Abstracts

Rationale: Students returning to school after epilepsy surgery may require extra services or supportive accommodations to succeed in their educational setting. Epilepsy can have a significant impact on academic functioning and the day-to-day performance of a student in the classroom. Many students with epilepsy struggle with memory or attention problems, slow processing speed, difficulty with written directions or motor tasks, or visual challenges. Or, they may have learning disabilities – which occur at a rate of 76% in youth with childhood epilepsy. While most children with epilepsy can participate with the other students in the classroom, some may require additional services, such as being allowed to take medication during school hours. Federal law, as well as many state laws, grants children with epilepsy the right to receive those supplemental services and if necessary, special education. The Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973 are both federal laws that may apply to students with epilepsy. Students with epilepsy may qualify for services under either law, depending on their needs. People of color have historically experienced more barriers to care, and received poorer quality care compared to Whites, all contributing to worse health outcomes. This study examines the utilization of supportive services in educational settings of a cohort of Blacks and Whites patients who received epilepsy surgery.

Methods: A retrospective chart review was conducted between 5/15/2024 and 6/10/2024 of pediatric patients who received surgery epilepsy who were identified in the medical record. The first 15 surgical patients with epilepsy from years 2020, 2021, 2022, 2023, and 2024 were included. Race, age, sex, insurance (Medicare, Medicaid, private insurance, self pay, no charge, or other), and type of supportive service (IEP, Section 504 plan) received were recorded, if any. For the race variable, only patients with a known race were included, and only Black and White patients were included. The characteristics of patients, providers, and hospitals were summarized by descriptive statistics. Results were expressed as mean (standard deviation, median, and range) for continuous variables and frequency (percentage) for categorical variable.

Results: A total of 75 patient records were included in the review. The mean age of these patients was 12.4 years. 54.6% (41/75) percent of these patients were women, 13.3% (10/75) were African American, and 48.0% (36/75) had private insurance. White patients are more likely to have a 504 plan compared to their Black patients as 40% (4/10) of African American patients received supportive services compared to 58.5% (38/65) of White patients who received supportive services that fit the definition of a Section 504 plan or IEP.

Conclusions: There are disparities in the utilization of supportive services for pediatric epilepsy; race appears to be an influential factor related to such disparities. Identifying and implementing effective strategies to eliminate racial inequities in access to and utilization of educational supportive services should be made a priority.

Funding: Children's Hospital of Pittsburgh Foundation