Attention Deficit Hyperactivity Disorder in Children With Cerebral Palsy: A Case-Control Study
Michele Zaman1, Tarannum Behlim2, Pamela Ng2
1Department of Medicine, Queen's University, Ontario, Canada.
Neurology
|February 25, 2025
Summary
Attention deficit hyperactivity disorder (ADHD) is significantly more common in children with cerebral palsy (CP). This highlights the need to consider neurodevelopmental disorders in CP care.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Public Health Research
Background:
- Cerebral palsy (CP) is the leading physical disability in children, frequently co-occurring with neurodevelopmental disorders (NDDs) like attention deficit hyperactivity disorder (ADHD).
- Both CP and ADHD are influenced by complex genetic and environmental factors, significantly impacting a child's daily functioning and overall well-being.
- Understanding the prevalence and associated factors of ADHD in children with CP is crucial for comprehensive care and intervention strategies.
Purpose of the Study:
- To determine the prevalence of ADHD in school-aged children diagnosed with cerebral palsy (CP).
- To investigate factors associated with ADHD in children with CP, including sex, socioeconomic status, epilepsy, prematurity, CP subtype, and motor function.
- To compare ADHD prevalence in children with CP against a control group.
Main Methods:
- A cross-sectional study utilizing linked data from a population-based CP registry and administrative health claims databases in Quebec, Canada.
- Inclusion criteria: Children diagnosed with CP born between 1999 and 2002.
- ADHD diagnosis was identified through International Classification of Diseases codes and ADHD medication prescriptions; statistical analyses (odds ratios, confidence intervals) were employed to explore associations.
Main Results:
- The study included 302 children with CP and 6,040 matched controls.
- ADHD prevalence was substantially higher in the CP cohort (38%) compared to controls (12%).
- Multivariate analysis indicated that less severe motor impairment was significantly associated with higher odds of ADHD in children with CP (OR 2.02, 95% CI 1.07-3.94).
Conclusions:
- Children with cerebral palsy exhibit a significantly higher prevalence of ADHD, supporting the concept of a neurodevelopmental overlap between these conditions.
- The findings underscore the importance of screening for and managing NDDs, particularly ADHD, in the comprehensive care of children with CP.
- Further research is warranted to elucidate the neurobiological underpinnings connecting CP and ADHD and their combined impact on health outcomes.
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