Colorado Responds to Children with Special Needs

Colorado Responds to Children with Special Needs (CRCSN) is the birth defects monitoring and prevention program at the Colorado Department of Public Health and Environment. The program began in 1989 under the guidance of an advisory board of parents, physicians, advocates, and representatives from state agencies.

The mission of CRCSN is to characterize the prevalence of birth defects and related disabilities and provide epidemiologic information for prevention and research. It is the most comprehensive source of information on the occurrence of birth defects for entire state of Colorado. Hospitals, health care facilities, and laboratories are required to report birth defects, developmental disabilities, and chromosomal abnormalities diagnosed prenatally and up to age three. The program has several additional surveillance and prevention projects that focus on specific conditions including fetal alcohol syndrome, autism, muscular dystrophy, and neural tube defects recurrence prevention.

Birth defects surveillance programs throughout the country vary in disease reporting requirements.  CRCSN took a broad view in establishing its criteria, comprising a larger range of conditions and a longer age range than is seen in many other surveillance programs. Colorado’s approach, including developmental disabilities and risk factors, ensures that a greater proportion of children are identified for special services they may require and that decision makers and service providers have more complete information on the potential needs of Colorado’s children.

CRCSN primarily uses passive case ascertainment for case identification. Data sources submit case reports of medical conditions to the program. Over many years, CRCSN has developed data quality improvement procedures to address accuracy and timeliness. Staff is continuously working to improve data collection and perform ongoing quality control.

To be included in CRCSN a child must be a Colorado resident diagnosed prenatally to three years of age with an eligible condition. About 8,000 children each year are identified because they meet CRCSN eligibility criteria. About 5% of all births in Colorado are reported with major congenital anomalies.

CRCSN is active in the National Birth Defects Prevention Network ( and Colorado data have been contributed to a variety of multi-state collaborative projects.
CRCSN contributes birth defect data to the National Environmental Public Health Tracking Program ( ).  CRCSN also provides a public queriable dataset for selected years and birth defects occurring in Colorado resident live births at

Since 1989, a component of CRCSN has been the Community Notification and Referral Program.  CRCSN collaborates with local agencies to connect children and families with services and resources in their own communities. The local agencies include public health departments, community nursing services, early intervention programs, and Family Voices Colorado.  The confidentiality of information collected for CRCSN is protected by Colorado state law, Board of Health regulations and strict procedural safeguards.

More specific inquiries about CRCSN are welcome and can be addressed to:

Colorado Department of Public Health and Environment
Colorado Responds to Children With Special Needs
4300 Cherry Creek Drive South
Denver, CO 80246

Fax: 303-697-7821