Functional Difficulties in Children

Pediatric audiologists may be interested in a National Center for Health Statistics report (Weeks et al., 2025) that examined functioning in children in the United States.

Weeks and colleagues (2025) used data from the 2021–2023 National Health Interview Survey. The Washington Group (WG)/United Nations Children’s Fund (UNICEF) Child Functioning Module (CFM; UNICEF, 2022) was added to the National Health Interview Survey in 2019 to assess child functioning. The CFM asks different questions depending on the child’s age. There is a version for those 2–4 years of age and one for those 5–17 years of age. Readers are referred to Weeks et al. (2025) for the exact wording of the questions, as well the methods used for collecting and analyzing the data in their report. 

Among children aged 2–4 years, almost 25 percent of children had at least some difficulty in the functioning, while just over 50 percent of those aged 5–17 years had at least some difficulty in functioning. Of those that reported at least some functional difficulty, difficulties were more commonly reported for only one domain of function versus multiple domains in both age groups.

Hearing and communication were two of the assessed domains of function for both age groups. Approximately 2 percent of children in both age groups had at least some difficulty with hearing, with a larger percentage of children having difficulty with communication. Among those aged 2–4 years, 18.7 percent had at least some difficulties with communication, while only 7.3 percent of those aged 5–17 years had at least some difficulty with communication. It should be noted that the hearing-related functioning questions asked about and considered hearing aid utilization.

Differences in functioning (composite indicator only) based upon selected sociodemographic factors also were evaluated. Readers are encouraged to access the full report for these results.

References

UNICEF. (2022). Module on child functioning: Questionnaires. Retrieved December 30, 2025.

Weeks, J.D., Madans, J.H., Black, L.I., Elgaddal, N., & Zablotsky. B. (2025). Difficulties in functioning among children in the United States: 2021–2023. Natl Health Stat Report. Sept;(218):1–20.