In the United States, special needs is a term used in clinical diagnostic and functional development to describe individuals who require assistance for disabilities that may be medical, mental, or psychological. For instance, the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases 9th edition both give guidelines for clinical diagnosis. Types of special needs vary in severity. People with autism, Down syndrome, dyslexia, blindness, ADHD, or cystic fibrosis, for example, may be considered to have special needs. However, special needs can also include cleft lips and or palates, port wine birth marks, or missing limbs.
In the United Kingdom, special needs often refers to special needs within an educational context. This is also referred to as special educational needs (SEN). In the United States, 18.5 percent of all children under the age of 18 (over 13.5 million children) had special health care needs as of 2005.
More narrowly, it is a legal term applying in foster care in the United States, derived from the language in the Adoption and Safe Families Act of 1997. It is a diagnosis used to classify children as needing "more" services than those children without special needs who are in the foster care system. It is a diagnosis based on behavior, childhood and family history, and is usually made by a health care professional.
"Special needs" are commonly defined by what a child can't do -- by milestones unmet, foods banned, activities avoided, experiences denied. These minuses hit families hard, and may make "special needs" seem like a tragic designation. Some parents will always mourn their child's lost potential, and many conditions become more troubling with time. Other families may find that their child's challenges make triumphs sweeter, and that weaknesses are often accompanied by amazing strengths.