Autism spectrum disorder and attention-deficit/hyperactivity disorder in children with cerebral palsy: results from scre
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ORIGINAL CONTRIBUTION
Autism spectrum disorder and attention‑deficit/hyperactivity disorder in children with cerebral palsy: results from screening in a population‑based group Magnus Påhlman1,2 · Christopher Gillberg1 · Elisabet Wentz3 · Kate Himmelmann2,4 Received: 6 August 2019 / Accepted: 3 January 2020 © The Author(s) 2020
Abstract Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are more common in children with cerebral palsy (CP) than in the general population, but may still be underdiagnosed. This study aimed to estimate screenpositive ASD and ADHD in a population-based group of 264 school-aged children with CP born 1999–2006 from the CP register of western Sweden. Validated parent-completed questionnaires were used at a median age of 12 years 11 months (range 8–17 years). Three different scales were used to detect signs of ASD and ADHD, respectively. Response rate was 88% (232/264). In 19 children, all in the most disabled group, the screening procedure was not feasible due to too few questionnaire items completed, leaving 213 for analyses. One third (74/213) of the children screened positive for ASD and half of the children (106/213) for ADHD, which was about twice as often as ASD/ADHD diagnoses had been clinically identified. Children with intellectual disability, epilepsy and/or impaired speech ability more often screened positive for ASD as well as ADHD. Severe motor impairment was more frequently associated with screen-positive ASD, but not ADHD. Neither sex nor CP type was associated with screen-positive ASD/ADHD. In conclusion, school-aged children with CP very often screened positive for ASD and/or ADHD. The prevalence of ASD and ADHD is most likely underestimated in children with CP. These screening findings require further investigations. Keywords Cerebral palsy · Autism · ADHD · Children · Screening
Introduction Cerebral palsy (CP) is the most common cause of motor disability in childhood, affecting about 2 per 1000 live births [1, 2]. CP is an umbrella term of conditions, heterogeneous in causation and manifestations, of non-progressive * Magnus Påhlman [email protected] 1
Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
2
Regional Rehabilitation Centre, Queen Silvia Children’s Hospital, Gothenburg, Sweden
3
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
4
Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
disturbances affecting the immature brain. Children with CP often have other functional disabilities and activity restrictions than the motor disability. In the most recent definition [3] problems relating to cognition, communication, behaviour, and sensation are mentioned. Several studies have described how the accompanying disabilities can be more disabling th
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