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Aim To examine the prevalence of mental health disorders among children with and without cerebral palsy (CP), and to examine how physical risk factors in children with CP might mitigate any elevated risk of mental health disorders in this population. Method Children from 6 years to 17 years of age with (n=111) and without (n=29 909) CP from the 2016 National Survey of Children's Health were included in this cross‐sectional study. Mental health disorders included depression, anxiety, behavior/conduct problems, and attention deficit disorder/attention‐deficit/hyperactivity disorder (ADHD). Physical risk factors included physical activity (number of active days ≥60min), sleep duration, and pain. Results Adjusting for sociodemographics, children with CP had higher odds of mental health disorders (odds ratio [OR]=2.7–7.1, p<0.05) except for attention deficit disorder/ADHD (OR=2.5; 95% confidence interval [CI]=0.9–7.1). Further adjusting for physical factors, the odds of depression were no longer increased (i.e. attenuated) in children with CP (OR=1.0; 95% CI=0.3–3.3); however, the odds of anxiety (OR=3.8; 95% CI=1.9–7.8) and behavior/conduct problems (OR=3.8; 95% CI=1.3–11.1) remained elevated. Assessed individually, low physical activity and pain attenuated the odds of depression in children with CP (OR=1.9; 95% CI=0.7–5.3; OR=1.4; 95% CI=0.6–3.8 respectively). Interpretation Children with CP have an elevated prevalence of mental health disorders even after accounting for physical risk factors. Low physical activity and pain partially accounts for the association between CP and depression. What this paper adds Children with cerebral palsy (CP) have an elevated risk of developing mental health disorders. Physical factors do not fully account for higher mental health disorder prevalence. Physical activity partially accounts for the relationship between CP and depression. Pain partially accounts for the relationship between CP and depression.

Objective To examine the associations between sleep problems and quality of life (QoL) in children with cerebral palsy (CP). Methods Prospective correlational study using parent-report forms to measure QoL and sleep disorder symptoms. Two groups comprised of 41 children with CP and 91 typically developing (TD) controls age 8–12 years participated in a prospective correlational study. Results Measures were the PedsQL-4.0 Generic scales and the Pediatric Sleep Questionnaire, with subscales of interest including sleep disordered breathing (SDB), excessive daytime sleepiness (EDS), insomnia (INS) and snoring (SNOR). Hierarchical regression analyses indicated that EDS contributed unique variance in physical QoL, and INS contributed unique variance in psychosocial QoL in children with CP; for TD children, sleep disorder symptoms were infrequent and not associated with physical or psychosocial QoL. Conclusions Findings highlight the importance of assessing sleep difficulties when addressing the needs of children with CP.

Complicated mild-to-severe TBI earlier in childhood is associated with worse long-term neurocognitive and psychosocial outcomes than injury sustained in late adolescence. Findings provide further support for theories that early brain injury onset interferes with development of immature or rapidly developing skills, and may be associated with further magnification of deficits during the course of later development.