One‐third of school‐aged children with cerebral palsy have neuropsychiatric impairments in a population‐based study

Abstract

Aim: To describe motor function and associated impairments, particularly autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), in school-aged children with cerebral palsy (CP).Methods: Population-based study of all children with CP born 1999-2006 from the county of V€ astra G€ otaland, Sweden; 264 children (141 males, 123 females). Information was obtained from the CP Register of western Sweden (data collected at 4-8 years of age) and all medical records at 10-17 years of age.Results: Cerebral palsy was spastic in 76%, dyskinetic in 17% and ataxic in 7% of all children. Sixty-three per cent were independent walkers. Associated impairments were present in 75%. Vision was impaired in 19%, hearing in 8% and speech in 54%. Intellectual disability (ID) was present in 53% and epilepsy in 41%. ID had increased from 42% to 53% since preschool-age. Neuropsychiatric impairments were present in 32% of the children; ASD in 18%; and ADHD in 21%. All impairments, except for ASD and ADHD, increased with more severe motor impairment.Conclusion: Three in four school-aged children with CP have associated impairments, underscoring the need to broadly assess every child. The high rate of ASD and ADHD points to the importance of in-depth studies of such impairments in CP. 2048

Mental health problems in cerebral palsy: comprehensive management for children and their families

“…2 Two recent papers address the neuropsychiatric problems associated with CP in children and their parents. We have known since 1996 that autism is overrepresented in CP 1 and that other mental health conditions (including attention-deficit/hyperactivity disorder [ADHD]) also occur at higher rates in children with CP.…”

“…We have known since 1996 that autism is overrepresented in CP 1 and that other mental health conditions (including attention-deficit/hyperactivity disorder [ADHD]) also occur at higher rates in children with CP. Further, it is unclear why the authors did not include autism among the disorders that they looked for, given the high rate (18%) of autism reported by P ahlman et al 2 The systematic review by Barreto et al reports a higher prevalence of symptoms of depression and anxiety in parents of children with CP. 3,4 They draw attention to the need to broaden the scope of assessment, work-up, and follow-up of children and families affected by CP.…”

“…Further, it is unclear why the authors did not include autism among the disorders that they looked for, given the high rate (18%) of autism reported by P ahlman et al 2 The systematic review by Barreto et al reports a higher prevalence of symptoms of depression and anxiety in parents of children with CP. 3 This contrasts with the very high rates of (potentially treatable) ADHD we found in population-based studies of children with CP.…”

“…3 This contrasts with the very high rates of (potentially treatable) ADHD we found in population-based studies of children with CP. Further, it is unclear why the authors did not include autism among the disorders that they looked for, given the high rate (18%) of autism reported by P ahlman et al 2 The systematic review by Barreto et al reports a higher prevalence of symptoms of depression and anxiety in parents of children with CP. Further, it is unclear why the authors did not include autism among the disorders that they looked for, given the high rate (18%) of autism reported by P ahlman et al 2 The systematic review by Barreto et al reports a higher prevalence of symptoms of depression and anxiety in parents of children with CP.…”

“…2 Given the 70% non-responserate in Whitney et al's study and the high rate of ADHD among non-responders in general child population studies, it is possible that ADHD rates were underestimated. Further, it is unclear why the authors did not include autism among the disorders that they looked for, given the high rate (18%) of autism reported by P ahlman et al 2 The systematic review by Barreto et al reports a higher prevalence of symptoms of depression and anxiety in parents of children with CP. 4 With regard to anxiety, however, Barreto et al seem to have only actually found one study indicating there is no presented evidence that the rate is higher than in typical children or in parents of children with other neurological disorders.Even so, the two papers 3,4 are invaluable in identifying the need for prospective, longitudinal, controlled studies of child and parent mental (and physical) health in the context of CP.…”