Background: Intellectual disability (ID) and attention deficit hyperactivity disorder (ADHD) are common neurodevelopmental disorders in childhood and may coexist, resulting in significant cognitive, behavioral, and functional impairment. Identifying associated factors is essential for early recognition and intervention. Methodology: This prospective cross-sectional study was conducted at the Children’s Hospital of Nanjing Medical University, China, from May 2023 to December 2024. A total of 148 children aged 4–10 years were enrolled. Cognitive function was assessed using the Wechsler Intelligence Scale for Children–Revised (WISC-R). ADHD symptoms and functional impairment were evaluated using the Swanson, Nolan, and Pelham Rating Scale – Fourth Version (SNAP-IV), Conners Parent Rating Scale (CPRS), and Weiss Functional Impairment Rating Scale–Parent (WFIRS-P). Sociodemographic, prenatal, perinatal, and caregiver-related variables were extracted from electronic medical records. Multivariate logistic regression analyses were performed to identify factors independently associated with ID and ADHD. Results: Intellectual disability or borderline cognitive functioning was identified in approximately 24% of participants, while 29.3% met diagnostic criteria for ADHD. Independent factors associated with ID included younger age, larger head circumference, history of allergic disease, and lower caregiver education level, whereas higher caregiver education was protective. ADHD was independently associated with older age, lower maternal pre-pregnancy weight, umbilical cord complications during pregnancy, and democratic or neglectful parenting styles. Conclusion: ID and ADHD in children aged 4–10 years are influenced by multiple biological, prenatal, and caregiver-related factors. These findings support early integrated screening, caregiver education, and optimization of maternal and perinatal health to improve neurodevelopmental outcomes.
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