Executive Function, Attention and Autism Symptomatology in School-Aged Children with Cerebral Palsy

Objective: Children diagnosed with cerebral palsy have been reported to be at increased risk of executive function deficits and neurodevelopmental disorders. This population-based cohort study aimed to assess executive function, attention, behaviour, and autism symptomatology in school-aged children with CP, using parent-report measures that can provide insight into everyday functioning in these neurodevelopmental domains. Methods: 74 participants (male n = 51) mean age 9 years 9 months, SD 1 year 1.2 months (range 8 years 0 months to 12 years 11 months), GMFCS I = 45 (60.8%), II = 17 (23%), III = 8 (10.8%), and IV = 4 (5.4%), were assessed on measures of attention and behaviour (Conners-3), executive function (BRIEF), and autism symptomatology (AQ10-Child). Analysis was via one-sample t-tests and MANCOVAs. Results: Participants' scores were elevated in comparison to the general population in all domains, while 29.1% of participants scored above the cut-off level on an autism symptomatology screener. Greatest impairment was reported for working memory (M = 60.7, SD = 10.0, t(72) = 9.2, p < .001), peer relations (M = 72.7, SD = 16.2, t(73) = 12.0, p < .001), and inattention subscales (M = 66.3, SD = 12.5, t(73) = 11.2, p < .001). No statistically significant differences were found for different GMFCS levels on domains of executive functioning. A statistically significant difference was found between GMFCS levels for inattention F(3, 71) = 3.83, p = .013, partial eta(2) = 0.162, with most elevated scores associated with GMFCS level II (M = 74.1, SD = 14.2). Conclusion: EF, attention and behavioural difficulties, and autism symptomatology are commonly reported in school-aged children with CP. Screening for these comorbidities using ratings scales will assist with early diagnosis and targeted intervention.