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Longitudinal trajectories of behavior problems and social competence in children with new onset epilepsy
Qianqian Zhao1, Paul J Rathouz, Jana E Jones
1Departments of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Insights
Behavioral and social competence problems in children with epilepsy (IGE and LRE) do not worsen over time. Problems present at diagnosis tend to decrease, though competence issues may persist.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
Background:
- Epilepsy in children can impact behavior and social competence.
- Understanding the long-term trajectory of these issues is crucial for effective management.
Purpose of the Study:
- To examine the prospective course of parent-reported behavior and social competence problems in children with new-onset epilepsy.
- To compare these trajectories with healthy controls over 5-6 years post-diagnosis.
Main Methods:
- Longitudinal study of 69 children with new-onset epilepsy (IGE and LRE) and 62 healthy controls.
- Behavioral assessments using the Child Behavior Checklist at diagnosis, 2 years, and 5-6 years.
- Random effects regression modeling to analyze group trajectories over time.
Main Results:
- Behavioral problems were present at diagnosis in epilepsy groups and tended to decrease over 5-6 years.
- Social competence problems were also present and remained relatively stable.
- No progressive worsening of problems was observed in either epilepsy group (IGE or LRE).
Conclusions:
- Children with idiopathic generalized epilepsy (IGE) and localization-related epilepsies (LRE) do not experience progressive worsening of behavioral or social competence issues.
- Behavioral problems may improve, while competence challenges can be more persistent.
- These findings support early intervention and ongoing monitoring.
Aim:
To characterize the prospective trajectory of parent-reported behavior and social competence problems in children with new or recent onset epilepsy from diagnosis to 5 to 6 years after diagnosis compared to healthy control participants.
Method:
Thirty-five children (21 males, 14 females; mean age 14y 1mo [SD 3y 4mo] range 8-18y) with new/recent onset idiopathic generalized (IGE) and 34 children with localization-related epilepsies (LRE; 19 males, 15 females; mean age 10y 8mo [SD 2y 2mo] range 8-18y) underwent behavioral assessment (Child Behavior Checklist) at baseline, 2 years, and 5 to 6 years after diagnosis. The assessment comprised the summary scales Total Behavior Problems Internalizing Problems, Externalizing Problems, and Total Competence. Sixty-two children with normal development served as comparison participants. Analyses were based on random effects regression modeling comparing trajectories with respect to time since epilepsy diagnosis among groups.
Results:
Differences in parent-reported behavioral problems between LRE and IGE syndrome groups and healthy comparison participants were detectable at or near the time of diagnosis and remained either stable (competence) or tended to abate (behavior problems) over the ensuing 5 to 6 years without evidence of progressive worsening. These trends were evident for both LRE and IGE groups, with no differences between them.
Interpretation:
Behavior and competence problems in children with LRE and IGE are not characterized by progressive worsening over a 5- to 6-year period. Behavioral problems are present near the time of diagnosis and tend to abate over time, with competence problems being more persistent across serial assessments, and present in both LRE and IGE groups.
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