VLADIMIR TRAJKOVSKI, MD, PhD, Full Professor
Macedonian Scientific Society for Autism, Institute of Special Education and Rehabilitation, Faculty of Philosophy, University “Ss. Cyril and Methodius”
Address: Blvd. “Goce Delchev 9A, 1000 Skopje, Republic of Macedonia
Relevance: Clinical heterogeneity among children with neurodevelopmental disorders reflects diversity in strengths and needs that can have important implications for therapeutic management. Autism Spectrum Disorder (ASD) is sometimes a co-occurring associated condition of cerebral palsy. Whereas cerebral palsy affects motor functioning, autism affects certain areas of brain development. Cerebral palsy (CP) is primarily a motor disorder, caused by a cerebral lesion occurring in the developing brain.
Purpose: To explore autism spectrum symptoms in children with cerebral palsy (CP), and the association between autism spectrum symptoms and medical and psychiatric co-morbidity.
Results: Over the past two decades there has been greater recognition that risk of mental health and neurobehavioral disorders is shared across the broad continuum of developmental medicine, including cerebral palsy. The current best practice for diagnosing ASD in a child with CP is completing a thorough clinical assessment and combining this with the clinician’s
judgement. The assessment of ASD in the face of CP should entail a detailed history, examination and structured observation of the child’s social and communication skills, complemented with standardized diagnostic instruments which are validated for children with motor difficulties. Both conditions are discovered at roughly the same age, usually. Cerebral palsy is usually discovered a little earlier, at perhaps 6 months to 2 years of age. Autism is discovered a little later, usually by 5 years of age. They are highly variable, with some symptoms present in some children but not others. Both conditions can be very severe or hardly noticeable.
Conclusions: A holistic approach is required when evaluating a child who demonstrates impairments in social communication skills in the presence of motor impairment More attention should be given to autism spectrum symptoms in the regular follow-up of children with CP in an attempt to enhance social functioning.
Key words: cerebral palsy, autism spectrum disorders, neurodevelopmental disorders.