A systematic review of comorbidity between cerebral palsy, autism spectrum disorders and Attention Deficit Hyperactivity Disorder

Nov 18, 2018European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society

Overlap of cerebral palsy, autism, and ADHD: a systematic review

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Abstract

Among 28 identified studies, Autism spectrum disorders and Attention-Deficit/Hyperactivity Disorder appear to be more common in individuals with Cerebral Palsy than in the general population.

The review identified 2542 studies related to Cerebral Palsy and Autism spectrum disorders, and 998 studies on Cerebral Palsy and ADHD.
After screening, 47 full papers were deemed eligible, with 28 studies ultimately included in the analysis.
Standard diagnostic methods for Autism and ADHD may not be suitable for children with motor impairments associated with Cerebral Palsy.
There is a lack of peer-reviewed research focusing on the prevalence of Autism and ADHD across various subtypes of Cerebral Palsy.
Future psychometric studies are necessary to develop appropriate diagnostic measures for individuals with Cerebral Palsy.

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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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A systematic review of comorbidity between cerebral palsy, autism spectrum disorders and Attention Deficit Hyperactivity Disorder

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