Gender differences in the associations between developmental disabilities and anxiety and depression symptoms among US children: Insights from the 2021 National Health Interview Survey

Background: Limited research has explored the associations between developmental disabilities and symptoms of anxiety and depression among U.S. children during the COVID-19 pandemic. Objective: This study investigates the associations between developmental disabilities and symptoms of anxiety and depression among U.S. children and examines whether these associations differ by gender. Methods: The analysis included 6092 children aged 5-17 from the 2021 National Health Interview Survey (NHIS). Key risk factors for anxiety and depression symptoms included attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), intellectual disability (ID), learning disability (LD), and developmental delay (DD). Weighted multivariable logistic regression (MLR) was conducted to evaluate associations with anxiety and depression symptoms. Results: The overall prevalence of anxiety was 14.8 % (12.8 % for males and 17.0 % for females), while depression prevalence was 5.1 % (4.2 % for males; and 6.0 % for females). Children with developmental disabilities had significantly higher prevalence rates of anxiety and depression compared to their peers without such conditions (p < 0.05). MLR analysis revealed that being female and having a history of ADHD, ASD, LD, and DD were associated with increased odds of both anxiety and depression (p < 0.05). ID was associated with increased odds of anxiety but not depression. COVID-19 was not significantly associated with either anxiety or depression. Furthermore, the associations of ASD, LD, ID, and DD with anxiety and depression varied by gender. Conclusions: Developmental disabilities were significantly associated with symptoms of anxiety and depression among U.S. children in 2021, with notable gender differences. These findings highlight the importance of incorporating gender-sensitive approaches in designing effective prevention and intervention strategies.