Mental health disorders and physical risk factors in children with cerebral palsy: a cross‐sectional study

Whitney, Daniel G.; Warschausky, Seth; Peterson, Mark D.

doi:10.1111/dmcn.14083

Cited by 66 publications

(88 citation statements)

References 28 publications

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“…The average age at diagnosis of CP varies by country and setting and is reported to be between 12 and 27 months of age (Byrne, Noritz, Maitre,, & NCH Early Developmental Group, ; Granild‐Jensen, Rackauskaite, Flachs, & Uldall, ; Hubermann, Boychuck, Shevell, & Majnemer, ; Novak et al, ). A late diagnosis may result in missed intervention opportunities for children and their families: Delays in diagnosis are associated with significant parental dissatisfaction, stress, and depression (Baird, McConachie, & Scrutton, ; Novak et al, ) and higher rates of mental health problems in children and adolescents (Whitney, Warschausky, & Peterson, ). Conversely, early diagnosis, when given in a manner that is respectful, truthful, and responsive to parental need, can result in increased familial engagement and hope, driven by goals individualized to the child and family (McIntyre, Morgan, Walker, & Novak, ; Morgan, Novak, & Badawi, ; Novak et al, ).…”

Section: Introductionmentioning

confidence: 99%

Comparing parent and provider priorities in discussions of early detection and intervention for infants with and at risk of cerebral palsy

Byrne

Duncan

Pickar

et al. 2019

Child

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Background Although literature suggests that parents need support when their child is diagnosed with cerebral palsy (CP), it is unclear to what extent providers implement these supports in practice and what parental perspectives surround provider early diagnosis and management of CP. Therefore, we aimed to characterize and compare experiences of providers and parents of children with CP with regards to early detection and intervention. Method Seventeen parents participated in day‐long world‐café style workshops focused on categories extracted from the International Classification of Function framework and recent systematic reviews of early detection for CP. Thirty regional providers (generalists, specialists, and therapists) caring for infants with CP completed surveys with scaled score and open‐ended questions. Quantitative and qualitative data were independently assessed by two reviewers to identify prominent themes. Results All parents (100%) stated early diagnosis or high risk for CP classification was beneficial compared with only 50% of providers who often gave early CP diagnoses before 12 months. Top parent priorities were honesty and positively phrased messages. Providers most often addressed cognition, primary care need, motor, and feeding issues (80%, 62%, 54%, 54% frequently/sometimes). Matching priorities for discussion were neuroimaging timing/risk/benefit, cognition, primary care, motor, and feeding/nutrition. Discordance occurred for participation, parent well‐being, pain and vision, with parents wanting more education and resources. Conclusions Receiving early diagnoses or high‐risk for CP classification is a parent priority. Alignment between parents and providers exists for International Classification of Function domains of body functions/structures and activity, but less for those of environment, personal, and participation.

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Section: Introductionmentioning

confidence: 99%

Comparing parent and provider priorities in discussions of early detection and intervention for infants with and at risk of cerebral palsy

Byrne

Duncan

Pickar

et al. 2019

Child

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“…Although the severity and resulting health and functional sequelae of CP varies, the condition is associated with a disruption in the development of neuromotor pathways leading to a wide range of fine and gross motor function impairments. Many secondary complications that arise during childhood include problems with neuromuscular, musculoskeletal and psychological systems. In addition, children with CP tend to have lower societal integration and social enjoyment, which can amplify the already present complications, and lead to new problems throughout development.…”

Section: Introductionmentioning

confidence: 99%

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

et al. 2019

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Summary The purpose of our scoping review was to determine if children and young people with cerebral palsy (CP) have elevated total or regional body fat compared to children and young people without CP. Databases (Ovid MEDLINE, Embase Ovid, CINHAL and Scopus) were systematically searched from 1 January 1993 to 7 December 2018 in order to identify articles that compared weight status, total body fat or regional body fat (eg, abdominal) between children and young people (0‐21 years) with and without CP. Extracted data included country, subject characteristics, group sample sizes and matching strategies, methods/measures for weight status/fat depot, fat depot(s) assessed and key findings. Twenty‐two studies were included. Of these, 19 studies examined total body fat; the most common method was use of anthropometrics and the more common measures were body mass index and skin‐fold thickness. Twelve studies examined at least one regional fat depot; the most common method was use of anthropometrics and the most common measure was skin‐fold thickness. Findings were inconsistent across studies. Further, among 10 studies that examined total and regional body fat depots, 8 found differences across fat depots within the same children and young people (eg, no difference in total body fat but higher abdominal fat). This review provides a summary of inconsistent findings from published studies on body fat comparisons between children and young people with vs without CP, highlights limitations for evaluating body fat for children with CP and discusses future research directions.

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“…3 This contrasts with the very high rates of (potentially treatable) ADHD we found in population-based studies of children with CP. 3 This contrasts with the very high rates of (potentially treatable) ADHD we found in population-based studies of children with CP.…”

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confidence: 83%

“…We have known since 1996 that autism is overrepresented in CP 1 and that other mental health conditions (including attention-deficit/hyperactivity disorder [ADHD]) also occur at higher rates in children with CP. 3 They further state that increased risk of depression in children with CP is associated with low physical activity, suggesting that increased physical activity might lower the rate of depression in these children. 3,4 They draw attention to the need to broaden the scope of assessment, work-up, and follow-up of children and families affected by CP.…”

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confidence: 99%

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This commentary is on the systematic review by Barreto et al on pages 163-168 of this issue.

Cerebral palsy (CP) is a complex syndrome, rather than a unique disorder, separate from other neurological, neurodevelopmental, and neuropsychiatric conditions. 3,4 They draw attention to the need to broaden the scope of assessment, work-up, and follow-up of children and families affected by CP. 2 Two recent papers address the neuropsychiatric problems associated with CP in children and their parents.

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confidence: 99%

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Mental health problems in cerebral palsy: comprehensive management for children and their families

Gillberg

2019

Develop Med Child Neuro

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This commentary is on the systematic review by Barreto et al. on pages 163-168 of this issue.Cerebral palsy (CP) is a complex syndrome, rather than a unique disorder, separate from other neurological, neurodevelopmental, and neuropsychiatric conditions. We have known since 1996 that autism is overrepresented in CP 1 and that other mental health conditions (including attention-deficit/hyperactivity disorder [ADHD]) also occur at higher rates in children with CP. 2 Two recent papers address the neuropsychiatric problems associated with CP in children and their parents. 3,4 They draw attention to the need to broaden the scope of assessment, work-up, and follow-up of children and families affected by CP. Based on the US National Survey of Children's Health, Whitney et al. conclude that anxiety, behavioural problems, depression, and mental 'multimorbidity' are much more common in CP than in the general population of children. 3 They further state that increased risk of depression in children with CP is associated with low physical activity, suggesting that increased physical activity might lower the rate of depression in these children. While this seems to be a reasonable assumption and a good basis for a new study, no such effect of increased physical activity has yet been demonstrated.Whitney et al. also found no statistically significant increase in the prevalence of ADHD in their sample of children with CP. 3 This contrasts with the very high rates of (potentially treatable) ADHD we found in population-based studies of children with CP. 2 Given the 70% non-responserate in Whitney et al.'s study and the high rate of ADHD among non-responders in general child population studies, it is possible that ADHD rates were underestimated. Further, it is unclear why the authors did not include autism among the disorders that they looked for, given the high rate (18%) of autism reported by P ahlman et al. 2 The systematic review by Barreto et al. reports a higher prevalence of symptoms of depression and anxiety in parents of children with CP. 4 With regard to anxiety, however, Barreto et al. seem to have only actually found one study indicating there is no presented evidence that the rate is higher than in typical children or in parents of children with other neurological disorders.Even so, the two papers 3,4 are invaluable in identifying the need for prospective, longitudinal, controlled studies of child and parent mental (and physical) health in the context of CP. The many questions that remain unanswered in this regard include the following: (1) What is the full range of problems faced by children with CP and their families? An Early Symptomatic Syndromes Eliciting Neurodevelopmental (Neuropsychiatric) Clinical Examinations (ESSENCE) approach 5 could be taken to assess the full range of possible problems in each individual, including autism and other communication disorders, ADHD, depression, anxiety, and learning disorders. (2) What is the parents' health status before the occurrence of CP? (3) How old is the child when ev...

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Mental health disorders and physical risk factors in children with cerebral palsy: a cross‐sectional study

Cited by 66 publications

References 28 publications

Comparing parent and provider priorities in discussions of early detection and intervention for infants with and at risk of cerebral palsy

Comparing parent and provider priorities in discussions of early detection and intervention for infants with and at risk of cerebral palsy

Total and regional body fat status among children and young people with cerebral palsy: A scoping review

Mental health problems in cerebral palsy: comprehensive management for children and their families

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