Abstracts

Rationale: Individuals with autism spectrum disorders (ASD) have higher rates of epilepsy than the general population. Prevalence rates vary widely from 2% to 46%. Youth with ASD and epilepsy have been found to receive later ASD diagnoses as well as later additional medical diagnoses. Some studies have discussed how seizures in youth with ASD are likely due to intellectual disability (ID) rather than ASD. There is limited research studying the neuropsychological functioning of youth with ASD and epilepsy without ID. The purpose of this study was to assess the executive functioning (EF) profiles of children with ASD and epilepsy without ID and compare them to: 1) children with epilepsy only and 2) children with ASD only. We hypothesized that children with ASD and epilepsy without ID would have more EF difficulties than children with ASD only or epilepsy only.Methods: Demographic variables were compared across groups using chi-square analyses for demographic variables and one-way Analysis of Variance (ANOVA) for continuous variables. Participants had received a standardized IQ measure, such as Wechsler intelligence measures or the Differential Ability Scales. Executive functioning tasks were administered and parents completed the Behavior Rating Inventory of Executive Functioning (BRIEF).Results: 42 youth participated in this study, with 14 participants in each group. They were matched for age, sex (11 males and 3 females in each group), and IQ. See table for demographics. The ANOVA results indicated a significant main effect for the following BRIEF scales: Shift (F(2,41)=6.26, P<.005), Monitor (F(2,41)=3.63, p<.05), Initiate (F(2,41)=3.59, p<.05), and General Executive Composite (GEC) (F(2,41)=3.66, p<.05). Post-hoc tests revealed youth with ASD only had worse Shift scores when compared to those with epilepsy only (p<.005), also they had worse Initiate scores when compared to the ASD and epilepsy group (p<.05), and the overall GEC was worse when compared to epilepsy only group (p<.05). The ASD and epilepsy group had worse scores on the Monitor scale when compared to epilepsy only (p<.05). No significant differences were seen across groups on scores from the Test of Everyday Attention for Children (TEA-Ch). On the Tower of London, Drexel Version (TOL-DX), the ANOVA results indicated a significant main effect for Time Violations (F(2,33)=5.605, p<.01). Post-hoc tests found more time violations made by youth with ASD and epilepsy when compared to ASD only and more time violations made by youth with epilepsy only when compared to youth with ASD and epilepsy.Conclusions: This is one of the first studies assessing the EF profiles in youth with ASD and epilepsy without ID. Although we hypothesized that youth with ASD and epilepsy would have more EF difficulties than the other two populations assessed, we discovered that overall parents of youth with ASD only reported more struggles with daily EF. One possibility for this finding is the behavioral regulatory effects of some antiepileptic medications. It will be important to explore the EF profiles in this population further.