Abstracts

Rationale: Rationale: Problems in behavior and social competence are overrepresented in children with epilepsy (CWE) compared to healthy controls (HC), but their natural history is infrequently investigated. To determine if these problems are progressive, parent-report data on behavior and social competence were collected during three serial waves of assessment over 5 years. Methods: Methods: 75 children with new/recent-onset epilepsy and 62 healthy controls (age 8-18) were seen for three waves of assessments (baseline, 2 years, and 5 years). At baseline, epilepsy participants were assessed within 12 months of diagnosis, had normal neurological examinations, and had no lesions on clinical MRI. The control group consisted of age- and gender-matched first-degree cousins. Parents completed the Child Behavior Checklist (CBCL) at each visit. The raw scores for each measure, adjusted for age and gender, were analyzed using random effects regression models, first examining diagnostic group (epilepsy, control) and then by epilepsy syndrome (localization-related [LRE], idiopathic generalized [IGE], HC). Results: Results: Comparing CWE to HC, significant differences by omnibus test were detected for Total Competence, Total Problems, Internalizing and Externalizing Problems, Thought Problems and Attention Problems, with CWE performing worse across all measures. Further, by nominal p-value, these relationships held across all waves of assessment except for Total Problems and Internalizing and Externalizing Problems at 5 years. No group differences were found for Social Problems. The differences between CWE and HC did not vary over time for any measure except Total Problems and Internalizing Problems, with the group means growing closer together over time. Comparing LRE, IGE and HC groups, significant differences by omnibus test were detected for Total Problems, Total Competence, and Internalizing Problems, as well as Social Competence, Thought and Attention Problems scales. The LRE and IGE groups differed from HC, but not from each other. These patterns were significant at baseline and at 2 years. Total Competence and Attention Problems were also significant at 5 years. At 5 years there were no group differences for Total Problems, Internalizing Problems, Social Problems, or Thought Problems. In addition, the omnibus test was borderline significant for Externalizing Problems, with group differences at baseline but not at 2 and 5 years.Conclusions: Conclusions: Parent-reported social competence and behavioral abnormalities in CWE were detected at baseline, with some but not all problems persisting across subsequent assessments, and without any evidence of progression. Syndrome type (LRE, IGE) exerted minimal effects across competence and behavior problems. For those abnormalities identified as persistent over time, their appearance at or near the time of diagnosis offers an opportunity for early intervention.