Abstracts

Rationale: Individuals with epilepsy have social problems that are not accounted for by seizure severity or frequency. In childhood, as a group, they are more likely to have behavior and mental health problems than their peers. As adults, they are more likely than controls to be underemployed, to never marry, and to remain childless. Individuals with epilepsy may also have cognitive deficits. The purpose of this study was to examine the relationship between language ability and social functioning in children with epilepsy over a period of 36 months following their first recognized seizure. Methods: Participants were 119 children (65 girls, 54 boys) between 6 and 14 years of age (mean age = 9.7 years) who were enrolled in a larger ongoing longitudinal study of new onset seizures. Follow-up took place at 9, 18, 27, and 36 months. Children with seizures reported at every follow-up interval (n = 19) were considered to have persistent seizures. One hundred children had recurrent but not persistent seizures. The Child Behavior Checklist, which yields age- and sex-adjusted T-scores for Social Competence and Social Problems, was administered to each child’s parent or guardian at baseline, 18, and 36 months. Higher Social Competence T-scores indicate better social function; high Social Problems T-scores indicate worse social function. Children completed a neuropsychological test battery that included a language factor comprised of several well-standardized, reliable, and valid measures (Clinical Evaluation of Language Fundamentals, 3rd Ed.; Comprehensive Test of Phonological Processing); factor scores were based on standardized scores, corrected for age. Results: Multiple regression analyses showed that there was a significant association between the change in language factor scores from baseline to 36 months and the change in social competence ratings from baseline to 36 months in children with persistent seizures (β = 13.82, p = .03). This association was not found in children without persistent seizures. Similarly, there was a significant association between the change in language from baseline to 36 months and the change in social problems in children with persistent seizures (β = -6.61, p = .03) but not in those without persistent seizures (see Figures 1 and 2). Conclusions: These findings show that social problems increase and social competence decreases as language declines over time in children with persistent seizures. In contrast, children with persistent seizures but without language decline do not demonstrate poorer social function. Similarly, children whose seizures recur but are generally better controlled do not demonstrate poorer social functioning, with or without language decline.