Survey Results

Survey Items: Survey instrument item number for children 0-5 years: C8
Variable name in public use data file: K6Q12; K6Q13A; K6Q13B; K6Q14A; K6Q14B

Denominator: Children age 9 through 35 months

Numerator: Children, ages 9 through 35 months, who received a developmental screening using a parent-completed screening tool in the past year

Revisions and Changes: In 2017, this measure did not change from the 2016 NSCH.
Due to changes in the administration and sampling for the NSCH, results from surveys prior to 2016 are not directly comparable and should not be used to conduct trend analyses. In the 2011/12 NSCH, developmental screening questions were asked among children 10 months to 71 months (5 years) who received one or more types of services: medical, dental, mental health care or received/needed a specialist care (NUMB_SERVICES>0). In the 2016 and 2017 NSCH, these questions were asked among children 9-71 months. However, the denominator of this measure changed to all children 9-35 months to align with the AAP/Bright Futures screening recommendations. For more information on content changes in 2016, click here .

Additional Notes: The AAP recommends that all children should be screened for developmental delays during their regular well-check visits at 9, 18, and 24 or 30 months. This measure uses age-appropriate questions to verify whether young children received standardized developmental, behavioral and social screening using a parent-reported, standardized screening tool or instrument. Parent respondents for all children between 9 months and 5 years old were asked the following question: "During the past 12 months, did a doctor or other health care provider have you or another caregiver fill out a questionnaire about specific concerns or observations you may have about this child’s development, communication, or social behaviors?" (K6Q12). If the response to K6Q12 was “Yes”, parents were asked if the questionnaire covered language or social development (K6Q13 and K6Q13A, respectively, for ages 9-23 months, and K6Q14A and K6Q14B for ages 2-5 years). The measure is considered missing if both types of contents are missing.
This 3-item measure to assess whether screening occured was developed by the Child and Adolescent Health Measurement Initiative (CAHMI), with funding from the Commonwealth Fund and in conjunction with the Maternal and Child Health Bureau. Further information may be obtained on the CAHMI website or by contacting CAHMI at info@cahmi.org.

Treatment of Unknown Values: Missing values due to non-response or a “don’t know” response are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the data query results table. In the majority of cases, the proportion of missing values is less than 2%. Exceptions are noted in the form of a Data Alert at the bottom of a results table. The exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). If missing cases are handled in any other way, details can be found in the "Additional notes" section above.

History and Development:
Overview of the Title V Block Grant
The Title V Maternal and Child Health (MCH) Services Block Grant Program operates as a federal-state partnership in 59 states and jurisdictions to improve the health and well-being of MCH populations through the development of public health systems of care which are family-centered, community-based and culturally appropriate. To improve accountability and to more clearly demonstrate the impact of the Title V Block Grant Program, an updated national performance measure framework was introduced in 2015. This three-tiered framework includes National Outcome Measures (NOMs), National Performance Measures (NPM) and state-initiated Evidence-Based or –Informed Strategy Measures (ESMs). Updates to the Application/Annual Report Guidance released by HRSA in December 2017 retained the performance measure framework, but allowed greater flexibility for states in selecting national and state performance measures that align with their individual MCH priority needs. More information about the block grant can be obtained at the MCHB website.

About NSCH
The Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) funds and directs the National Survey of Children’s Health (NSCH), and develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children’s health, federal and state stakeholders, clinicians and researchers. The U.S. Census Bureau conducts the survey, oversees the sampling, and produces a final data set of survey results. Respondents’ cognitive understanding of the survey questions was assessed during the pretest phase of the survey redesign and reassessed after the 2016 survey; subsequent revisions were made. Previously validated questions and scales are used when available. The manuscript “The Design and Implementation of the 2016 National Survey of Children’s Health”, provides detailed information about the redesign of the NSCH, administration of the first redesigned survey (2016), and the sampling and administration changes for the 2017 NSCH. Prior to 2016, the NSCH and the National Survey of Children with Special Health Care Needs were each conducted three times as interviewer-assisted telephone surveys using random digit dial sampling. In 2016, the two surveys were combined into a single annual self-administered questionnaire. Due to decline in the number of households with landline telephones, the NSCH now utilizes an address-based sampling method to select participating households, thus all invitations are sent by mail. Participants may choose to complete the survey either online using a secure website or a mailed paper version of the survey. All final data components are verified by the Census Bureau, HRSA/MCHB and CAHMI/DRC staff prior to public release. More information about the survey can be found in the “About the National Survey of Children’s Health” section of this website and HRSA’s MCHB website.