Cerebral Palsy and ADHD

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Children with cerebral palsy often have several co-existing conditions, including attention deficit hyperactivity disorder (ADHD). ADHD causes inattentiveness, hyperactivity, and impulsive behaviors. Treatments include therapy and medications and are effective for many children.

What Is ADHD?

According to the National Institute of Mental Health (NIMH), ADHD is considered a brain disorder characterized by chronic inattentiveness, impulsiveness, and hyperactivity that can interfere with daily tasks and functioning.[1] Some children have problems with poor focus, while others have issues with hyperactivity. Some children have symptoms from both categories.

The Centers for Disease Control and Prevention (CDC) states that in 2011, around 11% of children, 4-17 years of age in the U.S. were diagnosed with ADHD. About 19% of children who have cerebral palsy also have ADHD.[2]

The most common signs and symptoms of ADHD include:

Inattentiveness

• Overlooking details
• Making careless errors
• Failure to listen when someone is speaking
• Easily distracted
• Constantly losing things, such as homework, school supplies, etc.
• Failure to finish schoolwork, household chores, or other tasks
• Difficulties in organizing tasks and activities
• Difficulties remembering important dates and turning in homework

Impulsiveness and Hyperactivity

• Fidgeting around while seated
• Constantly moving around
• Feeling restless
• Frequently interrupts conversations, games, or activities
• Trouble waiting their turn
• Jumping up from seat during class time or other times when being seated is expected

Several risk factors contribute to children developing ADHD. However, scientists and researchers are still unsure of exactly what causes it.

Possible risk factors include genetics, environmental toxin exposure during pregnancy, drinking, smoking during pregnancy, low birth weight, and brain injuries.

Boys tend to develop ADHD more than girls, but girls that do develop ADHD, generally have issues with inattention. They’re less likely to be hyperactive and impulsive.

Treatment Options

There are several treatment options available that have proven beneficial to many children with ADHD. Since each child is different, it’s always important to determine the best treatment plan by consulting with your child’s physician and other medical experts.

Behavioral Therapy

The first line of treatment for ADHD is typically behavioral therapy. It’s a form of psychotherapy that focuses on helping children change behavior patterns that hinder their success at home, school, and among friends and peers.

Behavioral therapists aim to teach children with ADHD how to focus on their own actions and behavior and how to praise themselves when they’ve acted appropriately in situations where they would usually be disruptive or inattentive.

Another form of behavioral therapy, known as cognitive behavioral therapy, incorporates meditation techniques to teach patients how to be aware of their actions while accepting their thoughts and feelings.

In some cases, according to studies, cognitive and behavioral therapy, in the long run, can be more beneficial than medication.[3]

Other forms of therapy and counseling options include family therapy, support groups, and mental health classes specializing in stress management techniques.

Medications

Select medications can be helpful in some children by helping them control impulsiveness and inattentiveness, reduce outbursts, and assist them with staying on task. As with most prescription medications, however, there are side effects. Discuss this issue with your child’s pediatrician before starting any medications.

Stimulant medications are often prescribed to children with ADHD because they increase the brain’s dopamine and help with attention span and thinking issues. According to the CDC, it’s the most commonly prescribed medicine for children with ADHD.[4]

Doctors might prescribe non-stimulant medications when stimulants fail to work. A non-stimulant drug generally takes longer to work when compared to stimulants. Once it starts working, it can help improve attention, impulsiveness, and focus, while helping decrease hyperactivity.

In some instances, physicians may prescribe anti-depressant medications to children with ADHD as anxiety and depression are common comorbidities of ADHD, and treating those symptoms can improve overall functioning.

Cerebral Palsy and ADHD Link

A few studies have found a link between ADHD, cerebral palsy, and autism. One study, which researched 700 children in Norway, indicated that close to 13% of the children in the study who have cerebral palsy also had ADHD. Around 17% had both autism and ADHD.

Pål Surén, MD, MPH, of the Center for Pediatric Epidemiology (one of the researchers in the study), said the findings showed that boys were at a higher risk of developing CP and ADHD or autism compared to girls.[5]

“The findings demonstrate the significant burden of disease associated with neurologic and neurodevelopmental disorders in children, and that this burden is disproportionately skewed towards boys.”

More studies are needed to figure out exactly why and how children with CP are more prone to develop ADHD or autism. Additional studies are currently underway.

Prognosis

There is no cure for ADHD, nor is there a cure for cerebral palsy. However, finding the right treatment, which may take a bit of trial and error, has been shown to increase the quality of many children’s lives significantly.