Prevalence and Trends of Developmental Disabilities among Children in the United States: 2009–2017
Abstract
OBJECTIVES: To study the national prevalence of 10 developmental disabilities in US children aged 3 to 17 years and explore changes over time by associated demographic and socioeconomic characteristics, using the National Health Interview Survey. METHODS: Data come from the 2009 to 2017 National Health Interview Survey, a nationally representative survey of the civilian noninstitutionalized population. Parents reported physician or other health care professional diagnoses of attention-deficit/hyperactivity disorder; autism spectrum disorder; blindness; cerebral palsy; moderate to profound hearing loss; learning disability; intellectual disability; seizures; stuttering or stammering; and other developmental delays. Weighted percentages for each of the selected developmental disabilities and any developmental disability were calculated and stratified by demographic and socioeconomic characteristics. RESULTS: From 2009 to 2011 and 2015 to 2017, there were overall significant increases in the prevalence of any developmental disability (16.2%–17.8%, P < .001), attention-deficit/hyperactivity disorder (8.5%–9.5%, P < .01), autism spectrum disorder (1.1%–2.5%, P < .001), and intellectual disability (0.9%–1.2%, P < .05), but a significant decrease for any other developmental delay (4.7%–4.1%, P < .05). The prevalence of any developmental disability increased among boys, older children, non-Hispanic white and Hispanic children, children with private insurance only, children with birth weight ≥2500 g, and children living in urban areas and with less-educated mothers. CONCLUSIONS: The prevalence of developmental disability among US children aged 3 to 17 years increased between 2009 and 2017. Changes by demographic and socioeconomic subgroups may be related to improvements in awareness and access to health care.
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Developmental delays and disabilities are common in children, affecting up to 18% of children aged 3 to 17 years in the United States.
“Developmental delays and disabilities are common in children, affecting up to 18% of children aged 3 to 17 years in the United States, according to recent national estimates.1”
From Early Childhood Care Coordination Through 211: A Randomized Clinical Trial (2024) · cites this paper as [1]
In a large US parent report survey of 88,530 children aged 3-17, the rate of any neurodevelopmental condition was 12.6% in females and 22.7% in males.
“In a large US parent report survey in 88,530 children aged 3–17 years, the rate of any neurodevelopmental condition, including ADHD, autism, speech fluency disorder (stuttering), learning disorders, intellectual disabilities or any other developmental delay was 12.6% in females and 22.7% in males12.”
From Sex and gender in neurodevelopmental conditions (2023) · cites this paper as [12]
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“…identified with disabilities in the ECLS-K: 2011 versus the ECLS-K: 1998, particularly during the earlier grades, is consistent with other work (Zablotsky et al., 2019) reporting increasing developmental disability prevalence possibly resulting from greater disability awareness, screening, and…”
ResultDrug development for Autism Spectrum Disorder (ASD): Progress, challenges, and future directions
McCracken, J. T., Anagnostou, E. A., Arango, C., Dawson, G., Farchione, T. R., Mantua, V., McPartland, J. C., Murphy, D., Pandina, G., & Veenstra-VanderWeele, J. M. (2021) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2021.05.010 · Cited by 87 · see citing works
“5% prevalence in children) (Baio et al., 2018; Christensen et al., 2019; Delobel-Ayoub et al., 2020; Guthrie et al., 2019; Maher et al., 2019; Zablotsky et al., 2019) syndrome of childhood-onset delays and deviations in social communication and interaction, narrowed and unusual interests, repetitive behaviors, and sen…”
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Prevalence of neurodevelopmental disorders among US children and adolescents in 2019 and 2020
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“93% of children were diagnosed with an NDD [1].”
BackgroundWang, T., Kim, C. N., Bakken, T. E., Gillentine, M. A., Henning, B., Mao, Y., Gilissen, C., Nowakowski, T. J., Eichler, E. E., Acampado, J., et al. (2022) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2203491119 · Cited by 72 · see citing works
Prevalence and Trends in Pediatric-Onset Chronic Conditions in the United States, 1999-2018
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Identification of Neuropsychiatric Copy Number Variants in a Health Care System Population
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“(Zablotsky et al., 2019).”
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Racial disparities in developmental delay diagnosis and services received in early childhood
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Association of Antipsychotic Drug Exposure in Pregnancy With Risk of Neurodevelopmental Disorders
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Sex Differences in Neurodevelopmental Disorders: A Key Role for the Immune System
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Diversity and consequences of structural variation in the human genome
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A Roadmap for US Robotics – From Internet to Robotics 2020 Edition
Christensen, H. I., Amato, N. M., Yanco, H. A., Matarić, M. J., Choset, H., Drobnis, A. W., Goldberg, K. Y., Grizzle, J. W., Hager, G. D., Hollerbach, J. M., et al. (2021) · Foundations and Trends in Robotics · doi:10.1561/2300000066 · Cited by 58 · see citing works
Carter, M. T., Srour, M., Au, P. Y. B., Buhaş, D., Dyack, S., Eaton, A. J., Inbar‐Feigenberg, M., Howley, H. E. A., Kawamura, A. A., Lewis, M. E. S., et al. (2023) · Journal of Medical Genetics · doi:10.1136/jmg-2022-108962 · Cited by 58 · see citing works
Knowns and unknowns about the neurobiology of stuttering
Neef, N. E., & Chang, S. (2024) · PLoS Biology · doi:10.1371/journal.pbio.3002492 · Cited by 58 · see citing works
Gregory, R. (2021) · Educational Research and Reviews · doi:10.5897/err2021.4128 · Cited by 55 · see citing works
“Current estimates indicate that 35 million Americans have a learning disability (LD), and dyslexia is by far the most diagnosed among all LDs (Zablotsky et al., 2019).”
BackgroundCasseus, M., Kim, W. J., & Horton, D. B. (2023) · Autism Research · doi:10.1002/aur.2894 · Cited by 53 · see citing works
“Additionally, there is a high level of consistency between results of the NSCH and other nationally representative surveys in estimating developmental disabilities including ASD (Kogan et al., 2018; Zablotsky et al., 2019).”
ResultLiu, L., Jiao, J., Yang, X., Zhang, J., Yu, H., Li, C., Pan, L., Ma, B., Sun, H., Zhang, J., et al. (2023) · Ophthalmology · doi:10.1016/j.ophtha.2023.02.002 · Cited by 53 · see citing works
Payne-Sturges, D., Taiwo, T. K., Ellickson, K. M., Mullen, H., Tchangalova, N., Anderko, L., Chen, A., & Swanson, M. (2023) · Environmental Health Perspectives · doi:10.1289/ehp11750 · Cited by 56 · see citing works
Ahn, Y., Sabouny, R., Villa, B. R., Yee, N. C., Mychasiuk, R., Uddin, G. M., Rho, J. M., & Shutt, T. E. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21093266 · Cited by 52 · see citing works
“5% prevalence of autism spectrum disorder (ASD) in the United States [5].”
BackgroundInfluentialPrimary Care Framework to Monitor Preterm Infants for Neurodevelopmental Outcomes in Early Childhood
Davis, B. E., Leppert, M. L. O., German, K. R., Lehmann, C. U., Adams-Chapman, I. S., Noritz, G. H., Agrawal, R., Foster, J. E. A., Fremion, E., Frierson, S. L., et al. (2023) · PEDIATRICS · doi:10.1542/peds.2023-062511 · Cited by 51 · see citing works
Goodman, C. V., Green, R. R., DaCosta, A., Flora, D. B., Lanphear, B. P., & Till, C. (2023) · Environmental Health · doi:10.1186/s12940-023-01029-z · Cited by 52 · see citing works
“Included in the analysis were studies that [1] evaluated general, verbal, and/or nonverbal IQ and [2] reported the interaction by sex (i.e., interaction coefficient/ p -value) or effects separately by sex.”
BackgroundAssociations of Metals and Neurodevelopment: a Review of Recent Evidence on Susceptibility Factors
Bauer, J. A., Fruh, V., Howe, C. G., White, R. F., & Henn, B. C. (2020) · Current Epidemiology Reports · doi:10.1007/s40471-020-00249-y · Cited by 50 · see citing works
“Finally, a cross-sectional study of 6– 9-year-old Spanish children reported an inverse association between total urinary As and measures of attention [71]. Possible sex differences were examined, but none was observed. Other Behavioral Outcomes While limited, there is also some evidence that As may adversely impact no…”
InfluentialVariability in Cerebral Palsy Diagnosis
Aravamuthan, B. R., Fehlings, D. L., Shetty, S., Fahey, M. C., Gilbert, L. A., Tilton, A. H., & Kruer, M. C. (2021) · PEDIATRICS · doi:10.1542/peds.2020-010066 · Cited by 50 · see citing works
Worldwide national intervention of developmental screening programs in infant and early childhood
Kim, S. (2021) · Korean Journal of Pediatrics · doi:10.3345/cep.2021.00248 · Cited by 48 · see citing works
Environmental Toxicants and the Developing Brain
Wylie, A. C., & Short, S. J. (2023) · Biological Psychiatry · doi:10.1016/j.biopsych.2023.01.007 · Cited by 48 · see citing works
“autism (32), are related to increasing environmental toxicant exposures (33).”
BackgroundTsamantioti, E., Lisonkova, S., Muraca, G. M., Örtqvist, A. K., & Razaz, N. (2022) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2022.03.028 · Cited by 47 · see citing works
Yu, J. A., Bayer, N. D., Beach, S. R., Kuo, D. Z., & Houtrow, A. J. (2022) · Academic Pediatrics · doi:10.1016/j.acap.2022.08.004 · Cited by 46 · see citing works
Using technology in special education: current practices and trends
Adewoyin, O., Akçayır, G., Ishola, O. M., & Epp, C. D. (2020) · Educational Technology Research and Development · doi:10.1007/s11423-020-09795-0 · Cited by 46 · see citing works
“The prevalence of cognitive and developmental disabilities has steadily increased over time (Boat and Wu 2015; Marquis et al. 2018; Zablotsky et al. 2019).”
BackgroundLinks Between Child and Adolescent Psychiatric Disorders and Cardiovascular Risk
Goldstein, B. I., & Korczak, D. J. (2020) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2020.06.023 · Cited by 46 · see citing works
Exercise Intervention in Treatment of Neuropsychological Diseases: A Review
Chen, Z., Lan, W., Yang, G., Li, Y., Xiang, J., Chen, L., Zhou, Y. N., & Li, S. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.569206 · Cited by 48 · see citing works
Inclusive practice for students with neurodevelopmental disorders in Sweden
Bölte, S., Leifler, E., Berggren, S., & Borg, A. (2021) · Scandinavian Journal of Child and Adolescent Psychiatry and Psychology · doi:10.21307/sjcapp-2021-002 · Cited by 45 · see citing works
Deep phenotyping in 3q29 deletion syndrome: recommendations for clinical care
Russo, R. S., Gambello, M. J., Murphy, M. M., Aberizk, K., Black, E., Burrell, T. L., Carlock, G., Cubells, J. F., Epstein, M. T., España, R., et al. (2021) · Genetics in Medicine · doi:10.1038/s41436-020-01053-1 · Cited by 45 · see citing works
Three decades of ASD genetics: building a foundation for neurobiological understanding and treatment
Eyring, K. W., & Geschwind, D. H. (2021) · Human Molecular Genetics · doi:10.1093/hmg/ddab176 · Cited by 41 · see citing works
“A national survey of US children, conducted between 2009 and 2017, estimated the prevalence of neurodevelopmental disorders (NDDs) at about 1 in 6, or 16% (1).”
BackgroundIqbal, M. A., Broeckel, U., Levy, B., Skinner, S. A., Sahajpal, N., Rodriguez, V., Stence, A. A., Awayda, K. M., Scharer, G. H., Skinner, C. D., et al. (2023) · Journal of Molecular Diagnostics · doi:10.1016/j.jmoldx.2022.12.005 · Cited by 45 · see citing works
Chua, J. Y. X., & Shorey, S. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-04893-1 · Cited by 44 · see citing works
Jarema, K. A., Hunter, D. L., Hill, B. N., Olin, J. K., Britton, K. N., Waalkes, M., & Padilla, S. (2022) · Toxics · doi:10.3390/toxics10050256 · Cited by 45 · see citing works
“The incidence of neurodevelopmental deficits in children is steadily increasing (reviewed in [1,2]), accompanied by warnings from many scientific fronts regarding the possible adverse effects of environmental chemicals on nervous system development [3–5].”
BackgroundDisruption of MeCP2–TCF20 complex underlies distinct neurodevelopmental disorders
Zhou, J., Hamdan, H., Yalamanchili, H. K., Pang, K., Pohodich, A. E., Lopez, J., Shao, Y., Osés-Prieto, J. A., Li, L., Kim, W., et al. (2022) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2119078119 · Cited by 43 · see citing works
Important Considerations for COVID-19 Vaccination of Children With Developmental Disabilities
Tinker, S. C., Cogswell, M. E., Peacock, G., & Ryerson, A. B. (2021) · PEDIATRICS · doi:10.1542/peds.2021-053190 · Cited by 42 · see citing works
“In 2015–2017, 1 in 6 children aged 3 to 17 years had a developmental disability (DD) such as cerebral palsy, autism spectrum disorder (ASD), or intellectual disability (ID).(1) DDs are a diverse group of chronic conditions that begin in childhood and can impact functioning throughout life.”
BackgroundMatias, S. L., Pearl, M., Lyall, K., Croen, L., Kral, T. V. E., Fallin, M. D., Lee, L., Bradley, C., Schieve, L. A., & Windham, G. C. (2021) · Obesity · doi:10.1002/oby.23228 · Cited by 42 · see citing works
“Children with (1) a previous ASD diagnosis, (2) an SCQ score ≥11, and/or (3) ASD symptoms noted by a SEED research clinician during the general developmental assessment were administered a full ASD developmental evaluation.”
BackgroundInfluentialSelf-citationMárquez-Caraveo, M. E., Rodríguez‐Valentín, R., Pérez-Barrón, V., Vázquez‐Salas, R. A., Sánchez‐Ferrer, J. C., de Castro, F., Allen‐Leigh, B., & Lazcano-Ponce, E. C. (2021) · Scientific Reports · doi:10.1038/s41598-021-97551-6 · Cited by 42 · see citing works
Minor sex trafficking of girls with disabilities
Franchino-Olsen, H., Silverstein, H. A., Kahn, N. F., & Martin, S. L. (2020) · International Journal of Human Rights in Healthcare · doi:10.1108/ijhrh-07-2019-0055 · Cited by 41 · see citing works
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“…and Disability Trends over Time Developmental disabilities affect 1 in 6 children in the United States, and the rate has increased over time (Zablotsky et al. 2019); these conditions include learning disabilities, sensory deficits, developmental delays, cerebral palsy, autism, and attention…”
BackgroundInfluentialKildal, E. S.-M., Stadskleiv, K., Boysen, E. S., Øderud, T., Dahl, I.-L., Seeberg, T. M., Guldal, S., Strisland, F., Morland, C., & Hassel, B. (2021) · Scientific Reports · doi:10.1038/s41598-021-86023-6 · Cited by 40 · see citing works
Makary, M. A., & Prasad, V. (2025) · JAMA · doi:10.1001/jama.2025.10116 · Cited by 40 · see citing works
Nguyen, U. T.-H., Tinsley, B., Sen, Y., Stein, J., Palacios, Y., Ceballos, A., Welch, C. J., Nzenkue, K., Penn, A., Murphy, L., et al. (2020) · NeuroToxicology · doi:10.1016/j.neuro.2020.12.007 · Cited by 40 · see citing works
“These studies can be followed by analysis of NDDassociated neuronal phenotypes through examination of the simple neural structures of fruit flies.”
BackgroundInfluentialJeanne, M., Demory, H., Moutal, A., Vuillaume, M., Blesson, S., Thépault, R., Marouillat, S., Halewa, J., Maas, S. M., Motazacker, M. M., et al. (2021) · The American Journal of Human Genetics · doi:10.1016/j.ajhg.2021.04.004 · Cited by 34 · see citing works
“Intellectual disabilities (IDs) define a group of frequently associated neurodevelopmental disorders (NDDs), which affect at least 1% of the general population and consequently represent a major public health issue.(1) NDDs are”
BackgroundThe effects of the exposure to neurotoxic elements on Italian schoolchildren behavior
Renzetti, S., Cagna, G., Calza, S., Conversano, M., Fedrighi, C., Forte, G., Giorgino, A., Guazzetti, S., Majorani, C., Oppini, M., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-88969-z · Cited by 39 · see citing works
Nielsen, T. C., Nassar, N., Boulton, K., Guastella, A. J., & Lain, S. J. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05887-3 · Cited by 39 · see citing works
“…et al., 2021), the second reported a prevalence of 1.9% of 8 year old children based on abstraction of medical, education, and service records (Maenner et al., 2020), and the third reported a prevalence of 2.5% of children aged 3 to 17 based on a survey of parents (Zablotsky et al., 2019).”
BackgroundResultInfluentialModern Assessments of Intelligence Must Be Fair and Equitable
Holden, L. R., & Tanenbaum, G. J. (2023) · Journal of Intelligence · doi:10.3390/jintelligence11060126 · Cited by 39 · see citing works
Social cognition in autism and ADHD
Bölte, S. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106022 · Cited by 46 · see citing works
“A population-based survey from the USA estimated the prevalence of neurodevelopmental conditions at 17.8 % (Zablotsky et al., 2019).”
InfluentialThe cost-effectiveness of whole genome sequencing in neurodevelopmental disorders
Runheim, H., Pettersson, M., Hammarsjö, A., Nordgren, A., Henriksson, M., Lindstrand, A., Levin, L., & Soller, M. (2023) · Scientific Reports · doi:10.1038/s41598-023-33787-8 · Cited by 39 · see citing works
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Computational Decision Support System for ADHD Identification
Silva, S. D., Dayarathna, S., Ariyarathne, G., Meedeniya, D., Jayarathna, S., & Michalek, A. M. P. (2020) · Machine Intelligence Research · doi:10.1007/s11633-020-1252-1 · Cited by 38 · see citing works
Pierson, L. M., Thompson, J., Ganz, J. B., Wattanawongwan, S., Haas, A., & Yllades, V. A. (2020) · American Journal of Speech-Language Pathology · doi:10.1044/2020_ajslp-20-00037 · Cited by 39 · see citing works
A transdiagnostic approach to neurodiversity in a representative population sample: The N+ 4 model
Apperly, I. A., Lee, R., van der Kleij, S. W., & Devine, R. T. (2024) · JCPP Advances · doi:10.1002/jcv2.12219 · Cited by 37 · see citing works
“Our selection of 7 broader phenotype measures corresponded to some of the most frequent neuro-developmental conditions (e.g. as identified by Cleaton & Kirby, 2018, Zablotsky et al., 2019, Francés et al., 2022, Straub et al., 2022), and 6/ 7 had two or more subscales.”
BackgroundCanals, J., Morales‐Hidalgo, P., Voltas, N., & Hernández‐Martínez, C. (2024) · Autism Research · doi:10.1002/aur.3146 · Cited by 37 · see citing works
“…comprise a group of persistent conditions with an early onset in childhood, commonly addressed within mental health services (Hansen et al., 2018; Zablotsky et al., 2019). attention deficit hyperactivity disorder (ADHD) and autism are among these conditions, which have demonstrated a significant…”
BackgroundFinnigan, K. A. (2024) · Land · doi:10.3390/land13050636 · Cited by 37 · see citing works
Gesù, C. M. D., Matz, L. M., & Buffington, S. A. (2021) · Neuroscience Research · doi:10.1016/j.neures.2021.05.003 · Cited by 46 · see citing works
Massuti, R., Maia, C. R. M., Campani, F., Sônego, M. L., Amaro, J., Akutagava‐Martins, G. C., Tessari, L., Polanczyk, G. V., Cortese, S., & Rohde, L. A. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.06.001 · Cited by 36 · see citing works
- Authors
- Zablotsky, B., Black, L. I., Maenner, M. J., Schieve, L. A., Danielson, M. L., Bitsko, R. H., Blumberg, S. J., Kogan, M. D., & Boyle, C. A.
- Affiliations
- Centers for Disease Control and Prevention (US)
- Health Resources and Services Administration (US)
- Corresponding author
- Zablotsky, Benjamin
- ORCID
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2019-10-01
- Volume
- 144
- Issue
- 4
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC7076808
- OpenAlex
- W2976851556
- Cited by
- 1,217
- References
- 54
- Citations by year
- 2026: 116 · 2025: 189 · 2024: 210 · 2023: 218 · 2022: 218 · 2021: 184 · 2020: 75 · 2019: 4 · 2012: 1
- FWCI
- 111.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (CC999999)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Health Sciences › Health Professions › General Health Professions › Health and Medical Studies
- Keywords
- developmental disabilities, prevalence trends, attention deficit hyperactivity disorder, autism spectrum disorder, intellectual disability, developmental delay, learning disabilities, cerebral palsy, hearing loss, blindness, seizures, stuttering, socioeconomic disparities, demographic disparities, children, United States
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Age Factors, Attention Deficit Disorder with Hyperactivity, Blindness, Cerebral Palsy, Child, Developmental Disabilities, Child, Preschool, Educational Status, Female, Humans, Male, Intellectual Disability, Population Dynamics, Seizures, Sex Factors, Socioeconomic Factors, Stuttering, United States, Prevalence, Insurance Coverage, Hearing Loss
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