Brief clinical screening for academic underachievement in new-onset childhood epilepsy: Utility and longitudinal results

Abstract

Objective To determine the lifetime rate and distribution of supportive academic and educational services provided to children with new/recent onset epilepsy and typically-developing controls, the relationship of this history to objective academic test performance, and the course of performance over serial evaluations (baseline, 2 and 5 years later). Methods Research participants were 91 children aged 8-18 at study entry, including 50 youth with recent-onset epilepsy (28 Focal [FE] and 22 Generalized [GE] epilepsy) and healthy first-degree cousin controls (n=41). Epilepsy sample included children with uncomplicated epilepsy, normal imaging and development. Lifetime history of a diversity of supportive educational services was determined via structured interview with parents at the baseline study visit. Associations were examined between these support services and participants' academic performance in reading, spelling, and arithmetic (Wide Range Achievement Test Rev. 3 [WRAT3][1]) during three serial study visits including baseline, 2 and 5-years later. Results Children with epilepsy had a higher lifetime rate of provision of diverse academic supportive services compared to controls at the baseline visit (52% vs. 18%). These services antedated epilepsy diagnosis in the majority (80.8%) of the children with epilepsy. Among children with epilepsy, children who presented with academic services had significantly lower WRAT3 reading, spelling, and arithmetic performance at baseline, 2 and 5-year follow-up. Conclusion A brief structured clinical interview conducted with parents identifies children with epilepsy who are at academic risk at the time of diagnosis with that risk persisting up to 5-years later.

Contribution of Family Relatedness to Neurobehavioral Comorbidities in Idiopathic Childhood Epilepsies

“…18%). While previous studies support findings of elevated academic service rates in children with epilepsy (Almane et al, 2015; Berg et al, 2005; Overvliet et al, 2011; Sogawa, Masur, O’Dell, Moshe, & Shinnar, 2010), the noted elevated rates of academic services in epilepsy siblings is a unique finding of the current study. Academic service rates by group are summarized in Figure 1.…”

“…Finally, regarding academic problems, children with epilepsy again had higher rates of supportive academic services than unaffected siblings and controls, and a trend was observed of more problems in the unaffected siblings compared with controls (51% vs. 31% vs. 18%). While previous studies support findings of elevated academic service rates in children with epilepsy (Almane et al, 2015;Berg et al, 2005;Overvliet et al, 2011;Sogawa, Masur, O'Dell, Moshe, & Shinnar, 2010), the noted elevated rates of academic services in epilepsy siblings is a unique finding of the current study. Academic service rates by group are summarized in Figure 1.…”

“…An extensive literature that includes population-based, community-based and clinical investigations has documented significantly elevated rates of a variety of neurobehavioral comorbidities in children with epilepsy, including behavioral problems (i.e., depression, anxiety, attention deficit hyperactivity disorder [ADHD]), lower social competence, academic difficulties, and executive dysfunction (Almane et al, 2015;Berg et al, 2007;Hoie et al, 2005;Jones et al, 2008;Lin, Mula, & Hermann, 2012; MacAllister epilepsy and its treatment or psychosocial complications (Austin et al, 2001;Fastenau et al, 2009;Oostrom et al, 2003). Furthermore, behavioral problems (Austin et al, 2001), academic struggles (Berg et al, 2005;McNelis, Johnson, Huberty, & Austin, 2005;Overvliet, Aldenkamp, Klinkenberg, Vles, & Hendriksen, 2011), and rates of specific psychiatric comorbidities (i.e., depression, anxiety, ADHD) (Hesdorffer et al, 2004;Jones et al, 2007) have been reported even antecedent to the first recognized seizure and epilepsy diagnosis, implicating antecedent neurodevelopmental dysmaturation (Pohlmann-Eden et al, 2015).…”

“…An extensive literature that includes population-based, community-based and clinical investigations has documented significantly elevated rates of a variety of neurobehavioral comorbidities in children with epilepsy, including behavioral problems (i.e., depression, anxiety, attention deficit hyperactivity disorder [ADHD]), lower social competence, academic difficulties, and executive dysfunction (Almane et al, 2015; Berg et al, 2007; Hoie et al, 2005; Jones et al, 2008; Lin, Mula, & Hermann, 2012; MacAllister & Schaffer, 2007; Parrish et al, 2007; Rantanen, Eriksson, & Nieminen, 2012; Russ, Larson, & Halfon, 2012). These elevated rates of neurobehavioral comorbidities have been demonstrated in comparison with typically developing children as well as in comparison to children with other medical disorders such as asthma, diabetes, cardiac problems, and other physical problems (Austin et al, 2001; Austin, Huberty, Huster, & Dunn, 1998; Davies, Heyman, & Goodman, 2003; Hoare, 1984; McDermott, Mani, & Krishnawami, 1995; Rutter, Graham, & Yule, 1970).…”

Perceived stigma and school attendance among children and adolescents with epilepsy in South Western Uganda

“…These findings may also explain why children with epilepsy have poor academic achievement 22 , 23 , as well as overall academic underachievement 24 , 25 as reported by existing studies 26 , 27 . Similar to many resource-limited settings, there are no special schools for children with epilepsy in SouthWestern Uganda.…”