Abstract
Objective
To examine the association of cerebral palsy with autism spectrum
disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD),
providing evidence for interdisciplinary medical service for children
with cerebral palsy.
Design
A large-scale nationwide population-based study.
Setting
The National Health Interview Survey (NHIS).
Patients
177 899 children aged 3–17 years among NHIS participants from 1997
to 2003 and 2008 to 2018.
Results
Among the 177 899 children included in this analysis, 602 (0.33%)
had cerebral palsy, 1997 (1.16%) had ASD, and 13 697 (7.91%) had ADHD.
Compared with children without cerebral palsy, children with cerebral
palsy had a higher prevalence of ASD (6.09% vs 1.15%; p<0.001) and
ADHD (15.91% vs 7.89%; p<0.001). After adjustment for age, sex,
race/ethnicity, family highest education level, family income level and
geographical region, the OR among children with cerebral palsy, compared
with children without cerebral palsy, was 5.07 (95% CI 3.25 to 7.91) for
ASD (p<0.001) and 1.95 (95% CI 1.43 to 2.66) for ADHD (p<0.001).
Furthermore, the association of cerebral palsy with ASD and ADHD
remained significant in all subgroups stratified by age, sex and
race.
Conclusion
In a large, nationally representative sample of US children, this
study shows that children with cerebral palsy are at an increased risk
of ASD and ADHD.