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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. Special needs can range from people with autism, cerebral palsy, down syndrome, dyslexia, blindness, ADHD, and cystic fibrosis. They can also include cleft lips and/or palates, port-wine stains, and missing limbs. The types of special needs vary in severity, and a student with a special need is classified as being a severe case when the students IQ is between 20 and 35.  These students typically need assistance in school, and have different services given to them for them to succeed in a different setting. 
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.
U.S. special needs adoption statistics
In the United States, more than 150,000 children with special needs are waiting for permanent homes. Traditionally, children with special needs have been considered harder to place for adoption than other children, but experience has shown that many children with special needs can be placed successfully with families who want them. The Adoption and Safe Families Act of 1997 (P.L. 105-89) has focused more attention on finding homes for children with special needs and making sure they receive the post-adoption services they need. Pre-adoption services are also of critical importance to ensure that adoptive parents are well prepared and equipped with the necessary resources for a successful adoption. The United States Congress enacted the law to ensure that children in foster care who cannot be reunited with their birth parents are freed for adoption and placed with permanent families as quickly as possible.
The disruption rate for special needs adoption is found to be somewhere between ten and sixteen percent. A 1989 study performed by Richard Barth and Marianne Berry found that of the adoptive parents that disrupted, 86% said they would likely or definitely adopt again. 50% said that they would adopt the same child, given a greater awareness of what the adoption of special needs children requires. Also, within disrupted special needs adoption cases, parents often said that they were not aware of the child's history or the severity of the child's issues before the adoption. There is also more care that goes into it when a child of special needs is in the process of getting adopted. Because of the Adoption Assistance and Child Welfare Act of 1980 P.L. 96-272, the child's needs have to be met within the home before allowing adoption, including being able to financially support the child. 
Special Education Needs
The term Special Needs is a short form of Special Education Needs and is a way to refer to students with disabilities, in which their learning may be altered or delayed compared to other students. The term Special Needs in the education setting comes into play whenever a child's education program is officially altered from what would normally be provided to students through an Individual Education Plan which is sometimes referred to as an Individual Program plan. Special Education aids to the students learning environment, to create a uniform system for all children. 
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- "Severe Disabilities: Definition & Examples".
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- Barth, Richard P.; Miller, Julie M. (2000). "Building Effective Post-Adoption Services: What is the Empirical Foundation?". Family Relations. 49 (4): 447. doi:10.1111/j.1741-3729.2000.00447.x.
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