Academic Underachievement in Children with Epilepsy

Abstract

Academic achievement was studied in 78 children with epilepsy, ages 5 to 13 years, to determine how seizures, treatment of seizures, and sociocultural factors influence academic achievement. Cognitive abilities were assessed with either the McCarthy Scales of Children's Abilities or the Wechsler Intelligence Scale for Children--Revised. Achievement was measured with the Peabody Individual Achievement Tests. Achievement scores were corrected for cognitive ability (IQ), and underachievement was defined as achievement score 1/2 standard deviation or more below IQ. Information regarding seizure history (severity, duration) and treatment with anticonvulsant drugs was obtained. In addition, the family was extensively interviewed regarding the child's environment, behavior, and demographic background. The Home Observation for Measurement of the Environment (HOME) scale was completed on a home visit. Underachievement was frequent, ranging from 16% (Reading Recognition) to 50% (General Knowledge), but there was no relationship between severity or duration of seizure disorder or total exposure to anticonvulsant medications and achievement. Major determinants of achievement included subscales of the HOME scale, age (older children more likely to be underachieving), and parental education. An equal proportion of newly diagnosed and/or untreated subjects were underachieving compared to those with longstanding epilepsy and anticonvulsant drug treatment.

Chronic Illness and Developmental Vulnerability at School Entry

“…This is contrary to previous research, which has revealed an increased prevalence of behavioral and cognitive problems in children with epilepsy compared with those without. 13,36 This may be because the majority of epilepsy diagnoses in our cohort were either generalized idiopathic epilepsy, which is suggested to be associated with more mild impairments of social and educational function compared with other forms of epilepsy, 37 or "epilepsy unspecified" (convulsions, fits, or seizures not otherwise specified), which may capture children with more transient symptoms. Given the large body of research demonstrating adverse outcomes for children with epilepsy, we would caution against concluding from the findings of this study that epilepsy is not associated with developmental vulnerability for children.…”

“…Previous research on the association between chronic illness and academic outcomes has mostly been on the basis of either specific pediatric samples, [12][13][14] or used informant reports of health status. 4,[7][8][9] Although providing important findings, these 2 designs have limitations in terms of the generalizability of results, and potential reporting bias, respectively.…”

Psychometric properties of the Family Resilience Assessment Scale: A Singaporean perspective

“…Associations between family functioning and a range of psychosocial and health outcomes in young people with epilepsy has also been demonstrated. Poorer levels of family functioning have been shown to predict higher levels of behavioral problems [9,10], lower self-esteem [11], social competencies [10,12], academic achievement [13,14], and treatment adherence [15,16].…”

Academic performance in children with new-onset seizures and asthma: A prospective study

“…Williams et al (19) found no differences in performance on cognitive measures between children with new-onset seizures before and after six months of treatment with AEDs compared to children with recently diagnosed diabetes mellitus. Increased seizure frequency has been negatively related to performance in some studies (7,(23)(24)(25)(26), although other studies found that seizure variables were not strongly related to academic achievement (2,4,14,27).To more clearly define the etiology and natural history of academic difficulties, longitudinal studies beginning early in the course of the seizure disorder are needed. To date, only four studies have examined academic problems among children with new-onset seizures, and in two of the studies (4,14) data on children with both new-onset and chronic seizures were combined and not reported separately.…”

“…To date, only four studies have examined academic problems among children with new-onset seizures, and in two of the studies (4,14) data on children with both new-onset and chronic seizures were combined and not reported separately. Berg et al (28) enrolled children 1 month to 16 years of age into a study of new-onset epilepsy and reported academic progress at a 5-year followup.…”