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A systematic review of comorbidity between cerebral palsy, autism spectrum disorders and Attention Deficit
Francesco Craig1, Rosa Savino1, Antonio Trabacca1
1Scientific Institute I.R.C.C.S, "Eugenio Medea", "La Nostra Famiglia", Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi Research Centre, Brindisi, Italy.
Insights
Autism spectrum disorders (ASDs) and Attention-Deficit/Hyperactivity Disorder (ADHD) are more common in children with Cerebral Palsy (CP). Further research is needed to develop suitable diagnostic tools for this population.
Area of Science:
- Neurology
- Developmental Pediatrics
- Psychiatry
Background:
- Cerebral Palsy (CP) is a complex developmental disorder affecting movement and posture.
- Autism Spectrum Disorders (ASDs) and Attention-Deficit/Hyperactivity Disorder (ADHD) are common neurodevelopmental conditions.
- Understanding the comorbidity between CP, ASDs, and ADHD is crucial for comprehensive care.
Purpose of the Study:
- To systematically review the incidence and prevalence of comorbidity between Cerebral Palsy (CP), Autism Spectrum Disorders (ASDs), and Attention-Deficit/Hyperactivity Disorder (ADHD).
Main Methods:
- A comprehensive literature search was conducted across major databases including PubMed, EBSCOhost, Scopus, and Web of Science.
- Search terms combined "cerebral palsy" with "autism" OR "ASD" OR "pervasive development disorder" AND "Attention Deficit Hyperactivity Disorder" OR "ADHD".
- Full-text articles were screened for eligibility, with a focus on peer-reviewed studies.
Main Results:
- The review identified a significant number of studies on CP and ASD (n=28) and CP and ADHD (n=19).
- Findings suggest that ASD and ADHD are more prevalent in individuals with CP compared to the general population.
- Current gold-standard diagnostic methods for ASD and ADHD are not well-suited for individuals with motor impairments associated with CP.
Conclusions:
- Early assessment of ASD and ADHD in children with CP can improve healthcare costs and daily living for affected families.
- There is a need for psychometric studies to develop diagnostic measures appropriate for individuals with CP.
- Further research is required to investigate the occurrence of ASD and ADHD across different CP subtypes and explore common pathogenic mechanisms.
Objectives:
The aim of this systematic review was to examine the incidence and prevalence of comorbidity between Cerebral Palsy (CP), Autism spectrum disorders (ASDs) and Attention-Deficit/Hyperactivity Disorder (ADHD).
Methods:
We searched for articles indexed in PubMed, EBSCOhost, Scopus, Web of Science and other potentially relevant internet sources using a combination of expressions including "cerebral palsy" AND "autism" OR "ASD" OR "pervasive development disorder" AND "Attention Deficit Hyperactivity Disorder" OR "ADHD".
Results:
We identified 2542 studies on CP and ASD and 998 studies on CP and ADHD. After screening titles and abstracts and removing duplicated studies, 47 full papers (CP and ASD n = 28; CP and ADHD n = 19) were downloaded and screened for eligibility. Twenty-eight (CP and ASD n = 16; CP and ADHD n = 12) studies were identified in the peer-review literature. Based on this systematic review, ASD and ADHD seem to be more common in people with CP than in the general population, yet the gold standard methods for diagnosing ASD or ADHD are not suitable for children with motor problems.
Conclusions:
Assessing the occurrence of ASD and ADHD would improve the significant cost of healthcare, therapies, and overall daily living for families with children affected by CP. However, psychometric studies are needed in the future to promote development of measures suitable for individuals with CP. In addition, this review highlights the paucity of peer-reviewed studies investigating the occurrence of ASD and ADHD in children with different CP subtypes or functional abilities, and there are still some open questions about pathogenic mechanisms common to CP, ASD and ADHD.
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