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Routine developmental and autism screening in an epilepsy care setting
Breanne Fisher1, Catherine Dezort, Douglas R Nordli
1Epilepsy Center, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL 60611, USA.
Insights
Routine screening for developmental delay and autism in children with epilepsy is highly effective. Early detection through screening in hospital programs can identify significant needs and guide further evaluations for affected children.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Child Psychiatry
Background:
- Epilepsy in children frequently co-occurs with developmental delay and autism spectrum disorder.
- Early identification of these comorbidities is crucial for timely intervention and improved outcomes.
- Hospital-based programs offer a setting for routine developmental and autism screening.
Purpose of the Study:
- To evaluate the effectiveness and yield of routine developmental delay and autism screening in a pediatric epilepsy program.
- To determine the proportion of children with epilepsy who screen positive for developmental delay and/or autism.
- To assess the actionability of screening findings and the need for further evaluations.
Main Methods:
- Parents of 65 children (average age 2.5 years) with epilepsy completed developmental and autism screening questionnaires.
- Children were assessed within a hospital-based program, including both new and established epilepsy patients.
- Screening results were analyzed for positive and borderline findings, and correlations with existing diagnoses and services were examined.
Main Results:
- A high percentage of children screened positive: 72% for developmental delay and 37% for autism.
- All children who screened positive for autism also screened positive for developmental delay.
- Screening identified actionable findings in 31% of children, necessitating further evaluation and referrals.
Conclusions:
- Routine developmental and autism screening in pediatric epilepsy programs has a high yield.
- The findings support the implementation of routine screening for all children with epilepsy to identify developmental delays and autism.
- Screening facilitates early intervention and appropriate management of co-occurring conditions in children with epilepsy.
Abstract:
Developmental delay (delay) and co-morbidities like autism are common in children with epilepsy. We assessed the yield of routine screening for delay and autism in a hospital-based program. Parents completed developmental and autism screeners for 65 children (average age=2.5y; 38(58%) boys). Forty-nine (75%) were established epilepsy patients, and 16 (25%) were new patients. For development, 47 (72%) children screened positive and 8 (12%) had borderline results. Twenty-four (37%) scored positive for autism, all of whom also screened positive for developmental delay. Delays and neurologic deficits accounted for the positive autism results in 20 of the 24. Developmental findings were confirmatory (already receiving services) in 32/55 (58%) children and actionable in 17 (31%) (requiring further evaluation). Referrals for further evaluations were made for most with actionable findings. The yield of routine screening of children in a tertiary center is sufficiently high to support its use and to consider screening of all children seen with epilepsy.
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