Abstracts

Rationale: Despite the importance of language in children’s academic performance and social functioning, this topic is understudied in children with epilepsy with normal intelligence. This study examined the range of linguistic impairments in young, intermediate, and adolescent youth with epilepsy and how these deficits were associated with illness effects, nonverbal intelligence, and psychopathology. Methods: Language, intelligence, and achievement tests, as well as structured psychiatric interviews were administered to 182 epilepsy youth, aged 6.1-7.9, 8.9-11.4, and 12.7-14.9 years and to 102 age and gender matched normal children. Parents provided demographic, seizure-related, and behavioral information on their children. Results: Significantly more young (27%), intermediate (35%), and adolescent epilepsy subjects (59%) had mean language scores 1SD below average than the young (4%) intermediate (3%), and adolescent normal control groups (3%). They also had significantly lower mean linguistic than their normal matches and a wider range of linguistic deficits in the intermediate and adolescent vs. young epilepsy groups. Language scores 1SD below average in the young epilepsy subjects were related to longer duration of illness, a childhood absence diagnosis, lower socioeconomic status, and affective/ anxiety disorder diagnoses. A history of prolonged seizures, lower Performance IQ, and minority status predicted language scores 1SD below average in the intermediate epilepsy group. Adolescent epilepsy subjects with language scores 1SD below average had poor seizure control, decreased Performance IQ, and lower socioeconomic status. Linguistic deficits were also related to reading scores 1SD below average. Conclusions: The age-related higher rate of language impairment, wider range of linguistic deficits, and diverse association with seizure variables, together with the relationship with poor reading scores highlight the developmental, clinical, theoretical, and academic implications of linguistic vulnerability in epilepsy youth.