Cerebral palsy and ADHD

What is ADHD?

Attention deficit hyperactivity disorder (ADHD) is a behavioral disorder that can cause an individual to be overly active, impulsive and have issues with focus and attention. Symptoms of ADHD typically begin to present themselves around the age of 7, but many children are not properly diagnosed until they get older.

Children with cerebral palsy have an increased risk for an array of co-existing conditions, such as autism and epilepsy. However, ADHD is reported to be more common in children with CP than in the general population.

While the full scope of the ways in which CP and ADHD interact is still being researched, there are many things parents and caregivers can do to care for both conditions simultaneously. By utilizing a dual treatment method for a child with CP and ADHD, this will provide them with the highest chance of success across all areas of their life.

What causes ADHD?

The cause of ADHD cannot be tied to a single source. There is much discussion among researchers surrounding various aspects that can increase a child’s likelihood of developing ADHD.

Possible causes of ADHD include:

• Genetics – If a child’s parents or close relatives have ADHD, they have an increased chance of having this disorder
• Drug, alcohol or tobacco use during pregnancy – Children that were exposed to these toxic substances while in the womb are more likely to have ADHD
• Lead or pesticide exposure – Researchers have found a connection between ADHD and exposure to neurotoxic chemicals, which can hinder brain development
• Ingesting food dyes and preservatives – Certain artificial colorings and preservatives mainly used in processed foods have been shown to worsen ADHD symptoms
• Trauma to the developing brain – Damage due to a birth injury or serious illness can impact the healthy development of the frontal lobe, leading to a decline in neurological functioning

ADHD is a medical disorder that can stem from various things that occur before, during and after a child is born. If you suspect that your child may have co-occurring cerebral palsy and ADHD, it is less important to try and track down the exact cause of their attention disorder than it is to treat both conditions as thoroughly as possible.

Facts about ADHD

1. ADHD is a “real” medical condition. ADHD is recognized as a legitimate diagnosis by major medical, psychological and educational organizations, including the American Psychiatric Society’s Diagnostic and Statistical Manual of Mental Disorders.

ADHD is the result of a chemical imbalance in the brain’s messengers and neurotransmitters. This is what creates the primary symptoms of this disorder, including inattention, impulsivity and hyperactivity.

2. ADHD is not a “phase”, or something a child will grow out of. Before a child receives a diagnosis and treatment regiment for their ADHD, this can be a frustrating time for parents. Children with this condition may act out and have difficulty paying attention or handling themselves appropriately in social situations. Yet, this is not a condition that has the ability to disappear on its own.

It’s important for parents to understand that ADHD is not the result of a child simply choosing to be disobedient, unmotivated or difficult. This is a condition that requires a medical evaluation and individualized treatment plan in order for improvement to take place.

3. ADHD occurs in both men and women. A common misconception that has persisted for decades is that ADHD can only occur in men, or occurs much more often among this sex. However, recent studies have shown that females are just as likely to have ADHD as males.

One notable difference between men and women with ADHD are their symptoms. Symptoms of ADHD in women are often subtler, which can make it difficult to immediately identify. Another factor that has contributed to this misconception is that the guidelines used in medical assessments and diagnoses of ADHD have traditionally focused on the way that ADHD affects men. This can often leave women in a situation where their symptoms are not properly recognized as ADHD until later on in life.

In addition to the disorder itself, there are many myths surrounding the possible causes of ADHD.

 The following items are NOT proven to cause ADHD:

• Diet – Around the 1970’s, it became a population notion to associate ADHD with food allergies or consuming excessive amounts of sugar. Recent research indicates there is no proven link between diet and ADHD.
• Hormones – While a child with ADHD may have a lack of control over their emotions or behavior, there is no significant connection between improper hormone functioning and hyperactivity or inattentiveness.
• Poor parenting or a challenging home-life – There is no research that supports the idea that ADHD is caused by poor parenting techniques or other home environment variables. While these things certainly do not help to improve a child’s symptoms, they are not proven to be a cause.
• Excessive TV watching or video games – No studies have found a direct correlation between watching excessive amounts of television or playing video games and having ADHD. In addition, there are no studies that indicate that children with ADHD watch more television than those without ADHD.

Types of ADHD

With ADHD, there is no “one size fits all” diagnosis. It is essential that your child receives the correct diagnosis for their symptoms, as this will provide them with the proper tools to lead a healthy, happy life.

There are three basic types of ADHD and all come with their own set of symptoms and treatments. The different types of ADHD are:

• Inattentive type
• Hyperactive-impulsive type
• Combined type

Inattentive ADHD

If your child is struggling with a severe lack of focus, they may be diagnosed with inattentive ADHD. Inattentive ADHD is usually not coupled with symptoms such as hyperactivity or impulsivity, which are found in the other types of ADHD. What differentiates inattentive ADHD is the primary symptom of an inability to focus or pay attention.

Children diagnosed with inattentive ADHD are commonly described by parents, teachers or family as seeming constantly lost in thought or disconnected from the activities around them. Rather than acting out during class, wiggling in their seats or distracting classmates, children with this form of ADHD are more likely to be found staring intensely at a book or screen in a wandering, “daydream-like” mental state.

When compared to children with hyperactive-impulsive or combined ADHD, those with inattentive ADHD experience subtler symptoms. As a result, countless cases of inattentive ADHD go undiagnosed each year.

A child being tested for inattentive ADHD must exhibit at least 6 of the 9 following symptoms:

• Not paying attention to detail
• Making careless mistakes
• Failing to pay attention or stay on task
• Not listening
• Being unable to follow or understand instructions
• Avoiding tasks that involve effort
• Being distracted
• Forgetfulness
• Losing important items needed to complete tasks

Hyperactive-impulsive ADHD

If you find that your child is constantly overactive in their speech, movements and behavior, they may be diagnosed with hyperactive-impulsive ADHD. Hyperactivity refers to excessive motor activity in the brain, and this symptom can appear differently for each child.

Children with hyperactive-impulsive ADHD may also have a tendency to make rash, spontaneous decisions without putting much thought into the consequences of their behavior. They may interrupt conversations or have trouble waiting their turn in games or lines. This is where the “impulsive” part of this condition’s name comes from.

A child with hyperactive-impulsive ADHD is always on the move and exhibits excessive talkativeness. They may run or jump around at inappropriate times, get up from their seat when they are not supposed to, or constantly fidget with clothing or toys. This differs from individuals with inattentive ADHD, who are more likely to remain introverted or lost in their own thoughts.

A child being tested for inattentive ADHD must exhibit at least 6 of the 9 following symptoms:

• Fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
• Difficulty sustaining attention in tasks or play activities
• Often does not seem to listen when spoken to directly
• Not following through on instructions, fails to finish school work, chores or duties in the work place
• Difficulty organizing tasks or activities
• Often avoids or is reluctant to engage in tasks that require sustained mental effort
• Losing important things necessary for tasks or activities
• Easily distracted by extraneous stimuli
• Forgetful in daily activities

Combination type ADHD

According to the National Institute of Mental Health, most children with an attention disorder fall into the category of combination type ADHD. This type of ADHD is used to describe children who do not fit neatly into the characteristics associated with inattentive or hyperactive-impulsive ADHD.

Children with combination type ADHD experience:

• Six or more inattentiveness ADHD symptoms
• Six or more hyperactive-impulsive ADHD symptoms

A child with this form of ADHD may have difficulty sitting still or waiting their turn (hyperactive-impulsivity), but they also struggle with focus (inattentive). Another example is a child who is constantly staring into space, lost in thought (inattentive), but also experiences excessive talkativeness and movements (hyperactive-impulsive).

The reason that combination type ADHD is so common is that it is fairly unlikely for children with an attention disorder to show explicit symptoms of only one type. Oftentimes, they will show signs of having a little bit of both types. If you suspect that your child may have this form of ADHD, it is important to talk to your doctor about the best way to treat the symptoms of ADHD your child has.

Treating coexisting ADHD and CP

If your child is diagnosed with ADHD and cerebral palsy, there are various treatment methods available to improve concentration and impulsivity, while also maintaining CP symptoms.

Doctors will typically prescribe a form of oral stimulant medication to improve your child’s focus and behavior. Common medications used to treat ADHD include:

• Concerta
• Adderall XR
• Vyvanse
• Ritalin
• Metadate
• Dexedrine

Your doctor will likely also suggest behavioral therapy for your child, in addition to medication. Behavioral therapy is used to help children learn ways to expel their energy into healthy outlets. A dual treatment approach of both medicine and therapy is the most highly recommended method to ensure that ADHD symptoms are being improved upon on a regular basis.

If your child is already undergoing any of the following types of therapy, you should talk to your therapist to see if you can work on your child's ADHD during these sessions as well:

• Physical therapy
• Occupational therapy
• Speech therapy

Managing ADHD and cerebral palsy

Unfortunately at this time, no cure exists for ADHD or cerebral palsy. However, it is very possible for your child to lead a full life if they are dealing with both conditions. Through medication and regular therapy sessions, children will be able to develop healthy habits and learn how to maintain positive relationships with teachers, parents and loved ones.

If you suspect that your child’s coexisting ADHD and cerebral palsy was the result of a birth injury due to medical malpractice, contact us today to start your free case review.