmental Conditions with health insurance. Of insured children 

or Behavioral Conditions Health Insurance Never or Sometimes aged 2-17 years without emotional, 40 Meeting Adequacy Criteria behavioral, or developmental condi- 36.9 

35 Offers Benefits or

29.4 28.7 27.4 

23.8 

21.1 

9.0 

12.0 

5 10 15 20 25 

tions, the parents of 18.8 percent 

reported that the out-of-pocket costs 

were never or sometimes reasonable; 7.0 percent were reported to 

have health insurance that never or 

sometimes offers benefits or covers 

services that meet their needs; and 

4.8 percent were reported to have 

health insurance that never or somePercent of Children with Current Coverage

 Covers Services 

30 that Meet 

Child’s Needs 

25 

Allows Child to 20 See the Health


 Care Providers
 

He/She Needs 15 

10 

Out-of-Pocket

 Costs Are 5 Reasonable 

times allows them to see the health 

care providers they need (data not 

shown). 

Children were considered to have 

adequate health insurance coverage if their parent answered “usually” or “always” to each of the three 

questions. Overall, 29.4 percent of 

children with emotional or behavioral problems lacked adequate 

insurance, compared to 23.8 percent 

of children without these conditions. 

Moreover, the more such conditions 

a child has, the lower the likelihood 

that his or her insurance is adequate. 

Among children with three or more 

No One One Two Three conditions or more condition conditions or more conditions conditions 

emotional, developmental, or behavioral conditions who had insurance, 

36.9 percent did not have adequate 

coverage. 

Of the three criteria for adequacy, 

reasonable costs seem to present the 

most substantial barrier to families of 

children with emotional, behavioral, 

or developmental conditions. Of children with at least one condition, the 

parents of 21.1 percent reported that 

the out-of-pocket costs for their chilPercent of Children with Current Coverage 

dren’s care were never or sometimes 

reasonable; 12.0 percent reported 

that their child’s plan never or sometimes offered benefits and covered 

services that met their child’s needs; 

and 9.0 percent reported that their 

child’s insurance never or sometimes offered access to the providers 

they needed. These figures are not 

mutually exclusive and the parents 

of some children may have reported 

more than one of these problems 

with their child’s coverage. 

The Mental and Emotional Well-Being of Children > Adequacy of Health Insurance Coverage 

18 
The National Survey of Children’s Health
 

Medical Home 

A number of aspects of high-quality health care for children are combined into the concept of the medical 

home. As defined by the American 

Academy of Pediatrics, children’s 

medical care should be accessible, 

family-centered, continuous, comprehensive, coordinated, compassionate, 

and culturally effective. The survey 

included several questions that 

sought to measure whether a child’s 

health care met this standard: 

• Whether the child has at least 

one personal doctor or nurse who 

knows him or her well and a usual 

source of sick care 

• Whether the child has no problems gaining referrals to specialty 

care and access to therapies or 

other services or equipment 

• Whether the family is very satisfied with the level of communication among their child’s doctors 

and other programs 

• Whether the family usually or 

always gets sufficient help coordinating care when needed and receives effective care coordination 

• Whether the child’s doctors usually or always spend enough time 

with the family, listen carefully 

to their concerns, are sensitive to 

their values and customs, provide 

any information they need, and 

make the family feel like a partner 

in their child’s care 

• Whether an interpreter is usually 

or always available when needed. 

A child was defined as having a 

medical home if his or her care is 

reported to meet all of these criteria. 

Among children aged 2-17 years 

without emotional, behavioral, or 

developmental conditions, the care 

of 58.5 percent of children met this 

standard. Of children in the same 

age group with emotional, behavioral, or developmental conditions, 

40.2 percent received care through a 

medical home. For children with one 

condition, this proportion was 44.1 

percent; for children with two conditions, 39.9 percent, and for those 

with three or more conditions, 27.1 

percent. 

0 

10 

20 

30 

40 

50 

Three or 

more 

conditions 

Two 

conditions 

One 

condition 

One or 

more 

conditions 

No 

conditions 

Percent of Children 

58.5 

40.2 

44.1 

39.9 

27.1 

Presence of a Medical Home: Presence of a Medical Home: 

Children Aged 2-17 Years Children Aged 2-17 Years 

with Emotional, Behavioral, without Emotional, Behavioral, 

or Developmental Conditions or Developmental Conditions 

Does Not Have a 

Medical Home 

41.5% 

Has a 

Medical Home 

58.5% 

Does Not Have a 

Medical Home 

59.8% 

Has a 

Medical Home 

40.2% 

Children With a Medical Home, 


by Number of Emotional, 


Developmental, or Behavioral Conditions
 

60 

The Mental and Emotional Well-Being of Children > Medical Home 

19 
 

The National Survey of Children’s Health
 

School and Activities
 Behavioral, emotional, and developmental conditions can hamper children’s ability to succeed in school and to participate 

in activities alongside their peers. This section reviews a number of indicators of children’s activities in and out of school, 

compared to children without emotional, behavioral, or developmental conditions. 

It is important to note that, while the differences between the populations of children with and without these conditions 

may be stark, these differences may not be attributable exclusively to the effects of the conditions. Variation in children’s 

family circumstances, including income and family structure, and community characteristics, such as neighborhood amenities, 

may also contribute to children’s school performance and opportunities for activities outside of school. 

The Mental and Emotional Well-Being of Children 

21 
The National Survey of Children’s Health
 

Repeating a Grade and 

School Engagement 

Overall, 10.6 percent of children 

aged 6-17 years have repeated a 

grade since starting kindergarten 

(data not shown). Among children 

with at least one emotional, behavioral, or developmental condition, 

this proportion is 26.8 percent. 

Of those with one condition, 22.2 

percent had repeated a grade; for 

those with two conditions, 29.7 

percent had repeated a grade; and 

38.2 percent of children with three 

or more conditions had done so (data 

not shown). Among children with no 

emotional, behavioral, or developmental conditions, 8.0 percent had 

repeated a grade. 

Likewise, 80.5 percent of children 

aged 6-17 years are reported by their 

parents to be adequately engaged in 

school, meaning that their parents 

reported that they usually or always 

care about doing well in school and 

do all required homework. Among 

children with at least one emotional, 

behavioral, or developmental condition, this proportion was 54.6 percent. For those with one condition, 

this proportion was 59.7 percent; 

for those with two conditions, 51.1 

percent; and for those with three 

or more conditions, 42.5 percent. 

Among children with no emotional, 

behavioral, or developmental conditions, it was 84.5 percent (data not 

shown). 

Children Aged 6-17 Years with Children Aged 6-17 Years without 

Emotional, Behavioral, or Developmental Emotional, Behavioral, or Developmental 

Conditions Who Have Repeated a Grade Conditions Who Have Repeated a Grade 

No 

92.0% 

Yes 

8.0% 

No 

73.2% 

Yes 

26.8% 

Children Aged 6-17 Years with Children Aged 6-17 Years without 

Emotional, Behavioral, or Developmental Emotional, Behavioral, or Developmental 

Conditions Who Are Engaged in School Conditions Who Are Engaged in School 

No 

15.5% 

Yes 

84.5% 

No 

45.4% 

Yes 

54.6% 

The Mental and Emotional Well-Being of Children > Repeating a Grade and School Engagement 

22 
The National Survey of Children’s Health
 

Children Aged 6-17 Years with 


Social Skills, by Number of 


Emotional, Behavioral, or 


Developmental Conditions
 

100 95.9 

90 85.3 

79.3 80 

73.1
 

70
 67.7 

Social Skills 

Children begin developing positive 

social skills at an early age, a process 

Percent of Children

60 

50 

40 

that will influence their relation- 30 

ships with others throughout their 

lives. Parents of children aged 6-17 

years were asked if their children had 

never, rarely, sometimes, usually, or 

always exhibited each of the following behaviors in the past month: 

showed respect for teachers and 

neighbors; got along well with other 

children; tried to understand other 

people’s feelings; and tried to resolve 

conflict with classmates, family, or 

friends. Overall, 93.6 percent of children aged 6-17 years were reported 

to usually or always exhibit two or 

more of these social skills (data not 

shown). 

Among children with emotional, 

behavioral, or developmental conditions, these social skills can be more 

challenging. Of children with at least 

one of these conditions, 79.3 percent 

usually or always exhibited two or 

more of the four skills. For children 

with one condition, 85.3 percent 

consistently demonstrated positive 

social skills, as did 73.1 percent of 

children with two conditions and 

67.7 percent of children with three 

or more conditions. Among children 

without emotional, developmental, or 

behavioral conditions, 95.9 percent 

consistently demonstrated two of the 

four social skills. 

20 

10 

No One One Two Three 

conditions or more condition conditions or more 

condition conditions 

The Mental and Emotional Well-Being of Children > Social Skills 

23 
The National Survey of Children’s Health
 

Children Aged 6-17 Years with 

Problem Social Behaviors, by Number 

of Emotional, Behavioral, or 

Developmental Conditions 

60 

50 

46.1 

30.5 

26.5 

19.0 

6.1 

Percent of Children

40 

Problem Social 

Behaviors
 

Some children have trouble getting 

30 

20 

along with others. Parents of 6- to 

17-year-olds were asked if their chil- 10 

dren had never, rarely, sometimes, 

usually, or always exhibited each of 

the following behaviors in the past 

month: arguing too much; bullying 

or being cruel or mean to others; 

being disobedient; and being stubborn, sullen, or irritable. Overall, 8.9 

percent of children aged 6-17 years 

were reported to usually or always 

exhibit two or more of these problem 

behaviors (data not shown). 

Among children with emotional, 

behavioral, and developmental conditions, problem social behaviors are 

more common. More than one-quarter (26.5 percent) of children with at 

least one condition usually or always 

exhibit two or more of the four problem behaviors. For children with one 

condition, problem behaviors were 

common in 19.0 percent of children; 

for children with two conditions, 

this proportion was 30.5 percent; 

and among children with three or 

more conditions, it was 46.1 percent. 

Among children without emotional, 

behavioral, or developmental conditions, 6.1 percent consistently exhibit 

these problem behaviors. 

No One One Two Three 

conditions or more condition conditions or more 

condition conditions 

The Mental and Emotional Well-Being of Children > Problem Social Behaviors 

24 
The National Survey of Children’s Health
 

Participation in Activities Outside of Participation in Activities Outside of 

School Among Children Aged 6-17 School Among Children Aged 6-17 

Years with Emotional, Behavioral, Years without Emotional, Behavioral, 

or Developmental Conditions or Developmental Conditions 

No 

18.0% 

Yes 

82.0% 

No 

27.8% 

Yes 

72.2% 

Activities Outside of 

School 

For school-aged children, participation in activities—such as sports 

teams, lessons, Scouts, religious 

groups, or Boys’ or Girls’ Clubs—after 

school or on the weekends can be an 

important part of overall development and can provide enrichment 

and contribute to the development of 

social skills. Parents of children aged 

Participation in Activities Outside of
 

School Among Children Aged 6-17 Years, 


by Number of Emotional, Behavioral, 


or Developmental Conditions
 

100 

90 

82.0 

72.2 75.1 73.6 

60.8 

80 

70 

Percent of Children

60 

50 

40 

30 

6-17 years were asked if their children had participated in any of these 

types of activities in the past year. 

Overall, 80.7 percent of school-aged 

children participated in at least one 

organized activity outside of school 

(data not shown). 

Despite the social and behavioral 

challenges that children with mental health problems face, they were 

nearly as likely as children as a whole 

to participate in activities outside 

of school. A total of 72.2 percent 

of children with at least one emotional, behavioral, or developmental 

condition participated in organized 

activities. While this percentage is 

lower for children with multiple 

conditions, even among children with 

three or more conditions, more than 

half (60.8 percent) participated in 

activities outside of school. Among 

children without emotional, developmental, or behavioral conditions, this 

percentage was 82.0. 

20 

10 

No One One Two Three 

conditions or more condition conditions or more 

condition conditions 

The Mental and Emotional Well-Being of Children > Activities Outside of School 

25 
The National Survey of Children’s Health

The Child’s Family
 Having a child with an emotional, behavioral, or developmental condition can affect the health, stress, and functioning of 

the entire family. This section explores various aspects of family well-being and how they vary in families with a child with an 

emotional, behavioral, or developmental condition. 

The Mental and Emotional Well-Being of Children 

27 
The National Survey of Children’s Health

Parenting Stress 

The demands of parenting can 

cause considerable stress for families. Parents were asked how often 

during the past month they had felt 

that their child was much harder 

to care for than others of his or her 

age; how often the child did things 

that really bothered them a lot; and 

how often they had felt angry with 

the child. Parents were considered to 

often feel stressed if they answered 

“usually” or “always” to at least one 

of these measures: Overall, parents of 

Percent of Children with Emotional, 


Behavioral, or Developmental Conditions 


Whose Parents Report Stress
 

Rarely, 

Sometimes, Usually or Always 

or Never Feel at Least One 

Feel Stress Form of Stress 

69.1% 30.9% 

Percent of Children without Emotional, 


Behavioral, or Developmental Conditions 


Whose Parents Report Stress
 

Usually or Always 

Feel at Least One 

Form of Stress 

8.2% 

Rarely, Sometimes, 

or Never Feel Stress 

91.8% 

Children Whose Parents Usually 


or Always Feel Stress, by
 

Number of Emotional, Behavioral, 


or Developmental Conditions
 

60 

54.0 

50 

40 37.5 

30.9 

30 

21.8 

20 

10.7 percent of children reported often feeling stressed (data not shown). 

For parents of children with emotional, behavioral, or developmental 

conditions, stress was much more 

common. Parents of 30.9 percent of 

children with at least one condition 

Percent of Children 

10 8.2 

reported usually or always feeling at 

least one type of stress. For parents 

of children with one condition, this 

proportion was 21.8 percent; for parents of children with two conditions, 

37.5 percent; and for parents of children with three or more conditions, 

more than half (54.0 percent) usually 

or always felt stress. Among children 

with no emotional, behavioral, or developmental conditions, the parents 

of 8.2 percent usually or always felt 

one of these types of stress. 

No One One Two Three conditions or more condition conditions or more condition conditions 

The Mental and Emotional Well-Being of Children > Parenting Stress 

28 
The National Survey of Children’s Health
 

Children Whose Mothers are in Excellent
 

or Very Good Physical and Mental Health, 


by Number of Emotional, Behavioral, 


or Developmental Conditions
 

100 

90 

80 

73.1 

54.6 

60.6 

51.9 

37.0 

70 

Percent of Children

Parents’ Health Status
 

The health of children is closely 

related to the health of their parents; 

60 

50 

40 

30

the physical and mental health of 20 children and adults are influenced by 

the health of the family as a whole. 

Parents with physical or mental 

health problems may be less able to 

care for their children, and children’s 

health conditions may make it more 

difficult for parents to care for themselves. 

The survey asked about the physical and mental health of parents who 

lived with the child. Overall, the 

mothers of 71.1 percent of children 

reported themselves to be in excel- 80 

lent or very good physical and mental 

health, and the fathers of 76.7 percent of children were in excellent or 

very good physical and mental health 

(data not shown). 

However, the health of parents 20 

and children are interdependent, 10 

as is evident in the health status 

10 

No One One Two Three 

conditions or more condition conditions or more 

condition conditions 

Children Whose Fathers are in Excellent
 

or Very Good Physical and Mental Health, 


by Number of Emotional, Behavioral, 


or Developmental Conditions
 

100 

90 

70 

77.7 

66.8 70.0 

65.7 

55.2

Percent of Children

60 

50 

40 

30 

of parents of children with emotional, behavioral, or developmental 

conditions. Overall, the mothers of 

54.6 percent and the fathers of 66.8 

percent of children with at least one 

condition reported their physical and 

mental health to be excellent or very 

good. This percentage is far lower 

for parents of children with multiple 

conditions: of children with two 

No One 

conditions or more 

condition 

conditions, the mothers of 51.9 percent were in excellent or very good 

health, and of children with three 

or more conditions, the mothers of 

37.0 percent reported their health as 

excellent or very good. The health of 

One Two Three 

condition conditions or more 

conditions 

fathers is somewhat better: of children with two conditions, the fathers 

of 65.7 percent were in excellent or 

very good health, as were the fathers 

of 55.2 percent of children with three 

or more conditions. 

The Mental and Emotional Well-Being of Children > Parents’ Health Status 

29 
The National Survey of Children’s Health

Child Care 

Even in the healthiest of families, 

the availability of child care, and 

the need to make backup child care 

arrangements in emergencies, can 

cause stress. Overall, parents of 59.3 

percent of children aged 2 to 5 years 

reported that their child received 

some form of nonparental child care; 

of children with emotional, behavioral, or developmental problems, 62.5 

percent received care. In addition, 

9.8 percent of children with emotional, behavioral, or developmental 

conditions did not receive child care 

that they needed, compared to 8.4 

percent of children without these 

conditions (data not shown). 

Parents of children aged 2-5 who 

received care from someone other 

than a parent were asked whether 

they had had to make different child 

Percent of Children with Current Coverage

50 47.8 47.3 47.3 

40 

35.2 

30 

20 

10 

care arrangements in the past month 

due to circumstances beyond their 

control and whether anyone in the 

family had had to quit a job, not take 

a job, or greatly change their job because of child care problems within 

the past year. Overall, the parents of 

46.0 percent reported having to make 

last-minute child care arrangements 

in the past month, and the parents of 

10.9 percent reported having to quit, 

not take, or change a job because 

of child care problems (data not 

shown). 

Children Aged 2-5 Years 


Whose Families Experienced 


Child Care Problems
 

One or More 

Child Care 

Issues Reported 

70.2% 

No Child Care 

Issues Reported 

29.8% 

Children Aged 2-5 Years with Emotional, 


Behavioral, or Developmental Conditions 


Whose Families Experienced 


Child Care Problems
 

One or More 


Child Care Issues

Reported 


46.2%
 

No Child Care 

Issues Reported 

53.8% 

Children Aged 2-5 Years Whose Families 

Had to Make Alternative Child Care

Arrangements in the Past Month, by 

Number of Emotional, Developmental, 

or Behavioral Conditions 

60 

52.0 

No One 

conditions or more 

condition 

Parents of children with emotional, 

behavioral, or developmental conditions were especially likely to report 

child care problems. Of children aged 

2-5 with one or two conditions, the 

parents of nearly half reported having to make alternative arrangements 

at least once, and of children with 

three or more conditions, the parOne Two Three 

condition conditions or more 

conditions 

ents of more than half (52.0 percent) 

reported having this problem. The 

parents of nearly one-quarter (23.6 

percent) of children with at least 

one condition had to quit a job, not 

take a job, or greatly change their job 

because of their child care difficulties 

(data not shown). 

The Mental and Emotional Well-Being of Children > Child Care 

30 
The National Survey of Children’s Health

State-Level Data
	

The Mental and Emotional Well-Being of Children 

31 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Alabama AlaskaAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 14.0 9.9

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 18.8 11.6
 Age 12-17 years 14.9
 Age 12-17 years 14.9 14.8 12.5

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 15.9 12.7
 Female 7.9
 Female 7.9 12.1 6.8

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

18.9

 100-199% FPL 13.1 18.2 14.5


 200-399% FPL 10.0
 200-399% FPL 10.0 10.9 7.3
 400% FPL or more 9.5
 400% FPL or more 9.5 11.4 10.7

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 21.3 15.9
 Private 9.0
 Private 9.0 9.1 8.5

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 32.7 42.0
 Who receive coordinated, ongoing, Who receive coordinated, ongoing,  comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 35.4 44.2
 Whose health insurance is adequate Whose health insurance is adequate  to meet their needs 70.6
 to meet their needs 70.6 71.3 67.2 Who received mental health treatment Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6
 46.0 43.1 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

32 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Arizona ArkansasAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 9.8 15.4

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 9.1 18.2
 Age 12-17 years 14.9
 Age 12-17 years 14.9 15.7 16.0

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 13.5 19.3
 Female 7.9
 Female 7.9 6.2 11.4

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL 16.3 29.3
 100-199% FPL 13.1
 100-199% FPL 13.1 11.3 13.5
 200-399% FPL 10.0
 200-399% FPL 10.0 9.2 12.5
 400% FPL or more 9.5
 400% FPL or more 9.5 7.7 8.0

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 18.7 23.3
 Private 9.0
 Private 9.0 8.0 9.8

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 47.8 47.6 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 37.6 49.1 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 70.2 77.8 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 54.4 42.9 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

33 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

California ColoradoAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 9.8 10.0

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 8.2 11.2
 Age 12-17 years 14.9
 Age 12-17 years 14.9 14.1 14.8

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 11.9 11.8
 Female 7.9
 Female 7.9 7.6 8.3

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL † 13.1 100-199% FPL † 13.1 200-399% FPL † 10.0 200-399% FPL 10.0 9.1
 400% FPL or more 9.5
 400% FPL or more 9.5 12.3 11.4

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 13.3 15.3
 Private 9.0
 Private 9.0 8.5 8.6

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 27.2 37.8
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 45.2 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2
 Whose health insurance is adequate 


23.8 

 Whose health insurance is adequate 70.9 


 to meet their needs 70.6
 to meet their needs 70.6
 Who received mental health treatment 


70.8 

 Who received mental health treatment 46.0 

 or counseling in the past year 45.6 45.6 43.3 or counseling in the past year 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

34 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Connecticut DelawareAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 11.1 15.3

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 11.3 17.3
 Age 12-17 years 14.9
 Age 12-17 years 14.9 13.6 18.7

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 13.5 20.0
 Female 7.9
 Female 7.9 8.6 10.5

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL † 13.1 100-199% FPL 13.1 16.0
 200-399% FPL 10.0
 200-399% FPL 10.0 11.3 18.7
 400% FPL or more 9.5
 400% FPL or more 9.5 8.1 11.6

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 17.1 21.4
 Private 9.0
 Private 9.0 9.2 13.0


Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 34.7 46.2 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 38.2 40.6 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 68.2 72.0 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 51.3 55.7 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

35 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

District of Columbia FloridaAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 11.2 11.2

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 11.2 14.8
 Age 12-17 years 14.9
 Age 12-17 years 14.9 16.9 13.2

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 14.3 17.7
 Female 7.9
 Female 7.9 8.2 4.1

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

15.0

 100-199% FPL 13.1 11.3 14.4


 200-399% FPL 10.0
 200-399% FPL 10.0 10.7 11.0
 400% FPL or more 9.5
 400% FPL or more 9.5 9.2 7.8

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 12.4 18.8
 Private 9.0
 Private 9.0 10.4 8.4

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 42.8 56.9 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 32.8 38.8 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 68.9 54.6 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 50.5 40.9 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

36 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Georgia Hawaii All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 9.5 8.1

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 9.2 8.3
 Age 12-17 years 14.9
 Age 12-17 years 14.9 14.1 9.4

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 11.5 9.9
 Female 7.9
 Female 7.9 7.5 6.2

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL † 13.1 100-199% FPL † 13.1 200-399% FPL 10.0 200-399% FPL 10.0 8.5 6.6
 400% FPL or more 9.5
 400% FPL or more 9.5 7.9 5.6

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 12.9 12.5
 Private 9.0
 Private 9.0 7.5 6.9

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 43.9 43.0 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 47.9 46.4 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 80.6 79.2 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 41.1 52.4 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

37 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Idaho IllinoisAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 10.7 9.6

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 13.4 11.8
 Age 12-17 years 14.9
 Age 12-17 years 14.9 11.7 10.0

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 14.1 12.5
 Female 7.9
 Female 7.9 7.2 6.6

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL 13.1 100-199% FPL † 13.1 200-399% FPL 10.0

9.1

 200-399% FPL 10.0 9.7 8.9


 400% FPL or more 9.5
 400% FPL or more 9.5 10.1 8.3

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 25.0 10.5
 Private 9.0
 Private 9.0 6.5 9.6

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 49.0 39.8 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 34.7 37.6 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 71.1 66.0 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 49.2 40.1 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

38 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Indiana IowaAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 13.4 10.6

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 17.1 13.1
 Age 12-17 years 14.9
 Age 12-17 years 14.9 15.0 13.6

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 17.2 12.0
 Female 7.9
 Female 7.9 9.5 9.2

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

22.8

 100-199% FPL † 13.1

 200-399% FPL 10.0

14.8

 200-399% FPL 10.0 11.0 12.8


 400% FPL or more 9.5
 400% FPL or more 9.5 8.8 8.4

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 23.4 17.6
 Private 9.0
 Private 9.0 9.9 8.0

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 49.8 40.5 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 39.3 54.3 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 60.9 68.5 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 46.6 57.6 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

39 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Kansas Kentucky All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 12.2 14.3

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 12.4 13.6
 Age 12-17 years 14.9
 Age 12-17 years 14.9 16.6 20.7

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 13.9 18.3
 Female 7.9
 Female 7.9 10.5 10.1

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL 16.3 26.1 20.4
 100-199% FPL 13.1
 100-199% FPL 13.1 13.5 16.0
 200-399% FPL 10.0
 200-399% FPL 10.0 8.9 13.0
 400% FPL or more 9.5
 400% FPL or more 9.5 9.8 9.8

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 25.2 21.4
 Private 9.0
 Private 9.0 7.8 10.3

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 43.7 43.0 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 34.4 53.2 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 71.2 78.9 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 58.0 39.3 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

40 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Louisiana MaineAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 15.5 14.6

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 16.7 14.2
 Age 12-17 years 14.9
 Age 12-17 years 14.9 19.7 18.9

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 17.8 17.1
 Female 7.9
 Female 7.9 13.2 11.9

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL 16.3 22.6 30.5
 100-199% FPL 13.1
 100-199% FPL 13.1 19.6 19.9
 200-399% FPL 10.0
 200-399% FPL 10.0 11.6 10.3
 400% FPL or more 9.5
 400% FPL or more 9.5 11.9 9.1

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 19.9 27.9
 Private 9.0
 Private 9.0 11.6 8.2

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 42.0 47.1 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 40.9 42.8 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 76.2 75.5 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 35.6 43.8 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

41 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Maryland Massachusetts All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 12.4 14.1

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 8.1 16.5
 Age 12-17 years 14.9
 Age 12-17 years 14.9 20.4 17.3

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 13.6 17.6
 Female 7.9
 Female 7.9 11.3 10.4

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL † 13.1 100-199% FPL † 13.1 200-399% FPL 10.0 200-399% FPL 10.0 9.2 13.0
 400% FPL or more 9.5
 400% FPL or more 9.5 10.6 12.7

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 19.2 25.2
 Private 9.0
 Private 9.0 10.8 11.1

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 36.4 38.5 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 39.8 52.6 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 69.3 82.4 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 49.9 52.9 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

42 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Michigan Minnesota All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 12.3 10.4

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 11.3 11.9
 Age 12-17 years 14.9
 Age 12-17 years 14.9 17.2 13.5

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 13.6 10.7
 Female 7.9
 Female 7.9 11.0 10.1

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

14.0

 100-199% FPL † 13.1

 200-399% FPL 10.0

14.6

 200-399% FPL 10.0 11.3 9.3


 400% FPL or more 9.5
 400% FPL or more 9.5 11.5 11.0

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 18.7 18.6
 Private 9.0
 Private 9.0 10.0 8.9

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 35.9 41.4 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 50.1 49.5 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 75.2 62.2 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 45.3 48.4 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

43 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Mississippi MissouriAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 10.9 12.4

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 15.7 11.8
 Age 12-17 years 14.9
 Age 12-17 years 14.9 12.6 18.0

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 15.2 16.2
 Female 7.9
 Female 7.9 6.4 8.4

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL 16.3 14.6 19.7
 100-199% FPL 13.1
 100-199% FPL 13.1 11.8 14.4
 200-399% FPL 10.0
 200-399% FPL 10.0 10.3 10.5
 400% FPL or more 9.5
 400% FPL or more 9.5 8.3 9.1

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 13.2 20.0
 Private 9.0
 Private 9.0 8.6 8.8

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 36.1 28.2 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 39.6 51.0 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 62.4 74.9 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 34.7 43.4 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

44 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Montana NebraskaAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 11.8 11.1

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 11.6 10.1
 Age 12-17 years 14.9
 Age 12-17 years 14.9 15.5 17.6

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 12.3 13.0
 Female 7.9
 Female 7.9 11.3 9.2

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

26.5

 100-199% FPL † 13.1

 200-399% FPL 10.0

11.2

 200-399% FPL 10.0 7.8 8.4


 400% FPL or more 9.5
 400% FPL or more 9.5 7.8 7.1

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 22.4 28.8
 Private 9.0
 Private 9.0 7.8 5.6

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 50.2 45.8 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 48.2 47.6 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 66.2 81.4 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 55.5 57.6 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

45 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Nevada New HampshireAll All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 8.4 12.6

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 7.4 10.8
 Age 12-17 years 14.9
 Age 12-17 years 14.9 11.9 17.8

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 9.6 15.5
 Female 7.9
 Female 7.9 7.2 9.6

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL † 13.1 100-199% FPL 13.1 16.9
 200-399% FPL 10.0
 200-399% FPL 10.0 8.8 11.7
 400% FPL or more 9.5
 400% FPL or more 9.5 9.1 8.7

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 17.7 29.5
 Private 9.0
 Private 9.0 7.1 8.3

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 37.3 39.0 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 31.5 47.3 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 61.5 71.2 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 28.8 49.0 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

46 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

New Jersey New Mexico All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 10.8 9.1

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 10.8 7.7
 Age 12-17 years 14.9
 Age 12-17 years 14.9 13.7 11.2

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 15.6 10.6
 Female 7.9
 Female 7.9 5.7 7.5

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL † 13.1 100-199% FPL † 13.1 200-399% FPL 10.0 200-399% FPL 10.0 8.5 10.5
 400% FPL or more 9.5
 400% FPL or more 9.5 10.1 7.3

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 16.5 13.4
 Private 9.0
 Private 9.0 9.6 7.6

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 41.5 28.2 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 46.3 35.0 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 69.3 72.5 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 40.6 36.1 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

47 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

New York North CarolinaAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 10.6 16.0

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 11.2 18.3
 Age 12-17 years 14.9
 Age 12-17 years 14.9 13.8 21.5

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 14.8 21.0
 Female 7.9
 Female 7.9 6.1 10.7

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL 16.3 19.3 22.4
 100-199% FPL † 13.1
 100-199% FPL 13.1 16.1
 200-399% FPL 10.0
 200-399% FPL 10.0 10.1 14.0
 400% FPL or more 9.5
 400% FPL or more 9.5 7.3 14.7

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 17.8 23.0
 Private 9.0
 Private 9.0 7.5 13.2

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 38.1 42.4 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 35.6 43.3 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 67.9 71.8 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 42.1 40.5 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

48 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

North Dakota OhioAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 11.4 13.9

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 11.9 12.8
 Age 12-17 years 14.9
 Age 12-17 years 14.9 15.1 20.5

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 13.4 17.9
 Female 7.9
 Female 7.9 9.3 9.9

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL 16.3 31.6
 100-199% FPL 13.1
 100-199% FPL 13.1 13.5 14.8
 200-399% FPL 10.0
 200-399% FPL 10.0 9.5 9.2
 400% FPL or more 9.5
 400% FPL or more 9.5 10.7 6.6

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 20.5 26.7
 Private 9.0
 Private 9.0 9.6 10.2

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 30.3 40.8 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 43.3 59.1 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 72.5 75.2 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 53.7 47.9 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

49 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Oklahoma Oregon All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 13.6 11.9

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 14.5 13.8
 Age 12-17 years 14.9
 Age 12-17 years 14.9 18.0 15.2

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 16.1 14.3
 Female 7.9
 Female 7.9 11.1 9.4

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

20.5

 100-199% FPL 13.1 14.8 13.8


 200-399% FPL 10.0
 200-399% FPL 10.0 11.3 13.7
 400% FPL or more 9.5
 400% FPL or more 9.5 7.5 8.9

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 20.8 19.7
 Private 9.0
 Private 9.0 8.6 9.9

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 47.9 40.5 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 38.1 40.7 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 72.9 68.0 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 38.9 39.5 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

50 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Pennsylvania Rhode Island All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 13.4 13.5

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 16.8 12.2
 Age 12-17 years 14.9
 Age 12-17 years 14.9 15.1 19.8

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 18.0 17.4
 Female 7.9
 Female 7.9 8.8 9.4

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

22.0

 100-199% FPL 13.1 23.6 17.3


 200-399% FPL 10.0
 200-399% FPL 10.0 10.6 14.2
 400% FPL or more 9.5
 400% FPL or more 9.5 7.1 9.5

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 26.8 23.9
 Private 9.0
 Private 9.0 7.2 9.9

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 44.6 45.3 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 38.6 42.8 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 77.4 75.1 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 63.1 54.7 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

51 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

South Carolina South DakotaAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 11.3 10.4

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 13.0 10.1
 Age 12-17 years 14.9
 Age 12-17 years 14.9 14.5 14.1

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 14.8 12.4
 Female 7.9
 Female 7.9 7.6 8.3

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

19.7

 100-199% FPL 13.1 9.5 12.5


 200-399% FPL 10.0
 200-399% FPL 10.0 10.7 9.2
 400% FPL or more 9.5
 400% FPL or more 9.5 7.4 5.6

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 18.4 17.2
 Private 9.0
 Private 9.0 8.0 7.6

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 46.9 37.7 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 47.2 45.1 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 71.9 73.0 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 46.3 49.8 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

52 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Tennessee TexasAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 12.4 8.0

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 13.7 9.8
 Age 12-17 years 14.9
 Age 12-17 years 14.9 15.6 10.2

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 14.4 11.5
 Female 7.9
 Female 7.9 10.4 4.3

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL 16.3 5.8
 100-199% FPL 13.1
 100-199% FPL † 13.1 200-399% FPL 10.0

18.1

 200-399% FPL 10.0 8.8 10.5


 400% FPL or more 9.5
 400% FPL or more 9.5 8.1 7.6

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 21.1 7.2
 Private 9.0
 Private 9.0 7.3 9.2

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 45.5 38.1 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 48.8 32.7 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 76.8 67.7 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 46.8 44.2 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

53 
The National Survey of Children’s Health

The Mental Health of Children: 

A Portrait of States and the Nation 2007

Utah VermontAll statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 8.7 15.1

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 10.5 14.9
 Age 12-17 years 14.9
 Age 12-17 years 14.9 13.0 21.2

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 11.0 19.2
 Female 7.9
 Female 7.9 6.4 11.0

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL 13.1 100-199% FPL 13.1 12.6 17.0
 200-399% FPL 10.0
 200-399% FPL 10.0 8.2 11.9
 400% FPL or more † 9.5
 400% FPL or more 9.5 15.5

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 23.7 19.8
 Private 9.0
 Private 9.0 6.8 12.7

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 41.5 36.7 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 45.8 38.9 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 74.1 72.4 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 49.3 53.3 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

54 
The National Survey of Children’s Health

The Mental Health of Children: 

A Portrait of States and the Nation 2007

Virginia Washington All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 12.4 12.2

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 13.3 12.7
 Age 12-17 years 14.9
 Age 12-17 years 14.9 16.1 15.7

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 16.9 16.1
 Female 7.9
 Female 7.9 7.6 8.2

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL † 16.3 0-99% FPL † 16.3 100-199% FPL † 13.1 100-199% FPL 13.1 13.0
 200-399% FPL 10.0
 200-399% FPL 10.0 12.4 13.7
 400% FPL or more 9.5
 400% FPL or more 9.5 9.5 9.8

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 19.5 15.9
 Private 9.0
 Private 9.0 10.1 10.5

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 43.3 43.1 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 36.1 35.1 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 76.4 63.0 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 47.4 51.5 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

55 
The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

West Virginia Wisconsin All statistics are based on parental reports. All statistics are based on parental reports. 

State % National % State % National % 

Percent of children aged 2-17 years Percent of children aged 2-17 years 
who have one or more emotional, 
 who have one or more emotional, 
behavioral, or developmental conditions* 11.3
 behavioral, or developmental conditions* 11.3 14.3 11.6

Prevalence by Age** Prevalence by Age**

 Age 6-11 years 12.1 Age 6-11 years 12.1 15.3 13.0
 Age 12-17 years 14.9
 Age 12-17 years 14.9 18.9 13.9

Prevalence by Sex Prevalence by Sex

 Male 14.5 Male 14.5 16.4 14.7
 Female 7.9
 Female 7.9 12.1 8.2

Prevalence by Poverty Level Prevalence by Poverty Level

 0-99% FPL 16.3 0-99% FPL † 16.3 100-199% FPL 13.1

26.0

 100-199% FPL † 13.1

 200-399% FPL 10.0

13.2

 200-399% FPL 10.0 11.4 8.9


 400% FPL or more † 9.5
 400% FPL or more 9.5 10.2

Prevalence by Insurance Type Prevalence by Insurance Type

 Public 17.5 Public 17.5 23.5 21.0
 Private 9.0
 Private 9.0 8.0 8.5

Percent of children aged 2-17 years Percent of children aged 2-17 years 
with emotional, behavioral,
 with emotional, behavioral,
or developmental conditions:
 or developmental conditions:

 Who have two or more conditions 40.3 Who have two or more conditions 40.3 49.1 38.1 
 Who receive coordinated, ongoing, 
 Who receive coordinated, ongoing, 
 comprehensive care within a medical home 40.2
 comprehensive care within a medical home 40.2 46.6 31.6 
 Whose health insurance is adequate 
 Whose health insurance is adequate 
 to meet their needs 70.6
 to meet their needs 70.6 81.4 60.0 
 Who received mental health treatment 
 Who received mental health treatment  or counseling in the past year 45.6 or counseling in the past year 45.6 53.1 47.6 

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.
**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision.
 

56 
State % National % 

Percent of children aged 2-17 years who have one or more emotional, behavioral, or developmental conditions* 11.3 

Prevalence by Age**

 Age 6-11 years 12.1 Age 12-17 years 14.9 

Prevalence by Sex

 Male 14.5 Female 7.9 

Prevalence by Poverty Level

0-99% FPL 16.3

 100-199% FPL 13.1 200-399% FPL 10.0

 400% FPL or more 9.5 

Prevalence by Insurance Type

 Public 17.5 Private 9.0 

Percent of children aged 2-17 years with emotional, behavioral,or developmental conditions:

Who have two or more conditions 40.3 Who receive coordinated, ongoing, 

 comprehensive care within a medical home 40.2 

Whose health insurance is adequate 

 to meet their needs 70.6 

Who received mental health treatment 

 or counseling in the past year 45.6

*The seven conditions addressed in the survey were: ADD/ADHD, anxiety, depression, ODD/conduct disorder, autism spectrum disorders, developmental delay, and Tourette Syndrome.**Estimates for children aged 2-5 years do not meet the standard for reliability or precision on the state level and are not reported. †Estimate suppressed as it does not meet the standard for reliability or precision. 

12.312.716.713.411.1

†

15.911.010.222.4

8.8

33.339.169.147.4

The National Survey of Children’s Health

The Mental and Emotional Well-Being of Children: 

A Portrait of States and the Nation 2007

Wyoming All statistics are based on parental reports. 

57 
The National Survey of Children’s Health
 

About the Survey 

The National Survey of Children’s 

Health (NSCH) was fielded using 

the State and Local Area Integrated 

Telephone Survey (SLAITS) mechanism. SLAITS is conducted by the 

National Center for Health Statistics 

(NCHS), Centers for Disease Control 

and Prevention (CDC). It uses the 

same large-scale random-digit-dial 

sampling frame as the CDC’s National 

Immunization Survey.1 

Approximately 2.8 million telephone numbers were randomly 

generated for inclusion in the NSCH. 

After eliminating numbers that were 

determined to be nonresidential or 

nonworking, the remaining numbers 

were called to identify households 

with children less than 18 years 

of age. From each household with 

children, one child was randomly 

selected to be the focus of the interview. 

The respondent was the parent or 

guardian in the household who was 

knowledgeable about the health and 

health care of the randomly selected 

child. For 73.5 percent of the children, the respondent was the mother. 

Respondents for the remaining 

children were fathers (20.5 percent), 

grandparents (4.2 percent), or other 

relatives or guardians (1.8 percent). 

Surveys were conducted in English, Spanish, Mandarin, Cantonese, 

Vietnamese, and Korean. Overall, 5.3 

percent of the interviews were completed in Spanish, and 0.2 percent of 

the interviews were conducted in one 

of the four Asian languages. 

Technical Appendix 

Data Collection 

Data collection began on April 5, 

2007 and ended on July 27, 2008, 

with interviews conducted from 

telephone centers in Chicago, Illinois 

and Las Vegas, Nevada. A computerassisted telephone interviewing system was used to collect the data. A 

total of 91,642 interviews were fully 

or partially completed for the NSCH, 

with 79 percent of the interviews 

completed in 2007. The number of 

completed interviews varied by state, 

ranging from 1,725 in Vermont to 

1,932 in Illinois. 

The interview completion rate, 

which is the proportion of interviews 

completed after a household was 

determined to include a child under 

age 18, was 66.0 percent. The overall 

response rate, which is the product 

of the resolution rate (the proportion of telephone numbers identified 

as residential or nonresidential), 

the screener completion rate (the 

proportion of households successfully screened for children), and the 

interview completion rate, was 51.2 

percent. This rate is based on the 

assumption that telephone numbers that were busy or rang with no 

answer on all attempts were nonresidential. 

Overall response rates ranged 

from 39.4 percent in New Jersey to 

61.9 percent in North Dakota. Several efforts were made to increase 

response rates, including sending 

letters to households in advance to 

introduce the survey, toll-free numbers left on potential respondents’ 

answering machines to allow them 

to call back, and small monetary 

incentives for those households with 

children who initially declined to 

participate. 

Data Analysis 

For producing the populationbased estimates in this report, the 

data records for each interview 

were assigned a sampling weight. 

These weights are based on the 

probability of selection of each 

household telephone number within 

each State, with adjustments that 

compensate for households that 

have multiple telephone numbers, 

for households without telephones, 

and for nonresponse. 

With data from the U.S. Bureau of 

the Census, the weights were also 

adjusted by age, sex, race, ethnicity, household size, and educational 

attainment of the most educated 

household member to provide a 

dataset that was more representative of each State’s population of 

noninstitutionalized children less 

than 18 years of age. Analyses were 

conducted using statistical software 

that accounts for the weights and 

the complex survey design. 

Responses of “don’t know” and 

“refuse to answer” were considered to be missing data. Records 

with missing data on the variables 

of interest were excluded from all 

analyses, with one exception. For 

households with missing data for income or household size, the household income relative to the federal 

poverty level was multiply imputed. 

Racial and ethnic groups are 

mutually exclusive; that is, data 

reported for White, Black, multiracial and children of other races do 

not include Hispanics, who may be 

of any race. 

The Mental and Emotional Well-Being of Children > Appendix A: Technical Appendix 

58 
The National Survey of Children’s Health
 

Accuracy of the Results 

The data from the NSCH are 

subject to the usual variability associated with sample surveys. Small 

differences between survey estimates 

may be due to random survey error 

and not to true differences among 

children or across States. 

The precision of the survey 

estimates is based on the sample 

size and the measure of interest. 

Estimates at the national level will 

be more precise than estimates at 

the State level. Estimates for all 

children will be more precise than 

estimates for subgroups of children 

(for example, children 0-5 years of 

age or children with the same race). 

For national estimates of the health 

and health care for all children, the 

maximum margin of error is 0.8 

percentage points. For the State-level 

indicators for all children, the maximum margin of error is 4.5 percentage points. 

Availability of the Data 

Except for data suppressed to protect the confidentiality of the survey 

subjects, all data collected in the 

NSCH are available to the public on 

the NCHS and MCHB websites. Data 

documentation and additional details 

on the methodology2 are available 

from the National Center for Health 

Statistics (www.cdc.gov/nchs/slaits. 

htm). 

Interactive data queries are possible through the Data Resource 

Center for the NSCH (www.childhealthdata.org). The Data Resource 

Center provides immediate access to 

the survey data, as well as resources 

and assistance for interpreting and 

reporting findings. 

1. Zell ER, Ezzati-Rice TM, Battaglia MP, Wright RA. National immunization survey: The methodology of a vaccination surveillance system. 

Public Health Reports 115:65-77. 2000. 

2. Blumberg SJ, Foster EB, Frasier AM, et al. Design and Operation of the National Survey of Children’s Health, 2007. National Center for Health 

Statistics. Vital Health Stat 1. 2009. 

The Mental and Emotional Well-Being of Children > Appendix A: Technical Appendix 

59 
The National Survey of Children’s Health
 

Appendix B: Survey Questions on the Presence of Conditions
	

Below are the questions asked 

in the National Survey of Children’s 

Health to determine whether children who were at least 2 years old 

had been diagnosed with, and currently have, any of seven emotional, 

behavioral, or developmental conditions. These questions only represent a small portion of the survey. 

For all of the questions listed here, 

respondents could answer “yes,” “no,” 

or “I don’t know,” or they could refuse 

to answer. If the respondent did not 

understand the question, the surveyor read the text presented in italics. 

Now I am going to read you a list 

of conditions. For each condition, 

please tell me if a doctor or other 

health care provider ever told you 

that [your child] had the condition, 

even if (he/she) does not have the 

condition now. 

Has a doctor or other health 

care provider ever told you that 

[your child] had... 

K2Q31A Attention Deficit Disorder 

or Attention Deficit Hyperactivity 

Disorder, that is, ADD or ADHD? 

A child with Attention Deficit Disorder or 

Attention Deficit Hyperactivity Disorder 

has problems paying attention or sitting 

still. It may cause the child to be easily 

distracted. 

[if yes] Does [your child] 

currently have ADD or ADHD? 

K2Q32A Depression? 

Depression is an illness that involves the 

body, mood, and thoughts. It is marked 

by persistent sadness or an anxious or 

empty mood. It affects how a person 

feels, and the way a person eats, sleeps, 

and functions. 

[if yes] Does [your child] 

currently have depression? 

K2Q33A Anxiety problems? 

Anxiety is a feeling of constant worrying. 

Children with severe anxiety problems 

may be diagnosed as having anxiety 

disorders. Anxiety disorders include 

panic disorder, obsessive-compulsive 

disorder, post-traumatic stress disorder, 

and phobias. 

[if yes] Does [your child] 

currently have anxiety 

problems? 

K2Q34A Behavioral or conduct problems, such as oppositional defiant 

disorder or conduct disorder? 

Oppositional defiant disorder is an 

ongoing pattern of defiant and hostile 

behavior that interferes with a child’s life 

and daily activities. 

[if yes] Does [your child] 

currently have behavioral or 

 conduct problems? 

K2Q35A Autism, Asperger’s Disorder, 

pervasive developmental disorder, or 

other autism spectrum disorder? 

Children with autism have delays in 

language, communication, and social 

skills. Children with Asperger’s disorder 

have impaired social skills but do not 

have speech or language delays. They 

often have an intense interest in a single 

subject or topic. Children with pervasive 

developmental disorder have severe and 

persistent delays in language, communication, and social skills. 

[if yes] Does [your child] 

currently have Autism or ASD? 

K2Q36A Any developmental delay 

that affects (his/her) ability to learn? 

A child with a developmental delay does 

not achieve certain skills as quickly other 

children of the same age. A developmental delay is a major delay in motor, 

language, social, or thinking skills. 

[if yes] Does [your child] 

 currently have developmental 

delay problems? 

K2Q38A Tourette Syndrome? 

Tourette Syndrome is a disorder that 

causes frequent sudden movements or 

sounds. 

[if yes] Does [your child] 

currently have Tourette 

Syndrome? 

The Mental and Emotional Well-Being of Children > Appendix B: Survey Questions 

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