Poster #14 - One diagnosis or more? Impaired language and reading in pediatric epilepsy

• In Event: Poster Session 11

Abstract

Epilepsy is the most prevalent neurological disorder in children (Plioplys et al., 2007), and is associated with deficits in cognition and academic achievement, including reading and language. Research examining phonological processing (the ability to manipulate sounds in working memory), and oral language in children with epilepsy is contradictory with some studies reporting no differences between children with epilepsy compared to their same-aged peers (e.g., Krause et al., 2008; Lopes et al., 2014) and others reporting differences (Bailey & Im-Bolter, 2019; Selassie et al., 2008). These conflicting findings may be attributed to heterogeneous samples and further investigations with homogeneous samples are needed to explain discrepancies in the literature (Bailey & Im-Bolter, 2020). The cognitive and achievement profile in children with epilepsy suggest that these children are at increased risk for developmental dyslexia (a learning disorder specific to reading) and language impairment, but little is known about the rate of these disorders in this group.
As a preliminary step, the present study examined the proportion of reading and oral language deficits in a small sample of school-aged children with epilepsy. We assessed phonological processing, reading decoding and comprehension, and semantic and syntactic language using standardized measures in a group of children with generalized seizures (N = 10; Mage = 10.58 years, SD = 2.72%; Monsetage = 6.36, SD = 3.47). We found that 27.3% of children had IQ scores that were at least 1 SD below the mean. As well, the majority of children performed more than 1 SD below the mean on phonological processing and reading comprehension (63.6% and 81.8%, respectively). More importantly, 81.8% of children had reading comprehension scores that met criteria for impairment. This includes three children who were unable to complete standardized reading tests because of their low reading skills. Children were also more likely to have scores that met criteria for language impairment for syntactic language compared to semantic language (54.5% and 36.4%, respectively). Five out of the nine children who had critically low reading scores also had syntactic language scores that were impaired.
It is not surprising that most of our sample of children who met criteria for developmental dyslexia also met criteria for language impairment given that more than half of the general population diagnosed with developmental dyslexia also meet diagnostic criteria for language impairment and vice versa (MacArthur et al., 2000). What is concerning, is that children with epilepsy are at increased risk for both disorders. We know that approximately 7% of school children are diagnosed developmental dyslexia (Yang et al., 2022) and with language impairment (Tomblin et al, 1997) in the general population. Our data suggest that children with generalized seizures are 10 times more likely to have developmental dyslexia and 5 times more likely to meet criteria for language impairment. As such, elucidating the rate of these disorders in this population may provide insights into the complexity of the cognitive difficulties in children with epilepsy and implications regarding methods aimed to provide early detection and intervention for their learning.

Authors

• Katharine M Bailey, University of Alberta
  Presenting Author

• Patrycia jarosz

• Nancie Im-Bolter, Trent University