Autism spectrum disorder phenotype in children with ambulatory cerebral palsy: A descriptive cross-sectional study

The current study aims to describe the cognitive profile, autism profile, medical and behavioral presentation of children with a dual diagnosis of cerebral palsy (CP) and autism spectrum disorder (ASD). Little is known about the dual presentation of CP and ASD. Timely diagnosis is imperative as early intervention may impact a child's developmental trajectory. The study used a cross-sectional descriptive design. We report data on cognitive profiles, ASD presenting symptoms, the time to definitive diagnosis of ASD, medical and behavioral co-morbidities in children with a dual diagnosis of CP and ASD. Seventy-two percent (72%) of children with CP + ASD had a developmental disability profile. Children were diagnosed with ASD at the median age of 66.5 months (range: 31–210 months). Repetitive behaviors were the most common ASD alerting symptom. Repetitive motor mannerisms were reported in 71% of CP + ASD population. Constipation, asthma and aggression showed highest statistical differences between CP + ASD group and CP only group. Our study has established that cognitive impairment is common amongst children with CP + ASD. ASD is diagnosed later in children with CP + ASD, than reference age of diagnosis in children with ASD. Medical and behavioral co-morbidities are common in children with CP + ASD. Clinicians need to be sensitized to the possibility of multiple diagnoses including ASD in children with cerebral palsy.

► ASD is diagnosed later in children with a dual diagnosis of CP + ASD.
► Repetitive behaviors are the most frequent ASD symptoms in children with CP + ASD.
► Aggression is a common behavioral concern in the CP + ASD population.
► There is a perceived acceptance of social atypicalities as part of the early developmental picture of CP.
► In CP the triad of motor mannerism, poor play skills and poor eye contact warrant further evaluation.