Abstracts

Rationale: Word finding (WF) or “naming” difficulty, is a frequent complaint among adults with language-dominant epilepsy. As complaints typically prompt neuropsychological evaluation and influence the nature of the assessment, it is important to understand how subjective concerns of WF difficulty relate to objective naming performance. In children, this relationship is particularly complicated as it is often the parent’s concerns that are conveyed to the clinician. We examined the relationships between 1) parent and child’s subjective report of WF difficulty and 2) both the parent and the child’s subjective report of WF difficulty with the child’s performance on pediatric visual and auditory naming tasks.Methods: Subjects were 59 children with unilateral epilepsy (34 left, ages 6-15 years, 17 girls, mean FSIQ = 94.0 SD= 12.0) who had neuropsychological evaluation at Columbia University Medical Center (n=18), University of Toronto Mississauga (n =28) or New York University Medical Center (n = 13). The visual naming test consists of 36 color photographs of familiar items. The auditory naming test consists of 36 descriptions of familiar items (e.g., “where birds lay their eggs”). Performance measures include number correct (within 20 seconds), mean response time (RT), tip-of-the-tongue responses (TOT, i.e., number of correct responses > 2 seconds + number correct following phonemic cue), and items requiring a phonemic cue. For subjective WF frequency and associated distress, two 7-point Likert-type scales were completed by both the child and the parent. Pearson correlations assessed relations between variables. Analyses were conducted separately for younger (6-9 years, n= 18) and older (10-15 years, n =41) children.Results: We found no laterality effects for subjective report; therefore, results are combined for left and right patients. Subjective WF frequency was not correlated with naming performance for younger children, older children or parents. However, for older children, subjective WF distress correlated with visual naming RT, r = .46, p = .006. For younger children, parent’s rating of the child’s distress correlated with auditory naming number correct, r = -.57, p = .034, and visual naming number correct, r = -.59, p = .027. Also in younger children, parent’s rating of child’s distress correlated with auditory naming TOT, r = .63, p = .015, and visual naming TOT, r = .59, p = .027.Conclusions: Results suggest that among children with epilepsy and their parents, subjective WF related distress is more closely related than subjective WF frequency to objective WF performance. Whereas parents appear to be better reporters of WF difficulty for younger children, older children are better reporters than their parents. This might reflect age related differences in time children spend with parents and in their ability to identify the source and magnitude of their own distress as they develop. These results suggest utility in inquiring about WF related distress in addition to frequency, and underscore the importance of subjective report in older children.NIHR01NS35140