Abstracts

Rationale: Children with epilepsy experience greater social isolation and have more difficulties with peers compared to healthy controls and to children with non-neurologic disease. Children s relationships with their peers are associated with multiple aspects of development and adjustment and thus play an important role in long-term psychosocial functioning. We therefore assessed peer relationships in children with epilepsy as reported by their classroom peers, who are involved in social interactions with them on a daily basis over time. Methods: Twenty-eight children with established epilepsy ages 9-11 years were asked to participate. The twenty-six schools (93%) of these 3rd to 6th grade subjects agreed to participate in the project. The children spent at least 50% of their time within the regular classroom setting. Friendship nominations and the peer acceptance ratings were collected in the classrooms of these schools. A classmate control was obtained for each child with epilepsy at the time of the classroom data collection, by identifying a participating classmate matched for gender, race, and age. During friendship nominations children are asked to write the names of the 3 peers in their class whom they think of as best friends. Children received scores based on the number of times they are chosen as friends by classmates. In addition, a reciprocal friendship score is generated based on the number of times children receive friendship nominations from classmates they also picked as friends. During the peer acceptance rating scale children are asked to rate all of their classmates on a five-point scale ranging from someone you do not like to someone you like a lot . An average acceptance score is computed for each child based on the ratings from classmates. Scores for children and their classmates controls were compared using the Mann-Whitney test. Results: Children with epilepsy were significantly less likely to be identified as a best friend by their classmates compared to their classroom controls (p=0.04). They were also less likely to be chosen as reciprocal best friends compared to their classroom controls (p=0.03). However, classmates did not rate children with epilepsy differently from classmate controls on the peer acceptance rating scale (p = 0.28). Conclusions: This first study using information obtained through friendship nominations and peer acceptance ratings provided by classmates, demonstrates that peers prefer not to seek out friendships with children with epilepsy. In other words, perceived friendships of children with epilepsy are not reciprocated. This finding is of concern given the important role that friends play in children s social development. Our results set the groundwork for future studies that focus on better understanding peer relationships in children with epilepsy.