Leveraging longitudinal in-school assessments to understand reading risk in SeLECTs: a proof-of-concept cohort

Despite often being considered benign, children diagnosed with Self-limited Epilepsy with Centrotemporal Spikes (SeLECTs) have been shown to display deficits in reading and language skills. However, due to a lack of objective language measures prior to disease onset, it is unknown whether reading difficulties are present before seizure onset. Utilizing classroom reading assessments completed from kindergarten through 2nd grade, we have retrospectively analyzed risk of reading impairment in a proof-of-concept cohort of 22 children with SeLECTs prior to their first recorded seizure. Additionally, in a subset of our cohort, we explored whether risk categorization changed following seizure onset. While the risk of reading difficulties increased as our cohort grew older, a subset of our cohort did not display an increased risk of reading difficulties at any time point. Moreover, we found no differences in reading risk assessment scores between children post-seizure onset and those who had not yet experienced their first seizure. Additionally, there was not a consistent impact of seizure onset on reading risk within individuals. Overall, our proof-of-concept cohort indicates that SeLECTs patients at risk for reading difficulties often manifest with this risk before seizure onset. Our findings emphasize the heterogeneity present within the SeLECTs patient population, and confirms the utility of using standardized testing obtained in the classroom setting to better measure language skills in patient populations prior to disease onset.