Children with special health care needs (CSHCN) are those children who have been or are at risk for a chronic physical, developmental, behavioral, or emotional condition

and who also require health and related services of a type or amount beyond that required by children generally(1). An estimated 12.8% of children in the United States had a spe­cial health care need in 2001(2).

Due to the large number of CSHCN, primary care providers (PCP) and pediatric subspecialists care for this compli­cated group of children on a regular basis. Routine health maintenance visits are frequently omitted in favor of visits for acute illnesses, which can result in a failure to discuss routine health care issues, such as growth and development, immunizations, vision, hearing, and dental care. Evaluation of chil­dren during an acute illness can pose unique chal­lenges to care providers relating to many factors, including extensive past medical and surgical his­tories, lengthy lists of medications, and the lack of typical signs and symptoms normally present dur­ing a typical childhood illness. This chapter will focus on a discussion of the provision of medical care to CSHCN using a medical home model, the routine health maintenance issues for children with disabilities, and the common acute medical issues that a PCP may be asked to evaluate in this group of children. Finally, this chapter will discuss the issue of palliative care for children with special health care needs.

More on the topic Children with special health care needs (CSHCN) are those children who have been or are at risk for a chronic physical, developmental, behavioral, or emotional condition:

1. The Health Care Team System
2. Performance of various diagnostic and therapeutic procedures on children
3. Instruments for Use With Young Children
4. Dental
5. Immunizations
6. CASE 187: Adopted Children*
7. The Children Who Fled to the North and East of the Netherlands
8. ON LOSING YOUR CHILDREN IN THE VATICAN
9. CASE 168: Mothers Inherit from Children*
10. CASE 165: Illegitimate Children*