Child behavior statistics show that behavior and functioning vary substantially by age, domain, family income, geography, and diagnosis. Recent U.S. survey results also connect adolescent mental and behavioral health conditions with school disengagement, missed days, bullying, and difficulty making or keeping friends.
Table of contents
- Functioning difficulties by age
- Which domains are most affected
- Differences by age, sex, race, geography, and income
- Adolescent mental and behavioral health
- Treatment and school experiences
- Daily health behaviors and child functioning
Functioning difficulties by age
The CDC NHIS 2021–2023 report measures functioning difficulty across several areas, including communication, learning, behavior control, playing, movement, and sensory functioning. The results use age-specific groups, so comparisons should not be read as a single measure of all childhood behavior.
Among children ages 2–4, 24.9% had any functioning difficulty. This included 4.1% with a lot of difficulty and 20.8% with some difficulty. The remaining 75.1% had no functioning difficulties (CDC NHIS 2021–2023 report).
The pattern was different among children ages 5–17. In this group, 50.8% had any functioning difficulty, including 13.0% with a lot of difficulty and 37.8% with some difficulty. A further 49.2% had no functioning difficulties (CDC NHIS 2021–2023 report).
These figures describe reported functioning difficulty, not a diagnosis and not a direct measure of intentional misbehavior. They include areas that can affect how a child communicates, learns, regulates behavior, participates in play, or manages everyday activities.
Age within the 5–17 group also mattered. The share with a lot of difficulty was 11.5% among children ages 5–10, 13.6% among those ages 11–13, and 14.5% among adolescents ages 14–17 (CDC NHIS 2021–2023 report).
A useful age comparison is shown below.
| Age group | Any difficulty | Some difficulty | A lot of difficulty | No difficulty |
|---|---|---|---|---|
| Ages 2–4 | 24.9% | 20.8% | 4.1% | 75.1% |
| Ages 5–17 | 50.8% | 37.8% | 13.0% | 49.2% |
Source: CDC NHIS 2021–2023 report.
Which domains are most affected
For children ages 2–4, communication was the most frequently reported domain among the supplied measures: 15.9% had some communication difficulty and 2.8% had a lot of communication difficulty. Learning difficulty affected 4.4% with some difficulty and 1.1% with a lot of difficulty.
Behavior regulation was reported separately. Controlling behavior affected 2.5% of children ages 2–4 with some difficulty and 1.0% with a lot of difficulty. Playing difficulty affected 2.9% with some difficulty and 0.7% with a lot of difficulty (CDC NHIS 2021–2023 report).
Other reported domains were less common in the lot-of-difficulty category. Walking difficulty affected 0.2%, seeing difficulty 0.2%, hearing difficulty 0.1%, and fine motor difficulty 0.1%. The corresponding some-difficulty shares were 1.7% for walking, 1.6% for seeing, 1.8% for hearing, and 1.3% for fine motor functioning (CDC NHIS 2021–2023 report).
For children ages 5–17, the report gives a broader view of emotional, cognitive, social, and physical functioning. Anxiety affected 20.9% with some difficulty and 5.9% with a lot of difficulty. Accepting change affected 18.6% with some difficulty and 4.3% with a lot of difficulty. Controlling behavior affected 11.9% with some difficulty and 3.4% with a lot of difficulty.
Social and learning measures had lower lot-of-difficulty shares. Making friends affected 8.2% with some difficulty and 2.6% with a lot of difficulty. Learning affected 8.4% with some difficulty and 1.9% with a lot of difficulty. Concentrating affected 5.8% with some difficulty and 1.6% with a lot of difficulty. Remembering affected 7.0% with some difficulty and 1.5% with a lot of difficulty (CDC NHIS 2021–2023 report).
Depression affected 10.9% with some difficulty and 1.4% with a lot of difficulty. Communication affected 5.9% with some difficulty and 1.4% with a lot of difficulty. The physical and self-care measures were lower: walking was 2.9% some and 0.9% a lot; self-care was 2.1% some and 0.7% a lot; seeing was 4.9% some and 0.5% a lot; and hearing was 2.1% some and 0.2% a lot (CDC NHIS 2021–2023 report).
The number of affected domains also varied. Among ages 5–17, 7.2% had a lot of difficulty in exactly one domain, 2.7% in two domains, 1.2% in three domains, and 1.9% in four or more domains. Among ages 2–4, the corresponding figures were 2.6%, 1.0%, 0.3%, and 0.1%. Among younger children who had some difficulties, 76.0% had difficulty in only one domain, 16.9% in two, 5.0% in three, and 2.2% in four or more domains (CDC NHIS 2021–2023 report).
Differences by age, sex, race, geography, and income
The CDC NHIS 2021–2023 report shows differences by sex among the reported age groups. For children ages 2–4, boys had 6.0% with a lot of difficulties compared with 2.1% for girls. Boys had 23.5% with some difficulties compared with 18.0% for girls.
Among children ages 5–17, the sex difference in a lot of difficulties was narrower: 13.6% for boys and 12.3% for girls (CDC NHIS 2021–2023 report).
Reported race categories also differed among children ages 5–17. The share with a lot of difficulties was 14.4% for Black children, 13.9% for White children, 11.3% for other and multiple-race children, and 11.0% for Hispanic children. For some difficulties, the report gives 41.3% for White children and 31.4% for Black children (CDC NHIS 2021–2023 report).
Geography showed variation as well. Among ages 2–4, children in large central metro areas had 5.4% with a lot of difficulties, compared with 4.6% in medium and small metro areas and 2.1% in large fringe metro areas. Children in nonmetropolitan areas had 29.3% with some difficulties.
Among ages 5–17, 11.3% of children in large central metro areas had a lot of difficulties, compared with 16.5% in nonmetropolitan areas. The share with some difficulties was 35.8% in large central metro areas, 38.7% in large fringe metro areas, and 39.4% in medium and small metro areas (CDC NHIS 2021–2023 report).
Family income was another reported difference. Among ages 2–4, 8.3% of children with family income below 100% of the federal poverty level had a lot of difficulties, compared with 2.3% of children with family income at or above 200% of the federal poverty level.
Among ages 5–17, the corresponding figures were 19.2% below 100% of the federal poverty level and 10.9% at or above 200%. For some difficulties, the report gives 34.1% for the lower-income group and 39.3% for the higher-income group (CDC NHIS 2021–2023 report).
Adolescent mental and behavioral health
The NSCH 2023 adolescent brief reports that 20.3% of adolescents ages 12–17 had a current diagnosed mental or behavioral health condition in 2023. Diagnosed anxiety affected 16.1%, diagnosed depression affected 8.4%, and diagnosed behavior or conduct problems affected 6.3%.
The reported sex patterns differed by condition. Girls had diagnosed anxiety at 20.1%, compared with 12.3% for boys. Girls had diagnosed depression at 10.9%, compared with 6.0% for boys. Boys had diagnosed behavior or conduct problems at 8.2%, compared with 4.3% for girls (NSCH 2023 adolescent brief).
The same brief reports increases between 2016 and 2023. Diagnosed mental or behavioral health conditions rose 35%, from 15.0% to 20.3%. Diagnosed anxiety rose 61%, from 10.0% to 16.1%, and diagnosed depression rose 45%, from 5.8% to 8.4% (NSCH 2023 adolescent brief).
The 2023 figures also include treatment needs. A total of 20.9% of adolescents were reported to need treatment or counseling from a mental health professional in the past year. Among those who needed treatment or counseling, 82.6% received it. Receipt was 85.4% among adolescents with anxiety, 86.7% among those with depression, and 82.2% among those with behavior or conduct problems (NSCH 2023 adolescent brief).
Access was not uniform: 61.0% of adolescents with a current diagnosis who needed treatment had difficulty getting needed treatment (NSCH 2023 adolescent brief).
Treatment and school experiences
The NSCH 2023 adolescent brief also compares school and social experiences for adolescents with and without a current diagnosis. School disengagement, defined in the supplied figures as never or sometimes engaged, was reported for 43.9% of adolescents with a current diagnosis, compared with 14.9% of peers without a diagnosis.
Two or more school problem contacts in the past year affected 32.8% of adolescents with a current diagnosis, compared with 7.4% of adolescents without a diagnosis. Missing 11 or more school days for health reasons affected 17.7% of adolescents with a current diagnosis and 3.5% of peers without a diagnosis (NSCH 2023 adolescent brief).
Bullying victimization in the past 12 months was reported for 60.5% of adolescents with a current diagnosis, compared with 27.2% of those without a diagnosis. A lot of difficulty making or keeping friends affected 20.4% of adolescents with a current diagnosis and 2.1% of peers without a diagnosis (NSCH 2023 adolescent brief).
These comparisons describe differences between groups in the 2023 brief. They do not by themselves establish that a diagnosis caused school disengagement, missed school, bullying victimization, or friendship difficulty.
Separate CDC 2023 YRBS results describe high school students rather than all children ages 12–17. In 2023, 40% of high school students had persistent feelings of sadness or hopelessness, down from 42% in 2021. Also in 2023, 19% were bullied at school, up from 15% in 2021, and 13% missed school because of safety concerns, up from 9% in 2021. More than 75% reported frequent social media use in 2023 (CDC 2023 YRBS results).
Daily health behaviors and child functioning
The NSCH healthy behaviors 2024 results connect daily routines with measures of chronic conditions and obesity. In 2024, 65.3% of school-aged children got adequate sleep on most weeknights, 48.1% limited screen time to two hours or less on most weekdays, and 19.2% got at least one hour of physical activity every day in the past week.
Sugary-drink patterns were also reported. A total of 70.5% of school-aged children limited sugary drinks to zero through three in the past week, including 19.4% who had none and 51.1% who had one to three (NSCH healthy behaviors 2024).
The urban-rural comparisons were mixed. Urban children were more likely to limit sugary drinks, at 71.6% versus 62.5% for rural children. Rural children were more likely to limit screen time, at 51.2% versus 47.7% for urban children, and to get at least 60 minutes of physical activity every day, at 24.2% versus 18.5% (NSCH healthy behaviors 2024).
In 2024, 22.5% of school-aged children had one or more chronic conditions with at least one frequent or chronic difficulty. This share was 27.4% among children who consumed four or more sugary drinks, compared with 20.7% among those who limited sugary drinks. It was 25.4% among children who did not get enough sleep, compared with 21.2% among those with adequate sleep.
The same pattern appeared for screen time and physical activity. A chronic condition with difficulty affected 26.6% of children with three or more hours of screen time, compared with 18.2% who limited screen time. It affected 23.2% of children who were not physically active every day, compared with 20.2% who were active every day (NSCH healthy behaviors 2024).
Obesity affected 16.0% of school-aged children in 2024. The reported shares were 18.8% among children with four or more sugary drinks versus 14.9% among those who limited sugary drinks; 20.0% among children without enough sleep versus 14.0% with adequate sleep; 18.2% with three or more hours of screen time versus 13.7% who limited screen time; and 16.7% among children not active every day versus 13.1% among those active every day (NSCH healthy behaviors 2024).