Abstracts

Rationale: An effective transition for youth with epilepsy is essential since approximately 50% will continue to require seizure management into adulthood (Camfield, Camfield, & Phlmann-Eden, 2012). In order to support a smooth transition, researchers have advocated for the implementation of multidisciplinary care given the prevalence of neurobehavioral comorbidities and negative psychosocial outcomes in patients with epilepsy across the lifespan (e.g., Carrizosa, Appleton, Camfield, & Von Moers, 2014; Geerlings, et al., 2015). Despite a call for multidisciplinary care, most epilepsy transition programs solely incorporate medical personnel. This study evaluated the role of psychology, neuropsychology, and social work during the transition period, with the goal of informing clinical practice and future research.  Methods: A retrospective, qualitative record review was conducted of a pilot sample consisting of 21 participants who completed an initial clinic appointment through the Transition-Age Program (TAP) at a Level 4 Epilepsy Center in the Midwest. The initial clinic visit lasted roughly two hours and included participants and their families meeting jointly with the TAP team – a psychologist, neuropsychologist, and social worker – for assessment, collaborative goal-setting regarding transition readiness, and recommendations to address areas of concern. Independent coders analyzed participant records to examine assessment data and identify themes regarding goals and interventions developed by the multidisciplinary team.  Results: Participants ranged in age from 17 to 24 and the majority were male (62%) with a focal epilepsy diagnosis (63%).All of the participants presented with at least one neurobehavioral comorbidity, with the most common being anxiety (57%), attention-deficit/hyperactivity disorder (43%), and depression (33%). Neuropsychology led the team in collaborating with families to establish individually tailored goals to support transition readiness. These goals pertained to educational, social, and/or vocational advancement as well as increased independence with self-care tasks and/or epilepsy management. In addition to goal setting, psychology intervened by providing methods to promote antiepileptic drug adherence, strategies to address minor behavioral difficulties, or to give referrals for outpatient psychotherapy whenever clinically significant symptoms were present. Additionally, social work assisted families with guardianship concerns, housing or financial needs, and to provide community resources.  Conclusions: This study provides preliminary evidence for the utility of multidisciplinary care during the transition of youth with epilepsy to adult medical care. Given the high rates of youth who require epilepsy management into adulthood, conducting further research on the transition process appears imperative. This study highlights the pivotal role psychology, neuropsychology, and social work can serve in supporting transition readiness and addressing the complex needs of families.  Funding: None