Why Are There So Many Special Needs Children Today?
Why are there so many special needs children today? It's rarely one cause. Diagnostic criteria for autism and related conditions have broadened significantly, screening starts earlier, families have better access to services and insurance coverage, and public health issues like the opioid epidemic have left more children with lasting developmental needs.
Fair question, right? Easy answer? Sort of. Not really, but kind of… biology and medical technology.
What You Don't Expect When You're Expecting
My best friend Lisa and her husband Jeff have been married about 12 years. When they discovered Lisa was pregnant, they were not yet married, but they decided to do what they'd planned all along and tie the knot. What they didn't expect was to have a miscarriage. After numerous miscarriages, Lisa discovered she was pregnant again.
By the time Lisa entered her fifth month of pregnancy, we all started to pray for the safety of both mother and baby during the remainder of the pregnancy. Lisa's doctor began to see signs of concern, so Lisa went on bed rest immediately. Within a day or two, Lisa went into labor.
The delivery was fraught with life-threatening issues for both mother and baby…and then we were blessed with Sweet Baby Boy's arrival. Thankfully, advanced medical technology and skilled medical professionals saved the lives of both Lisa and Sweet Baby Boy.
No Time For the Baby Blues
Upon delivery, the baby was immediately taken to the Neonatal Intensive Care Unit of one of the best hospitals in their state. Known for its international reputation in pediatric medicine, surgery, and research, this hospital has more pediatricians than any other facility in their region. While Lisa remained in the hospital fighting for her own life, this desperately wanted, much-loved child fought for his.
After nearly two weeks in the hospital, Lisa was able to head home, and, of course, she wanted to see her baby there. Making the daily 20-mile trip was physically grueling for her; her mother's heart knew what it needed to beat properly. They could not touch Sweet Baby Boy (who weighed in at just over a single pound and who wore diapers that fit a Beanie Baby). Jeff and Lisa's every waking moment was spent praying for Sweet Baby Boy, wondering about his future, and quite honestly, just getting through each day and celebrating another day with their child.
There was no time for post-partum depression. There was no time to celebrate the end of the school year for these two new parents, both of whom are Teachers. There was only time to be with their baby as often as they could, while taking measures to ensure Lisa recovered.
And Then, Life
As Sweet Baby Boy aged, it was evident there would be deficits in certain areas. Non-verbal. A diagnosis of Autism. A diagnosis of Cerebral Palsy. The need for a head shunt. Higher susceptibility to viruses. The need for a variety of therapies. The evident need for life-long care and provision. Fortunately, Lisa had, and has, amazing insurance, and they live in a state that requires insurance companies to cover the cost of Applied Behavior Analysis therapies. For families whose insurance does not cover the cost of services, the expense can be life-altering, reaching $45,000 or more per year.
Birth Rates
According to CDC research covering 2009 to 2017, developmental disabilities among children ages three to seventeen affected 16.93% overall across that period, rising from 16.2% in 2009-2011 to 17.8% in 2015-2017. According to the American Academy of Pediatrics, rates have increased by 16% in the past decade, with an apparent increase among families considered to be of higher socioeconomic status. Separately, there was a notable increase in rates of neurological developmental disabilities, doubling from nineteen cases in one thousand to thirty-six cases in one thousand over a ten-year span. The same research suggested that while typically, children who are of a low socio-economic status have a higher rate of incidence for disabilities, the rate of increase among other groups is also noteworthy.
Why the increase? Rising identification of Autism Spectrum Disorders reflects several factors working together: greater public awareness, more routine screening, better access to evaluation, and changes in diagnostic practice over time. Research comparing the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders against its predecessor has generally found similar or lower prevalence estimates under the newer criteria, so the increase in diagnoses can't simply be attributed to a broader definition. It's likely a mix of better detection and other factors researchers are still untangling.
The World Health Organization has reported treatment gaps of roughly 35-50% for people with severe mental disorders in high-income countries and 76-85% in low- and middle-income countries who received no treatment in the year prior to the study.
Marshall
Consider this situation from my own family: Marshall is 9 years old. He has a genetic predisposition to mental illness on both his mother's side as well as his father's side. On one side, the immediate generation manifests diagnosed Narcissism and Bi-Polar Disorder. On the other side of the genetic pool, there is also Bi-Polar Disorder, pathological behaviors (lying, etc.) which are chronic, and a few other proverbial items in the bag on both sides of the gene pool.
Marshall has also endured trauma at the hands of a human outside of the family, which Marshall's mother knew of and acknowledges she allowed to happen.
Marshall was finally placed in a healthy, loving situation with a family member who is not only a Special Education Teacher but is also a staunch advocate for all people with (and without) disabilities. The family member understands the "system" well enough to get as much as possible out of it. The person has called themselves a "Pit Bull and Lion for those who cannot do it for themselves."
Fortunately for Marshall, this person came along and lined up appropriate medical and psychiatric services, and got the ball rolling with the school to get the Individualized Education Plan in place... Oh, and gives the kid a crap-ton of love and care.
I promise you, Marshall isn't an anomaly. In my tenure as a Special Education Teacher, I found that situations like Marshall's are becoming the norm, and I've watched false assumptions about what special needs students can't do follow kids into the classroom long before anyone gives them a fair shot.
If mentally unwell people can't or don't seek services, is it because they are choosing not to, or is it because they are not only physically or emotionally disabled, but also financially disabled?
I have seen with my own brown eyeballs how difficult and expensive it can be to obtain an appropriate diagnosis for a child and then find an effective medication. Then, once the person is on an appropriate medication, insurance companies will often stop paying for that med or tell patients they must switch to a different medication, often without warning. This creates a whole new level of havoc as patients and families scramble without enough notification to step down from the original and still-working medication. This is objectively wrong.
Why is it that, in the low-income countries WHO studied, 51%-53% of people with disabilities reported being unable to afford needed health care, compared with 32%-33% of people without disabilities? Even with insurance, service prices are beyond what most of us can afford, and they almost always involve the phone-call shuffle between the doctors' billing offices and the insurance company. Sometimes it just seems easier to forego treatment.
Mama Doesn't Care Enough To Stop
Before anyone starts sending me nastygrams, hear this: we have a documented drug and alcohol epidemic in this country of ours, and anyone who disputes that has lived under a rock for the last five years. In 2012, more than 21,732 babies were born with Neonatal Abstinence Syndrome. NAS is the group of issues that can occur when a baby is physically dependent on opioids and experiences withdrawal after birth, because the mother used opioids, prescribed or otherwise, during pregnancy.
In a longitudinal study performed over 10 years gathering data on post-Opioid babies, issues which manifested in children as they aged included anxiety, behavioral and emotional issues, vision issues, issues with assault, speech/language delays, small head circumference, balance issues, hyperactivity, decreased attentiveness, intellectual disabilities. I will note that the presenters in this resource were careful to point out that Early On programs and other early interventions were key components of positive development for children in this situation.
According to the National Institute on Drug Abuse, mothers using/addicted to Opiates had babies who stayed in the hospital approximately sixteen days compared to the average stay of two days for a baby born healthy. State Medicaid programs pick up more than 80% of the $1.5 billion annual cost of caring for these babies.
The Talk Show
Social pragmatics…look, Ma! I'm using my first Master's degree! I'm excited to dust off my discourse about discourse.
Earlier today, I was chatting with my Really Smart Friend Kelly about a related issue. She reminded me that getting what we need is all about knowing what to say, how to say it, and to whom it should be said.
Parents who can articulate themselves clearly and communicate effectively with others have a significantly better opportunity for success when having conversations with professionals about their child's needs, or perceived needs. Crassly stated, doctors are busy and if you don't speak up, they're not going to give a crap. I'll backpedal a bit. They may care, but the busyness of their day won't be slowed unless a parent speaks up and speaks succinctly and clearly about what is going on with their child.
Back To the Question…
But have we figured out the WHY?
Have we only figured out a small part of what happens when governments, agencies, families, and individuals are left to navigate the murky waters of systems inundated with a record number of claimants and service recipients?
So WHY is there a seemingly higher rate of people with special needs and disabilities in 2018? Is it all in our heads, so to speak? Based on some easily accessible information, this hypothesis seems to be true… There is strong evidence pointing to all of the following:
- More advanced medical technologies that make early diagnosis more feasible
- A more widely understood definition of Autism Spectrum Disorders
- People are more savvy and able to better articulate and advocate for their loved ones
- Over-identification of children is an issue
Now What?
As a Special Education Teacher, my natural tendency is to see things through the lens of someone who prefers to educate children with a bent toward "What Works For This Child?"
Any teacher worth their salt knows that a room of 20 students brings 20 different sets of prior knowledge, needs, strengths, and barriers to learning, and effective teachers adapt instruction accordingly rather than teaching to one imagined average student. My other point of reference is that, during the era of Grunge Rock, when my career in Education began, the classrooms I served had fewer children. The Offices of Special Education Services were less busy because fewer children were placed in Special Education classes, but that's just my personal experience.
We Educators know that moving forward, we will continue to accept those precious children who arrive at our doorway, and we are eager to teach and eager to learn. We do our best; we judge them not; we do better than our best each day; and we interact as fully as possible with their caregivers. Sometimes that means fighting for services, and sometimes it's as simple as making sure a student gets the prom night everyone else takes for granted. We create a learning-rich environment and serve them well because we are Teachers.
Frequently Asked Questions
Why are there so many special needs children today?
It's a combination of factors rather than one single cause. Diagnostic criteria for conditions like Autism Spectrum Disorder have broadened, screening and early intervention start sooner, insurance and advocacy access has improved for many families, and public health issues like the opioid epidemic have left more children with lasting developmental needs.
Has autism actually become more common, or are more kids just getting diagnosed?
It's hard to fully separate the two. Rising identification reflects multiple factors, including greater awareness, more screening, better access to evaluation, and changes in diagnostic practice over time. Research comparing DSM-5 with its predecessor generally found similar or lower prevalence estimates, so the increase can't be attributed solely to broader diagnostic criteria.
What is Neonatal Abstinence Syndrome, and why does it matter for special education?
Neonatal Abstinence Syndrome, or NAS, happens when a baby is born dependent on opioids their mother used during pregnancy and then goes through withdrawal after birth. Prenatal opioid exposure and NAS have been associated with anxiety, speech and language delays, hyperactivity, and other developmental issues in some longitudinal research, though long-term outcomes are difficult to separate from other prenatal and environmental factors.
Why do some families get services for their child faster than others?
IEP eligibility itself is decided through evaluation by qualified professionals working with the parent, based on documented disability and educational need, not by how forcefully a parent advocates. That said, families with strong insurance coverage, time, and the ability to navigate school and healthcare systems often move through the evaluation and service-coordination process more quickly than families without those resources.
How much does early intervention matter for a child with special needs?
Early intervention programs, such as Early On, are frequently cited in research on developmental outcomes. Early identification and appropriate intervention can improve outcomes for many children with developmental needs, though results vary by child and circumstance.
- No single cause explains the rise - broader diagnostic criteria, earlier screening, and better parent advocacy are converging at once.
- Rising autism diagnoses reflect several factors at once - greater awareness, more screening, and better access to evaluation, not simply a broader DSM-5 definition.
- The opioid crisis left its mark on a generation of kids - prenatal opioid exposure and Neonatal Abstinence Syndrome have been associated with developmental and behavioral issues in some children.
- Navigating the system takes real resources - insurance, time, and the ability to work through school and healthcare bureaucracy affect how quickly a family gets services in place, though eligibility itself is decided by evaluation, not advocacy.
- Early identification and appropriate intervention can help - programs like Early On focus on a child's first few years for exactly that reason, though outcomes vary from child to child.
If reading this made you think about what it actually takes to support kids like Marshall in a classroom, that's worth exploring. Special education teachers are the ones translating diagnoses into daily support, and the sponsored programs on this page show a few different paths into that role.
- The Pros and Cons of Being a Principal: An Honest Look - July 29, 2021
- Special Needs Prom: How One Student Led His School’s Grand March - April 20, 2021
- Behavior Management Training for Teachers: What to Ask For - October 9, 2020
