Abstract
INTRODUCTION: Monitoring cerebral palsy (CP) prevalence and co-occurring conditions is crucial for planning lifelong support, but recent national estimates are somewhat limited. METHODS: We analyzed data on U.S. children aged 2-17 years from the 2016-2021 National Survey of Children's Health, conducted annually using a cross-sectional design, to calculate nationally representative prevalence estimates of ever-diagnosed CP, overall and by selected demographic and perinatal characteristics. Three-year estimates were compared to evaluate changes over time. Co-occurring conditions were assessed among children aged 3-17 years with a current CP diagnosis. We estimated prevalence ratios (PR) to quantify differences between groups. RESULTS: The overall prevalence of CP was 3.1 per 1,000 children, with a higher prevalence among boys (3.6/1,000) than girls (2.5/1,000) and children born with low and very low birthweight (46.6 and 7.1/1,000, respectively) and premature (12.7/1,000); differences by race/ethnicity did not reach statistical significance (non-Hispanic [NH] White: 2.9, NH Black: 4.2, and NH other: 4.5/1,000. There were no clear changes in CP prevalence over time, but caregiver-rated severe CP increased from 16.8% (2016-2018) to 30.3% (2019-2021). Most children with CP had at least one co-occurring condition, about four times more prevalent than in children without CP, with the largest differences for intellectual disability (PR = 43) and epilepsy or seizure disorder (PR = 69). DISCUSSION: There is a significantly higher prevalence of co-occurring developmental, neurological, and mental health conditions among children with CP compared to those without, highlighting the diverse services and resources that may be needed to optimally support this population as they transition into adulthood.