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Whitney P. Witt, PhD, MPH; Anne W. Riley, PhD; Mary Jo Coiro, PhD

Arch Pediatr Adolesc Med. 2003;157:687-695.

Background  During the last 30 years, several studies have indicated that children with disabilities are at increased risk for emotional and behavioral morbidity. Population-based studies are needed to understand the relationship between functional status, family stressors, and the psychosocial adjustment of children with disabilities.

Methods  Using data from the 1994 and 1995 National Health Interview Surveys, Disability Supplement, this study examines the associations between children's functional status, family stressors, and the psychosocial adjustment of school-aged children with disabilities.

Results  Regression analyses indicate that children's functional impairments in the areas of communication or learning, poor maternal health and mental health, family burden, and poverty are significantly and positively associated with psychosocial maladjustment among children with disabilities.

Conclusions  Children's functional activity limitations and family stressors are significant correlates of psychosocial adjustment among children with disabilities. These data indicate a need for routine screening for mental health problems among children with disabilities, as well as a family-oriented approach to their medical care.

From the Harvard Pediatric Health Services Research Fellowship Program, Harvard University, School of Medicine, and the Center for Child and Adolescent Health Policy, MassGeneral Hospital for Children, Boston, Mass (Dr Witt); and the Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md (Drs Riley and Coiro). Dr Witt is now with Healthcare Studies, Northwestern University, Chicago, Il.

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