Abstracts

Children with epilepsy have impaired Child Behavior Checklist (CBCL) (Achenbach, 1991) social competence scores involving school, social relations, and activities (Austin et al., 1994; Hermann et al., 1988; McCusker et al., 2002; Schoenfeld et al., 1999). Social competence scores are inconsistently related to seizure control, illness duration, and antiepileptic drug (AED) (Hermann et al., 1988; McCusker et al., 2002; Schoenfeld et al., 1999). We examined if social difficulties in pediatric epilepsy reflect the underlying seizure disorder and/or associated behavioral, cognitive, and linguistic problems. We compared social competence in children with epilepsy to normal children controlling for demographic, cognitive, and linguistic group differences. Using seizure factors derived from a principal components analysis, we examined the role of seizure-related, cognitive, behavioral, linguistic, and demographic variables in the social competence scores. 90 complex partial seizure disorder (CPS), 62 childhood absence epilepsy (CAE), and 91 normal children, aged 5-16 with average IQ scores participated in a structured psychiatric interview, cognitive, linguistic, and social communication testing. Parents completed CBCL forms, provided seizure-related information, and had a structured psychiatric interview about the child. Controlling for cognition, language, and demographics, ANCOVAs demonstrated similar social competence in the CPS and CAE goups, significantly reduced total social competence ([underline]p[/underline] [lt] .05) and more school problems ([underline]p[/underline] [lt] .0001), but no significant differences in social relations and activities in the patients compared to the normal subjects. Modeling total social competence with demographic, cognitive, linguistic, psychiatric disorder, CBCL scores, social communication, and seizure variables in the model yielded significant findings for IQ ([underline]p[/underline][lt].0001), ethnicity ([underline]p[/underline][lt].01), and psychopathology ([underline]p[/underline][lt].01) among patients. There was no main effect for the seizure components: onset age/duration; EEG lateralization/localization/severity; seizure frequency/number of AEDs; and prolonged seizures/febrile convulsions. Lower IQ, externalizing CBCL scores and disruptive disorders accounted for 42% and 40% of the variance of total social competence and school scores, respectively. Fewer peer interactions were related to reduced IQ ([underline]p[/underline][lt].0004) and externalizing behaviors ([underline]p[/underline][lt].0001). Less involvement in organized activities was associated with lower IQ ([underline]p[/underline][lt].06) and disruptive behaviors ([underline]p[/underline][lt].03). Ethnicity predicted total social competence ([underline]p[/underline][lt].01), social ([underline]p[/underline][lt].008), and activities scores ([underline]p[/underline][lt].01). Average IQ children with epilepsy with school and social problems need cognitive and behavioral assessments. (Supported by RO1 NS 32070)