IntroductionAs children with epilepsy may have a number of learning and behavioral problems, it is important that insight into the underlying neurocognitive differences in these children, which may underlie these areas of challenge is gained. Executive function (EF) problems particularly are associated with specific learning abilities as well as behavioral problems. We aim to review systematically the current status of empirical studies on the association between EF problems and behavior and socioemotional problems in children with epilepsy.
MethodsStudies were identified using Pubmed and Web of Science, whilst following the PRISMA guidelines. All studies were assessed for methodological quality and results were summarized descriptively.
ResultsAfter search, 26 empirical studies were identified, most of them of moderate quality. Overall, attention problems were the most reported cognitive deficit in test assessment and the most reported problem by parents. In 54% of the studies, children with epilepsy scored below average compared to controls/normative samples on different aspects of EF. Most studies reported behavior problems, which ranged from mild to severe. Forty-two percent of the studies specifically reported relationships between EF deficits and behavioral problems. In the remaining studies, below average neuropsychological functioning seemed to be accompanied by above average reported behavioral problems.
ConclusionsCognitive control and attention deficits seem mostly associated with especially externalizing behavioral problems. The epilepsy variables early age at seizure onset and high seizure frequency are important variables in the relationship between EF and behavior. Future research should distinguish specific aspects of EF and take age into account, as this provides more insight on the association between EF and behavior in pediatric epilepsy, which makes it possible to develop appropriate and early intervention.
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Social functioningEF also encompasses behaviors necessary for social interaction, such as initiation, self-monitoring, and self-regulation [14], which may be essential for adequate social functioning [63]. To engage in successful social interaction it is essential 292 Associating executive dysfunction with behavioral and socioemotional problems in children with epilepsy: a systematic review 65 2 Associating executive dysfunction with behavioral and socioemotional problems in children with epilepsy: a systematic review