Difficulties in Functioning Among Children in the United States: 2021–2023

In 2021-2023, about one-quarter (24.9%) of children ages 2-4 experienced difficulties in functioning (4.1% experienced a lot of difficulty in one or more domains and 20.8% experienced some difficulty). Among children ages 5-17, just over one-half (50.8%) experienced functioning difficulties (13.0% experienced a lot of difficulty and 37.8% experienced some difficulty). The prevalence of functioning difficulties varied by sex, with boys being more likely than girls to experience a lot of difficulty in at least one domain, but differences across other characteristics varied. Functioning difficulties were most prevalent in the domains of communication, learning, behavior, and playing among children ages 2-4. For those ages 5-17, the most prevalent domains were anxiety, accepting change, behavior, depression, and making friends. Among children who experienced functioning difficulties, most had difficulty in only one functional domain.