One of every dozen U.S. children and teenagers 5.2 million has a physical or mental disability, according to new figures from the 2000 Census that reflect sharp growth in the nation's young handicapped population over the past decade.
The disabilities captured by the census could range in severity from mild asthma to serious mental illness or retardation demanding full-time care.
The figures, which covered children ages 5 to 20, are the first collected on childhood disability in the decennial census in more than a century. But data from other sources have shown a rapid increase in the number and rate of childhood handicaps. Special-education enrollment rose twice as fast as overall school enrollment in the past decade. And a growing number of children receive federal Social Security payments because they suffer from serious disabilities.
The rising numbers come after a period of dramatic change in the nation's approach to disabilities. A vision of inclusiveness has been written into laws requiring equal access to services, including the 25-year-old federal law guaranteeing education to all handicapped children and the 10-year-old Americans With Disabilities Act.
While the extent to which society should accommodate people with disabilities is still being argued in courts and public discourse, the rising numbers already present a challenge to school systems and other public agencies.
Some reasons for the rise can be quantified. But it is difficult to know precisely how much is attributable to an increase in certain conditions and how much is explained by greater recognition, changing definitions or more willingness to report a handicap.
Improvements in medical care now can save low-birth-weight babies, whose greater risk of problems may explain some of the increase. Also, medical advances are allowing more people with spinal cord injuries or Down syndrome to live longer. Childhood obesity is rising, and with it the risk of disease such as diabetes. But there are more theories than answers for the sharp rise in autism, asthma and learning disabilities.
The definition of disability has broadened to include conditions such as attention deficit disorder, which decades ago was often not even recognized. Diagnosis of disability also has become more precise and aggressive. And some people with disabilities may be stepping forward because of lessened stigma or the availability of benefits.
Glenn Fujiura, a professor of disability studies at the University of Illinois at Chicago, said that although the reasons for the increase may not be clear, the results are. "More children are coming forward with needs and limitations that must be met," he said.
Steven Fine, a federal employee who lives in Columbia, Md., has seen this firsthand as the father of a 12-year-old boy with severe autism, a neurological disease.
"Ten years ago, when my son was diagnosed, autism was a rare thing that no one had ever heard of," Fine said. "Every year since then, at parents' meetings, the number of diagnoses seem to have increased exponentially.
"Now doctors are much quicker -- maybe a little too quick -- to say your kid has autism," Fine said.
Poor children are more likely to be disabled, surveys have shown, but why that is true is still being debated.
Experts offer several possible explanations for the link between poverty and childhood disability, including a higher risk of premature birth or birth to a drug-addicted mother, poor nutrition or more exposure to lead paint, which can cause brain damage.
"If you look at children with disabilities, they are more likely to be in single-parent homes, they are more likely to be poor, they are more likely to be in homes where secondhand smoke exposure is a risk," said Dennis Hogan, a Brown University sociology professor who studies disabled children. "But the direction of the cause and effect is not certain. Single parenthood, per se, is not more likely to produce a disabled child, but poverty associated with being a single mom may well produce that result."