Abstracts

Research suggests that children with epilepsy might have an increased risk for symptoms of attention deficit hyperactivity disorder (ADHD). Unfortunately, many children with epilepsy may go undiagnosed with ADHD. This study compared the rates of children classified with ADHD in the school with the rates of children meeting cutoff criteria for attention problems on standardized measures. It was hypothesized that children would be under-classified for ADHD in the school based on scores from standardized measures of attention. Participants were 85 children with chronic epilepsy. Children were assessed at baseline, 12 months, and 24 months. The mean age was 13.07 (SD= 1.94) at 24 month assessment, age of seizure onset was 7.00 (SD = 3.71), and 51% were females. Parents completed an educational services survey, on which they indicated whether the child was currently classified as having one of several diagnoses including ADHD (yes =1, no = 2). Additionally, a parent-report measure of attention problems (Child Behavior Checklist) and an objective measure of attention (Continuous Performance Test) were administered. 2 x 2 (Cutoff Score x Classification) Chi-Square analyses were conducted to determine whether significant differences emerged between those with or without a classification of ADHD. On the CBCL, results demonstrated a significant difference between those scoring in the [ldquo]at-risk[rdquo] (T [ge] 67) range for attention problems and those classified with ADHD ([chi] ² = 11.57, p = .001), where several children met cutoff scores for attention problems yet were not classified with ADHD. However, when using the clinical cutoff score (T [ge] 71), differences no longer remained significant ([chi] ² = 1.59, p = .21). On the CPT, participants scoring 2 SD from the mean (T [ge] 70) on omission rates were considered to demonstrate attention problems. Results yielded a significant difference between children demonstrating attention problems and those classified with ADHD ([chi] ² = 5.45, p = .020). Of note, 14 children were not able to complete the CPT, which may suggest that these results underestimate the rate of attention problems. Children with chronic epilepsy may go undiagnosed with ADHD when symptoms are present. However, these instruments are screening measures and do not replace diagnostic measures. Thus, measures incorporating DSM-IV criteria will be a critical follow-up to this study. Future studies should compare the rates of those children who are classified as ADHD with diagnostic measures utilizing DSM-IV criteria. (Supported by PHS R01 NR04536 from NIH/NINR to J.K.A.)