Autism, ADHD and parent-reported behavioural difficulties in young children with epilepsy
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Published on: December 7, 2018
Colin Reilly1, Patricia Atkinson2, Ayesha Memon2
1Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; UCL Great Ormond Street Institute of Child Health (ICH), 30 Guilford Street, London, WC1N 1EH, UK.
Insights
Young children with epilepsy show high rates of behavioral difficulties, Autism Spectrum Disorder (ASD), and Attention-Deficit/Hyperactivity Disorder (ADHD). These issues are comparable to other neurodevelopmental conditions, emphasizing the need for thorough assessments.
Area of Science:
- Pediatric Neurology
- Developmental Psychology
- Child Psychiatry
Background:
- Epilepsy in young children is often associated with neurodevelopmental challenges.
- Understanding the co-occurrence of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) is crucial for effective management.
- Parent-reported behavioral difficulties are common but require further investigation in relation to epilepsy.
Purpose of the Study:
- To determine the prevalence of ASD, ADHD, and behavioral problems in young children with epilepsy.
- To compare these findings with a matched group of children with neurodisability but without epilepsy.
- To identify factors associated with behavioral difficulties in children with epilepsy.
Main Methods:
- A cohort of 48 children with epilepsy (ages 1-7) and 48 matched children with neurodisability without epilepsy underwent psychological assessments.
- Parents completed the Strengths and Difficulties Questionnaire (SDQ) to report on child behavior.
- Diagnoses of ASD and ADHD were established through consensus case conferences, and linear regression analyzed behavioral associations.
Main Results:
- 18% of children with epilepsy met ASD criteria and 40% met ADHD criteria; non-epilepsy group figures were 41% and 27% respectively.
- 76%-78% in both groups scored at-risk on the SDQ, indicating widespread behavioral difficulties.
- Children with epilepsy showed more attention and mood concerns, but epilepsy-specific factors did not correlate with behavioral scores.
Conclusions:
- Young children with epilepsy exhibit high levels of parent-reported behavioral issues and elevated risks for ASD and ADHD.
- Behavioral concerns in children with epilepsy are similar to those with other neurodisabilities, except for attention and mood.
- Seizure-related factors do not appear to uniquely increase the risk for behavioral difficulties, underscoring the need for comprehensive multidisciplinary care.
Purpose:
To provide data on the prevalence of Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and parent reported behaviour difficulties in young children with epilepsy, and to compare results with children with neurodisability (neurodevelopmental/neurological difficulties) without epilepsy.
Method:
Children with epilepsy (1-7 years, n = 48) and children with neurodisability (1-7 years, n = 48) matched for gender, chronological and developmental age underwent psychological assessment. Parents completed measures of behaviour including the Strengths and Difficulties Questionnaire (SDQ). DSM-5 diagnoses of ASD and ADHD were made at consensus case conferences. Factors associated with child behaviour were analysed using linear regression.
Results:
Of the children with epilepsy, 18% met ASD criteria and 40% met ADHD criteria (corresponding figures in the non-epilepsy group were 41% and 27%). A large proportion (76%-78%) in both groups scored in the at-risk range on the SDQ and frequently had difficulties across multiple behavioural domains. Children with epilepsy had more concerns expressed regarding attention and mood. None of the epilepsy factors were significantly associated with scores on the behavioural measures.
Significance:
Young children with epilepsy had a very high level of parent reported behavioural difficulties and a high risk for ADHD and ASD highlighting the need for comprehensive multidisciplinary assessment. Behavioural concerns were not greater than for other children with non-epilepsy related neurodisability with the exception of attention and mood. Epilepsy related factors were not associated with child behaviour, suggesting that seizures per se do not confer a unique risk for behavioural difficulties.
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