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Researchers have struggled to explain the substantial growth over recent years in Supplemental Security Income (SSI) receipt among children younger than the age of 18. Although existing studies have examined caseloads at the state level, we explore the possibility that local conditions may play a more important role in driving caseload growth, and that different factors might matter in different parts of the country. In this article, we examine the importance of a number of factors in explaining county-level child SSI caseloads over time. We find that, nationally, these factors explain between 30% and 40% of the 2003 to 2008 growth in SSI caseloads and about 25% of the trend from 2008 to 2011. We also find that the importance of these factors in explaining growth varies substantially regionally and across states, which suggests that national models may lead researchers to overlook important determinants of caseload growth by averaging variation across regions and states. The finding also suggests that state-specific case studies of caseload growth with consideration of local factors may be fruitful in providing additional understanding of the child SSI caseload.