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Child Health Assessment and Monitoring Program (CHAMP)
The Maternal and Child Health Bureau (MCHB) defines Children with Special Health Care Needs (CSHCN) as "those who have or are at increased 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." (mchb.hrsa.gov)
The MCHB definition is broad and comprehensive and includes characteristics for a wide range of diagnoses and conditions. Health care needs may be physical, developmental, behavioral or emotional and may manifest in children of any age. Examples of the most common conditions of CSHCN consist of allergies, asthma, Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD), depression/anxiety, mental retardation and autism. CSHCN are often diagnosed with more than one condition, and frequently experience several functional difficulties, including respiratory problems, learning or behavior problems, difficulty with gross or fine motor skills, chronic pain or difficulty in making and keeping friends.
To identify CSHCN, N.C. CHAMP uses a non-condition specific screening tool based on parental report. N.C. CHAMP survey questions are similar to items included on the National Survey of Children’s Health, 
and focus on the health consequences a child experiences as a result of having an enduring chronic health condition rather than on a specific diagnosis, thus allowing for a more comprehensive assessment.
Please note that the N.C. CHAMP definition of CSHCN varies by survey year. The difference in prevalence of CSHCN across years of data collection is somewhat an artifact of the difference in the CSHCN definition. In 2008-2009, the N.C. CHAMP CSHCN definition was based on one screening question; in 2005-2007 & 2010, the definition was based on two screening questions. The prevalence of CSHCN was thus significantly greater in 2005-2007 & 2010 compared to 2008-2009. This difference in CSHCN definition must be taken into consideration when comparing years of data results posted in the N.C. CHAMP Web tables.
For more information, please refer to the N.C. CHAMP fact sheet and report on Children with Special Health Care Needs.
In 2008 and 2009, N.C. CHAMP defines CSHCN as those children who have an elevated need for medical, mental health, or educational services due to a medical, behavioral, or other health condition that has lasted or is expected to last for at least 12 months.
The CSHCN module consisted of one screening question to identify CSHCN in the 2008 and 2009 surveys:
Respondents who answered in the affirmative were then asked two follow-up questions:
Any child with an affirmative response to these three survey items was defined as having special health care needs.
In 2005, 2006, 2007 and 2010 to the present, N.C. CHAMP defined CSHCN as "those children who need prescription medications or have an elevated need for medical, mental health, or educational services due to a medical, behavioral, or other health condition that has lasted or is expected to last for at least 12 months."
The CSHCN module consisted of two screening questions to identify CSHCN in the 2005-2007 & 2010 surveys:
Respondents who answered in the affirmative were then asked two follow-up questions in reference to each of the stem screening questions:
A child is defined as having special health care needs if affirmative responses were given to the three survey items regarding elevated use of services OR if affirmative responses were given to the three survey items regarding prescription medication use.
