Although the general public in the United States assumes children to be generally healthy and thriving, a substantial and growing number of children have at least one chronic health condition. Many of these conditions are associated with disabilities and interfere regularly with children's usual activities, such as play or leisure activities, attending school, and engaging in family or community activities. In their most severe forms, such disorders are serious lifelong threats to children's social, emotional well-being and quality of life, and anticipated adult outcomes such as for employment or independent living. However, pinpointing the prevalence of disability among children in the U.S. is difficult, as conceptual frameworks and definitions of disability vary among federal programs that provide services to this population and national surveys, the two primary sources for prevalence data. Opportunities for Improving Programs and Services for Children with Disabilities provides a comprehensive analysis of health outcomes for school-aged children with disabilities. This report reviews and assesses programs, services, and supports available to these children and their families. It also describes overarching program, service, and treatment goals; examines outreach efforts and utilization rates; identifies what outcomes are measured and how they are reported; and describes what is known about the effectiveness of these programs and services.

The Diagnostic and Statistical Manual of Mental Disorders defines intellectual disability (ID) as "a disorder with onset during the developmental period that includes both intellectual and adaptive function deficits in conceptual, social, and practical domain." Young adults with ID from ages twenty-two to thirty may transition to community day programs post-school, where they are cared for by direct support providers (DSPs). In Gwinnett County, Georgia, it is the author's experience that young adults with ID currently have difficulty with transitioning from a specialized medically fragile program of Gwinnett County Public Schools to mainstream adult services in the community post-graduation. Anecdotally, there are community day programs in the region, but they do not accept individuals with severe profound intellectual disabilities with complex needs. This is due to a lack of DSPs who are trained to provide support with individuals who have such levels of disabilities and needs. Providing training in the community-based program can increase collaboration between DSPs and occupational therapy practitioners to improve service delivery to young adults with ID. As the DSPs at the day program gain knowledge and hands-on experience through the proposed program development plan, the day program may allot some of their placements to young adults with ID who are medically fragile.

The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.