Autism and attention‐deficit/hyperactivity disorder in children with cerebral palsy: high prevalence rates in a population‐based study

다국어 초록 (Multilingual Abstract)

To assess a total population of school‐age children with cerebral palsy (CP) for autism and attention‐deficit/hyperactivity disorder (ADHD) with a view to determining their prevalence and to relate findings to motor function, intellectual disability, and other associated impairments.
Of 264 children, born between 1999 and 2006, from the CP register of western Sweden, 200 children (109 males, 91 females, median age at assessment 14y, range 7–18y) completed comprehensive screening and further neuropsychiatric clinical assessments.
Ninety children (45%) were diagnosed with autism, ADHD, or both, 59 (30%) were diagnosed with autism, and 60 (30%) were diagnosed with ADHD. Intellectual disability was present in 51%. Two‐thirds had autism, ADHD, and/or intellectual disability. In regression models, autism was mainly predicted by intellectual disability (odds ratio [OR]=4.1) and ADHD (OR=3.2), and ADHD was predicted by intellectual disability (OR=2.3) and autism (OR=3.0). Autism was more common in children born preterm (OR=2.0). Gross motor function was not associated with autism. ADHD prevalence was low in children with severe motor impairment, possibly due to diagnostic limitations.
Autism and ADHD were common in this population of children with CP and were mainlyindependent of motor severity and CP type. The strongest predictor of autism/ADHD was intellectual disability. Assessment for autism and ADHD is warranted as part of the evaluation in CP.



Forty‐five percent of the children with cerebral palsy also had autism, attention‐deficit/hyperactivity disorder (ADHD), or both.

Autism and ADHD were predicted mainly by intellectual disability.

Established diagnostic instruments worked well for all but the most disabled group of children.


Evaluar una población total de niños en edad escolar con parálisis cerebral (PC) con miras a determinar prevalencia del autismo y el trastorno por déficit de atención / hiperactividad (TDAH) y relacionar los hallazgos con la función motora, la discapacidad intelectual y otros trastornos asociados. y discapacidades.
De 264 niños, nacidos entre 1999 y 2006, del registro de PC del oeste de Suecia, 200 niños (109 varones, 91 mujeres, mediana de edad en la evaluación 14 años, rango 7‐18 años) completaron un cribado completo y evaluaciones clínicas neuropsiquiátricas adicionales.
Noventa niños (45%) fueron diagnosticados con autismo, TDAH o ambos, 59 (30%) fueron diagnosticados con autismo y 60 (30%) fueron diagnosticados con TDAH. La discapacidad intelectual estuvo presente en el 51%. Dos tercios tenían autismo, TDAH y / o discapacidad intelectual. En los modelos de regresión, el autismo fue predicho principalmente por la discapacidad intelectual (razón de posibilidades [OR] = 4,1) y el TDAH (OR = 3,2), y el TDAH predicho por la discapacidad intelectual (OR = 2,3) y el autismo (OR = 3,0). El autismo fue más común en los niños nacidos prematuros (OR = 2,0). La función motora gruesa no se asoció con el autismo. La prevalencia del TDAH fue baja en niños con deterioro motor grave, posiblemente debido a limitaciones diagnósticas.
El autismo y el TDAH eran comunes en esta población de niños con parálisis cerebral y eran principalmente independientes de la gravedad motora y el tipo de parálisis cerebral. El predictor más fuerte de autismo / TDAH fue la discapacidad intelectual. Se justifica la evaluación del autismo y el TDAH como parte de la evaluación en PC.
Avaliar a população total de crianças em idade escolar com paralisia cerebral (PC) quanto a autismo e transtorno do déficit de atenção e hiperatividade (TDAH), visando determinar sua prevalência e relacionar os achados com a função motora, deficiência intelectual, e outras deficiências associadas.
Das 264 crianças, nascidas entre 1999 e 2006, e pertencentes ao registro de PC da região oeste da Suécia, 200 crianças (109 do sexo masculino, 91 do sexo feminino, idade mediana na avaliação de 14a, varianção 7–18a) completaram testes abrangentes e avaliações neuropsiquiátricas clínicas.
Noventa crianças (45%) foram diagnosticadas com autismo, TDAH, ou ambos, 59 (30%) foram diagnosticadas com autismo, e 60 (30%) foram diagnosticadas com TDAH. A deficiência intelectual esteve presente em 51%. Dois terços tiveram autismo, TDAH, e/ou deficiência intelectual. Nos modelos de regressão, o autismo foi previsto principalmente pela deficiênca intelectual (taxa de risco [TR]=4,1) e TDAH (TR=3,2), e o TDAH foi previsto pela deficiência intelectual (TR=2,3) e autismo (TR=3,0). O autismo foi mais comum em crianças nascidas prematuras (TR=2,0). A função motora grossa não foi associada com o autismo. A prevalência de TDAH foi baixa em crianças com deficiência motora severa, possivelmente devido a limitações diagnósticas.
Autismo e TDAH foram comuns nesta população de crianças com PC e foram em geral independentes da severidade motora e tipo de PC. O mais forte preditor do autism/TDAH foi a deficiência intelectual. Avaliação para autismo e TDAH é recomendada como parte da avaliação em PC.



Forty‐five percent of the children with cerebral palsy also had autism, attention‐deficit/hyperactivity disorder (ADHD), or both.

Autism and ADHD were predicted mainly by intellectual disability.

Established diagnostic instruments worked well for all but the most disabled group of children.


This article's abstract has been translated into Spanish and Portuguese.
Follow the links from the abstract to view the translations.
This article is commented on by Gecz and Berry on pages 247–248 of this issue.
Video Podcast: https://youtu.be/7vf3cgXFCoQ