Respondents to the NS-CSHCN are adults in the household familiar with the child’s health, usually the mother. Respondents are asked their relationship to the child, whether there are other adults in the household who act as parents to the child, and if so, the relationship of any such adult to the child (Blumberg et al., 2008). If the relationship is identified as “mother” or “father,” the follow-up question asks if that is biological, step, foster or adoptive. If either the respondent or another adult in the household is identified as “adoptive mother” or “adoptive father” and there are no biological parents in the household, the child is identified as adopted. Follow-up questions ask whether the child was adopted from another country or resided in foster care prior to adoption, allowing us to categorize adopted CSHCN’s adoption type as 1) international adoption, 2) foster care adoption, or 3) private domestic adoption (which includes all CSHCN identified as adopted who were neither adopted from another country nor from foster care).