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One-third of school-aged children with cerebral palsy have neuropsychiatric impairments in a population-based study
Magnus Påhlman1,2, Christopher Gillberg1, Kate Himmelmann2,3
1Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
Insights
Most school-aged children with cerebral palsy (CP) have associated impairments, including high rates of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Broad assessment is crucial for these children.
Area of Science:
- Neurology
- Developmental Pediatrics
- Child Psychiatry
Background:
- Cerebral palsy (CP) significantly impacts motor function in children.
- Associated neurological and developmental impairments are common in children with CP.
Purpose of the Study:
- To characterize motor function and associated impairments in school-aged children with CP.
- Specifically investigate the prevalence of autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in this population.
Main Methods:
- A population-based study included 264 children with CP born between 1999-2006 in Västra Götaland, Sweden.
- Data were collected from the CP Register and medical records between 4-17 years of age.
Main Results:
- 75% of children with CP had associated impairments; 63% were independent walkers.
- Prevalence of intellectual disability (ID) was 53%, epilepsy 41%, vision impairment 19%, hearing impairment 8%, and speech impairment 54%.
- Neuropsychiatric impairments affected 32%, with ASD in 18% and ADHD in 21% of children with CP.
Conclusions:
- Three in four school-aged children with CP experience associated impairments, highlighting the need for comprehensive assessments.
- The high incidence of ASD and ADHD in children with CP warrants further in-depth research into these specific conditions.
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 Västra Götaland, 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.
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