Pragmatic communication deficits in children with epilepsy

Various psychiatric and neurological disorders including epilepsy have been associated with language deficits. Pragmatic language deficits, however, have seldom been the focus of earlier studies in children with epilepsy. Moreover, it is unknown whether these pragmatic deficits are related to general intellectual functioning. Both issues will be addressed in this study.

1) Explore pragmatic language deficits in children with epilepsy while controlling for having a neurological illness and having to visit a tertiary paediatric hospital regularly, and 2) Determine whether pragmatic difficulties, if present, are discrete or associated with general intellectual functioning.

The Children's Communication Checklist (CCC), a pragmatic language questionnaire, created by D. V. M. Bishop in 1998, was filled out by parents of 30 children with epilepsy (mean age = 10 years), 30 age-matched children with various neurological disorders other than epilepsy, and 30 age-matched typically developing controls. The full-scale intelligence quotient (FSIQ) was individually measured to estimate the children's level of overall intelligence. The clinical groups were assessed in a tertiary paediatric hospital.

The pragmatic composite score distinguished between the two neurologically impaired groups, even after controlling for FSIQ. Of children with epilepsy, 23% had pragmatic deficits, whereas only 3% of the children with various other neurological disorders and none of the typically developing children had these deficits. When compared scale by scale with typically developing children, children in both clinical groups showed more structural language problems and problems of language use, but these differences disappeared when FSIQ was controlled for.

Pragmatic deficits in communication are present in children treated for various neurological impairments, but more so in children whose seizures necessitate referral to a tertiary hospital. Clinicians should be sensitive to and inquire after pragmatic aspects of communication. Additional research is needed to elucidate mechanisms underlying these deficits.