U.S. Counts One in 12 Children As Disabled
Census Reflects Increase Of Handicapped Youth

by D'Vera Cohn, Washington Post Staff Writer, Friday, July 5, 2002; Page B01

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.

In the Washington area, the census reported that 87,000 young people, or one in 14, were handicapped. 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 T. 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, 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. The District, which has the region's highest poverty rate, also has the highest rate of childhood disability, at 10 percent. The region's lowest child disability rate, 6 percent, is in Loudoun County, whose poverty rate is the lowest in the region.

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."

Among metropolitan areas, the Washington region's childhood disability rate ranks in the bottom quarter, and its household income is among the highest. The metro areas with the lowest childhood disability, according to 2000 Census figures analyzed by The Washington Post, are well-off ones such as Hunterdon County, N.J., Stamford, Conn., and the university areas of Charlottesville and Boulder, Colo.

The metropolitan areas with the highest child disability rates -- at least 10 percent -- include Lewiston-Auburn, Maine; Huntington, W.Va.; and Dothan, Ala. All have above-average poverty.

For people of all ages, the census counted 50 million disabled nationally, and more than 740,000 in the Washington area. Specialists say the census numbers probably understate the disability rate by not including people with mild problems, such as a minor speech impediment. That is one reason the nation's special-education enrollment is higher than the census total.

As special education is expanding, so are other activities for disabled children. A Montgomery County soccer league for the handicapped expects to double in size this fall. Parents also increasingly are pressing to include their disabled children in standard summer camps, team sports and after-school programs.

At the Early Years Academy in Manassas, which operates Adventure Day Camp during the summer, "it used to be rare" that children needed to have inhalers and other equipment on hand to prevent or stop asthma attacks, said Samia Harris, school principal and camp director. "Now it just seems to be the norm."

Ellen Tuttle, a school administrator who lives in Herndon, enrolled her 12-year-old daughter who has multiple handicaps in after-school classes in gymnastics, swimming, ice skating and karate that are not just for handicapped children. She has found that most teachers are willing to help, and her daughter often finds one empathetic friend in each class.

"If I put her in a class that might have worse disabilities than she has, she would not have anything to reach for," Tuttle said.

Ruth Spodak, a suburban Maryland psychologist who is a special education consultant, said families who seek ordinary activities for their disabled children encounter everything from outright rejection to quick acceptance.

Some parents volunteer to coach teams or lead Scout troops to ensure that their disabled child can participate, she said. Spodak said children often have more success in "offbeat" activities such as nature camps or performing arts groups.

"Things are moving in the right direction," Spodak said. "I still think we have a ways to go in terms of educating the public and making this a routine kind of availability."

Another trend that special education experts have noticed -- with an impact on their budgets -- is that more children are arriving with multiple disabilities, which require more intensive services. "Although there has been growth in the number of students, what we see as more significant is the number of services that special education students are receiving," said Patricia Addison, Fairfax County's special education director.

Down the road, more challenges await. Fairfax social service agencies recently were approached by parents of middle school students with multiple disabilities and little hope of being able to work after graduation. County officials are discussing day-care options.

"Right now, if you say 'adult day care,' people think seniors," said John Hudson, director of disability services for the county's Department of Family Services. "They don't think about young people coming out of school."

Database editor Dan Keating contributed to this report.