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Children with special health care needs

Lindsey K Grossman, MD
Teresa K Duryea, MD
Section Editor
Carolyn Bridgemohan, MD
Deputy Editor
Mary M Torchia, MD


The mission of pediatric health care providers changed considerably during the 20th century. Effective therapies were developed for many life-threatening infectious diseases and congenital abnormalities. Preventive health care (eg, immunization and anticipatory guidance for injury prevention) became more important. Many children with conditions that once were universally fatal now survive into adolescence, early adulthood, and beyond. Pediatric health care providers must be prepared to provide care to an increasing number of these children with special health care needs (CSHCN).

The traditional approach to chronic conditions in children is a categorical one, based upon an organ system, diagnosis-specific view of the condition, and an emphasis on pathophysiology and biomedical treatment. A noncategorical approach emphasizes the psychological, developmental, educational, and social aspects of the condition [1-4] and facilitates the development of programs to better assist CSHCN and their families.


The World Health Organization (WHO) defines impairment as an abnormality in body structure or appearance or in the function of an organ or system. A disability is an impairment that restricts activity. A handicap is a disability that causes an individual to be limited by society.

A chronic disorder is a serious health condition lasting at least one year that produces or is virtually certain to produce one or more of the following [1]:

Disability or limitation of function or activity

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Literature review current through: Nov 2017. | This topic last updated: Apr 03, 2017.
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