Screening for psychopathology in a national cohort of 8- to 15-year-old children with cerebral palsy.
Half of kids with cerebral palsy screen positive for psychopathology—use the CBCL at every visit.
01Research in Context
What this study did
Rackauskaite et al. (2016) mailed the Child Behavior Checklist to parents of Danish children with cerebral palsy.
Kids were 8 to 15 years old. The team wanted to know how many screened positive for psychopathology.
What they found
Forty-six percent of the children scored in the clinical range on the CBCL.
Risk was higher when the child also had cognitive disability or lived with one parent.
How this fits with other research
Griffith et al. (2012) saw a similar picture in Norway. They used face-to-face interviews and found 57% of five- to eight-year-olds with CP met full criteria for a psychiatric disorder. The two numbers look different, but the tools were different; the CBCL is a broader screen, so the gap is expected.
Shawler et al. (2021) followed the story into adulthood. Their registry study shows that mental-health needs do not fade; adults with CP still carry high rates of mood and anxiety disorders.
Wilson et al. (2023) add that 44% of Danish primary-schoolers with CP also have intellectual disability. Because ID boosts psychopathology odds, the CBCL finding is consistent with their cognitive data.
Why it matters
Half of your school-age clients with CP may have hidden emotional or behavioral problems. Add the CBCL to every annual review. If scores are high, refer for fuller assessment and loop in mental-health providers. Early catch spares the child and family years of strain.
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02At a glance
03Original abstract
UNLABELLED: Cerebral palsy (CP) is often accompanied by psychopathology and learning disability. AIMS: (1) to evaluate the prevalence of psychopathology as estimated by the Child Behavior Checklist (CBCL) parental questionnaire in 8- to 15-year-old Danish children with CP and to analyze its association with cognitive ability and families' social characteristics; (2) to examine to what extent children with CP had been evaluated by a child psychiatrist and/or psychologist. METHOD: The parents of 462 children with CP answered a questionnaire about their child's treatment and the family's characteristics and 446 the CBCL. The cutoff for psychopathology was the Total CBCL score or DSM-oriented scores above the 93rd percentile in an age- and gender-stratified population. RESULTS: The psychopathology screening was positive in 46.2% (CI 41.6-50.8%) against 15.1% in general population. Cognitive disability was associated with an increased prevalence of psychopathology (odds ratio (OR) 2.6, CI 1.4-4.6, for Developmental Quotient of cognitive function (DQ) 50-85 and OR 3.0, CI 1.3-7.0, for DQ<50). Children with CP and a single parent showed increased odds for a positive CBCL screening compared to children living with two parents (OR 2.1, 95% CI 1.1-4.0). Children with DQ 50-85 more often had a psychological evaluation. A positive CBCL screening was strongly associated with a psychiatric assessment (21% vs. 7%, p<0.01). CONCLUSION: The high prevalence of emotional and behavioral problems indicates that screening for psychopathology should be a part of multidisciplinary follow-up of CP. The CBCL can be used as a screening instrument in children with CP without severe motor and cognitive disability.
Research in developmental disabilities, 2016 · doi:10.1016/j.ridd.2015.11.019