Autism Spectrum Disorder in the Child with Cerebral Palsy

Cerebral palsy (CP) and autism spectrum disorder (ASD) are separate complex and heterogeneous disorders resulting from a range of etiologies impacting early brain development. Both CP and ASD are clinical descriptive terms that encompass many etiologies. At the intersection of CP and ASD, there are individuals that meet criteria for both of these disorders. Although CP has a defining focus on movement and posture and ASD is defined by difficulties in social communication, these distinct clinically defined disorders share many associated features. Further, the diagnostic evaluation of ASD may be uniquely challenging in children with CP depending upon their level of motor functioning. This chapter will explore the relationship between CP and ASD including incidence, causative factors, evaluation, and management of both clinical disorders.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Subscribe and save

• Get 10 units per month
• Download Article/Chapter or eBook
• 1 Unit = 1 Article or 1 Chapter
• Cancel anytime

Buy Now

eBook EUR 1,283.99 Price includes VAT (France)

Hardcover Book EUR 1,582.49 Price includes VAT (France)

Tax calculation will be finalised at checkout

Purchases are for personal use only

Similar content being viewed by others

Autism Spectrum Disorder in the Child with Cerebral Palsy

Cerebral Palsy and Autism Spectrum Disorder

Diagnosis of Cerebral Palsy

References

• Agrawal S, Rao SC, Bulsara MK et al (2018) Prevalence of autism spectrum disorder in preterm infants: a meta-analysis. Pediatrics 142. https://doi.org/10.1542/peds.2018-0134
• American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Arlington BookGoogle Scholar
• Ashwal S, Russman BS, Blasco PA et al (2004) Practice parameter: diagnostic assessment of the child with cerebral palsy. Am Acad Neurol 62:851–863 CASGoogle Scholar
• Ballaban-Gil K, Tuchman R (2000) Epilepsy and epileptiform EEG: association with autism and language disorders. Ment Retard Dev Disabil Res Rev 6:300–308 ArticleCASPubMedGoogle Scholar
• Bedford R, Pickles A, Lord C (2016) Early gross motor skills predict the subsequent development of language in children with autism spectrum disorder. Autism Res 9(9):993–1001. https://doi.org/10.1002/aur.1587ArticlePubMedGoogle Scholar
• Bent S, Hendren RL (2015) Complementary and alternative treatments for autism part 1: evidence supported treatments. AMA J Ethics 17(4):369–374 ArticlePubMedGoogle Scholar
• Bhat AN, Galloway JC, Landa RJ (2012) Relationship between early motor delay and later communication delay in infants at risk for autism. Infant Behav Dev 35(4):838–846. https://doi.org/10.1016/j.infbeh.2012.07.019ArticleCASPubMedPubMed CentralGoogle Scholar
• Boulanger-Bertolus J, Pancaro C, Mashour GA (2018) Increasing role of maternal immune activation in neurodevelopmental disorders. Behav Neurosci 12. https://doi.org/10.3389/fnbeh.2018.00230
• Center for Disease Control and Prevention (2014) Prevalence of autism spectrum disorder among children aged 8 years – autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR. Morbidity and Mortality Weekly Reports. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.html
• Choueiri RN, Zimmerman AW (2017) New assessments and treatments in ASD. Pediatr Neurol 19:6. https://doi.org/10.1007/s11940-017-0443-8ArticleGoogle Scholar
• Christensen D, Van Naarden Braun K, Doernberg N et al (2014) Prevalence of cerebral palsy, co-occurring autism spectrum disorders, and motor functioning – autism and developmental disabilities monitoring network, USA, 2008. Dev Med Child Neurol 56:59–65. https://doi.org/10.1111/dmcn.12268ArticlePubMedGoogle Scholar
• Cooper AS, Friedlaender E, Levy SE et al (2016) The implications of brain MRI in autism spectrum disorder. J Child Neurol 31. https://doi.org/10.1177/0883073816665548
• Council on Children with Disabilities, Section on Developmental Behavioral Pediatrics, Bright Futures Steering Committee and Medical Home Initiatives for Children With Special Needs Project Advisory Committee (2006) Identifying infants and young children with developmental disorders in the medical home: an algorithm for developmental surveillance and screening. Pediatrics 118:405–420 ArticleGoogle Scholar
• Delgado MR, Hirtz D, Aisen M et al (2010) Practice parameter: pharmacologic treatment of spasticity in children and adolescents with cerebral palsy (an evidence-based review). Neurology 74:336–343 ArticleCASPubMedPubMed CentralGoogle Scholar
• Delobel-Ayoub M, Klapouszczak D, Van Bakel M et al (2017) Prevalence and characteristics of autism spectrum disorders in children with cerebral palsy. Dev Med Child Neurol 59:738–742. https://doi.org/10.1111/dmcn.13436ArticlePubMedGoogle Scholar
• Dougherty CC, Evans DW, Myers SM et al (2016) A comparison of structural brain imaging findings in autism spectrum disorder and attention-deficit hyperactivity disorder. Neuropsychol Rev 26:25–43. https://doi.org/10.1007/s11065-015-9300-2ArticlePubMedGoogle Scholar
• Fahey MC, Maclennan AH, Kretzschmar D et al (2017) The genetic basis of cerebral palsy. 59 (5):462–469 Google Scholar
• Fournier K, Hass C, Naik S et al (2010) Motor coordination in autism spectrum disorders: a synthesis and meta-analysis. J Autism Dev Disord 40:1227–1240. https://doi.org/10.1007/s10803-010-0981-3ArticlePubMedGoogle Scholar
• Froehlich-Santino W, Tobon AL, Cleveland S et al (2014) Prenatal and perinatal risk factors in a twin study of autism Spectrum disorders. J Psychiatr Res 54:100–108. https://doi.org/10.1016/j.jpsychires.2014.03.019ArticlePubMedPubMed CentralGoogle Scholar
• Gururaj AK, Sxtriha L, Bener A et al (2003) Epilepsy in children with cerebral palsy. Seizure 12:110–114. https://doi.org/10.1016/S1059-1311(02)00255-8ArticleCASPubMedGoogle Scholar
• Hanson E, Kalish L, Bunce E et al (2007) Use of complementary and alternative medicine among children diagnosed with autism spectrum disorder. J Autism Dev Disord 37:628–636 ArticlePubMedGoogle Scholar
• Harrington JW, Rosen L, Garencho A et al (2006) Parental perceptions and use of complementary and alternative medicine practice for children with autistic spectrum disorders in private practice. J Dev Behav Pedaitr 27(2):S156–S161 ArticleGoogle Scholar
• Hendaus MA, Jomha FA, Alhammadi AH (2016) Melatonin in the management of perinatal hypoxic-ischemic encephalopathy: light at the end of the tunnel? Neuropsychiatr Dis Treat 12:2473–2479. https://doi.org/10.2147/NDT.S115533ArticleCASPubMedPubMed CentralGoogle Scholar
• Hurvitz EA, Leonard C, Ayyangar R et al (2003) Complementary and alternative medicine use in families of children with cerebral palsy. Dev Med Child Neurol 45:364–370. https://doi.org/10.1111/j.1469-8749.2003.tb00414.xArticlePubMedGoogle Scholar
• Jiang YH, Yuen RK, Jin X et al (2013) Detection of clinically relevant genetic variants in autism spectrum disorder by whole-genome sequencing. Am J Hum Genet 93(2):249–263 ArticleCASPubMedPubMed CentralGoogle Scholar
• Johnson CP, Myers SM, Council on Children with Disabilities (2007) Identification and evaluation of children with autism spectrum disorders. Pediatrics 120(5):1183–1215 ArticlePubMedGoogle Scholar
• Kilincaslan A, Mukaddes NM (2009) Pervasive developmental disorders in individuals with cerebral palsy. Dev Med Child Neurol 51:289–294. https://doi.org/10.1111/j.1469-8749.2008.03171ArticlePubMedGoogle Scholar
• Kirby RS, Wingate MS, Van Naarden Braun K et al (2011) Prevalence and functioning of children with cerebral palsy in four areas of the United States in 2006: a report from the autism and developmental disabilities monitoring network. Res Dev Disabil 32:462–469. https://doi.org/10.1016/j.ridd.2010.12.042ArticlePubMedGoogle Scholar
• Kolevzon A, Gross R, Reichenberg A (2007) Prenatal and perinatal risk factors for autism. Arch Pediatr Adolesc Med 161(4):326–333. https://doi.org/10.1001/archpedi.161.4.326ArticlePubMedGoogle Scholar
• Korzeniewski SJ, Birbeck G, DeLano MC et al (2008) A systematic review of neuroimaging for cerebral palsy. J Child Neurol 23(2):216–227 ArticlePubMedGoogle Scholar
• Liptak G (2005) Complementary and alternative therapies for cerebral palsy. Ment Retard Dev Disabil Res Rev 11:156–163 ArticlePubMedGoogle Scholar
• Loomes R, Hull L, Mandy WPL (2017) What is the male-to-female ratio in autism Spectrum disorder? A systematic review and Meta-analysis. J Am Acad Child Adolesc Psychiatry 56(6):466–474. https://doi.org/10.1016/j.jaac.2017.03.013ArticlePubMedGoogle Scholar
• Lungu C, Hirtz D, Damiano D et al (2016) Report of a workshop on research gaps in the treatment of cerebral palsy. Neurology 87:1293–1298. https://doi.org/10.1212/WNL.0000000000003116ArticleCASPubMedPubMed CentralGoogle Scholar
• Maramara LA, Wenzhuan H, Ming X (2014) Pre- and perinatal risk factors for autism spectrum disorder in a New Jersey cohort. J Child Neurol 29(12):1645–1651. https://doi.org/10.1177/0883073813512899ArticlePubMedGoogle Scholar
• McMichael G, Girirajan S, Moreno-De-Luca A et al (2014) Rare copy number variation in cerebral palsy. Eur J Hum Genet 22:40–45 ArticleCASPubMedGoogle Scholar
• Miller F, Bachrach S (2006) Cerebral palsy, a complete guide for caregiving, 2nd edn. Johns Hopkins Press, Baltimore Google Scholar
• Minocha P, Sitaraman S, Sachdeva P (2017) Clinical Spectrum, comorbidities, and risk factor profile of cerebral palsy children: a prospective study. J Pediatr Neurosci 12(1):15–18 ArticlePubMedPubMed CentralGoogle Scholar
• Modabbernia A, Velthorst E, Reichenberg A (2017) Environmental risk factors for autism: an evidence-based review of systematic reviews and meta-analyses. Mol Autism 8:13. https://doi.org/10.1186/s13229-017-0121-4ArticleCASPubMedPubMed CentralGoogle Scholar
• Molloy CA, Murray DS, Akers R et al (2011) Use of the Autism Diagnostic Observation Schedule (ADOS) in a clinical setting. https://doi.org/10.1177/1362361310379241
• National Institutes of Health. Complementary, alternative, or integrative health: What’s in a name? https://nccih.nih.gov/health/integrative-health. Accessed 2 Oct 2017
• Oskoui M, Coutinho F, Dykeman J et al (2013) An update on the prevalence of cerebral palsy: a systematic review and meta analysis. Dev Med Child Neurool 55(6):509–519. https://doi.org/10.1111/dmcn.12080ArticleGoogle Scholar
• Oskoui M, Gazzellone MJ, Thiruvahindrapuram B et al (2015) Clinically relevant copy number variations detected in cerebral palsy. Nat Commun 6:7949 ArticleCASPubMedGoogle Scholar
• Rosenbaum P, Paneth N, Van Naarden Braun K et al (2007) A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol 49:8–14. https://doi.org/10.1111/j.469-8749.2007.td2610.xArticleGoogle Scholar
• Schaefer GB, Mendelsohn NJ (2013) Clinical genetics evaluation in identifying the etiology of autism spectrum disorders: 2013 guideline revisions. Genet Med 15(5):399–407 ArticleCASPubMedGoogle Scholar
• Sebat J, Lakshmi B, Malhotra D et al (2007) Strong association of de novo copy number mutations with autism. Science 316(5823):445–449 ArticleCASPubMedPubMed CentralGoogle Scholar
• Segel R, Ben-Pazi H, Zeligson S et al (2015) Copy number variations in cryptogenic cerebral palsy. Neurology 84:1660–1668 ArticlePubMedGoogle Scholar
• Stadskleiv K, Jahnsen R, Anderson G et al (2017) Neuropsychological profiles of children with cerebral palsy. Dev Rehabil. https://doi.org/10.1080/17518423.2017.1282054
• Whittingham K, Fahey M, Rawicki B et al (2010) The relationship between motor abilities and early social development in a preschool cohort of children with cerebral palsy. Res Dev Disabil 31:1346–1351. https://doi.org/10.1016/j.ridd.2010.07.006ArticlePubMedGoogle Scholar
• Yu TW, Chahrour MH, Coulter ME et al (2013) Using whole-exome sequencing to identify inherited causes of autism. Neuron 77(2):259–273 ArticleCASPubMedPubMed CentralGoogle Scholar
• Zwaigenbaum L, Bauman ML, Chouieri R et al (2015) Early intervention for children with autism spectrum disorder under 3 years of age: recommendations for practice and research. Pediatrics 136:S60–S81 ArticlePubMedGoogle Scholar

Author information

Authors and Affiliations

1. Department of Pediatrics, Nemours/AI DuPont Hospital for Children, Wilmington, DE, USA Meghan Harrison & Persephone Jones
2. Division of Developmental Medicine, Department of Pediatrics, Nemours/AI DuPont Hospital for Children, Wilmington, DE, USA Meghan Harrison & Persephone Jones

1. Meghan Harrison