Children and Youth with Special Healthcare Needs Definition Visualization
This visualization is designed to offer a clear, structured overview of the diverse populations that fall within the CDPH/MCAH definition of Children and Youth with Special Health Care Needs (CYSHCN). CYSHCN are individuals from birth through age 21 who have, or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions that require health care, educational services, and other related supports beyond those needed by the general pediatric population. Chronic conditions are defined as those lasting one year or longer and that require ongoing medical care, limit activities of daily living, or both.
By outlining condition categories, risk factors, and subgroups at increased risk, this tool helps public health professionals recognize the broad and interconnected factors that may contribute to a child or youth being identified as a CYSHCN. It can be used as a foundational reference for needs assessments, program planning, workforce training, and cross-sector collaboration to ensure CYSHCN are accurately identified and effectively supported.
Please note that the conditions and risk factors included in this framework are not exhaustive and do not represent all circumstances in which a child or youth may be considered CYSHCN. The California Department of Public Health (CDPH) encourages using this framework as a dynamic resource and adapting it to include additional populations or risk factors relevant to the needs and context of your community.
Children and Youth with Special Health Care Needs
Physical Conditions —
Epilepsy, Sickle Cell Disease, Asthma, Cystic Fibrosis, Congenital Heart Disease, Diabetes Mellitus, etc.
Developmental Conditions —
Autism, Learning Disabilities, Down Syndrome, Fragile X Syndrome, Fetal Alcohol Syndrome, Prader-Willi Syndrome, Phenylketonuria, etc.
Behavioral Conditions —
ADHD, Conduct Disorder, Eating Disorders, etc.
Emotional Conditions —
Anxiety, Depression, PTSD, Suicidal Ideation, etc.
Childhood Trauma —
Adverse Childhood Experiences (e.g., abuse, neglect, household challenges), exposure to violence, family instability, loss, and other traumatic experiences
Biological Risks —
Very low birth weight, Prematurity, Presence of certain Metabolic deficiencies, Genetic changes/differences, Family history, etc.
Environmental Risks —
Absence of social support, Air pollution, Second-hand smoke, and Infestations that can exacerbate conditions such as asthma, etc.
Systemic/Structural Risks -
Racism/discrimination, limited culturally and linguistically appropriate services, immigration-related fear, under-resourced communities (e.g. rural areas), and lack of insurance, etc.
Justice-Involved Youth
Child Welfare System-Involved Children and Youth —
Foster, Emancipated, Kinship/ Guardianship, Differential Response, Adopted, etc.
LGBTQIA+
Neonatal Intensive Care Unit (NICU)/ Infants that experienced birth trauma
Homeless/Unaccompanied Youth
Pediatric Intensive Care Unit (PICU)
Pregnant or Parenting Youth
Exploited Youth — Sexual, financial, criminal and labor exploitation
CYSHCN Transitioning to Adulthood
One or more Social Determinants of Health (SDOHs) —
Poverty, Food Insecurity, Housing Instability, Poor Air Quality, Challenges Navigating the Health System.
Limited access to: Education, Primary/ Specialty Care, Healthy Food, Social Support, etc.
Children whose parent(s)/care giver(s) have special health care needs or serious illness
Infants born to mothers who use substances during pregnancy/Alcohol and Other Drugs (AOD)