Abstracts

There is a high rate of academic underachievement and learning disability in children with epilepsy. Past studies have identified a number of psychosocial, cognitive and neurological variable that impact on academic skills; however, these studies have included samples that comprised only children with well controlled epilepsy or samples where the degree of seizure control varied from well controlled to intractable. In the present study, we investigated the potential contribution of seizure-related variables and cognitive function on the performance of academic skills in children with medically refractory epilepsy., Fifty children and adolescents (25 male) with medication-resistant epilepsy were studied. They ranged in age from 7 to 17 years (mean = 13.3) and had a mean age of seizure onset of 6.2 years (range: 0 - 14). They were administered standardized tests of intelligence, word decoding, reading comprehension, spelling and arithmetic, verbal and visual memory, and sustained visual attention., Academic skills were not significantly related to sex, laterality or locus of seizure focus, frequency of seizures, extent of epileptogenic region, or number of antiepileptic medications. Age at seizure onset was correlated with IQ (r = .32, p [lt] .02) and arithmetic (r = .29, p [lt] .05) but not with the other cognitive or academic measures. IQ, memory and attention performance were all correlated with one another, and with all academic test scores. Stepwise regression analyses showed that IQ was a strong predictor of all academic skills, accounting for the following percentage of variance: word decoding: 38%; reading comprehension: 67%; spelling: 47%; arithmetic: 48%. Attention and memory did not explain any additional variance. The results did not change when children with low IQ ([lt]70) were excluded., These results highlight the strong contribution of intellectual function to the development of core academic skills in children with intractable epilepsy. Although memory and attention may have an important impact on the child[apos]s performance in the classroom and on the child[apos]s ability to benefit from instruction, these skills do not appear to contribute independently of intelligence to the child[apos]s ability to learn to read, spell and compute. These results are consistent with other studies that have identified higher rates of educational underachievement in children with epilepsy syndromes characterized by lower intelligence., (Supported by Ontario Mental Health Foundation.)