Speed and Complexity Characterize Attention Problems in Children with Localization-Related Epilepsy
Published Date:May 04 2015
Pubmed Central ID:PMC4457628
Funding:U01 DP003255/DP/NCCDPHP CDC HHS/United States
K23 NS065121/NS/NINDS NIH HHS/United States
T32 HD046388/HD/NICHD NIH HHS/United States
P30 HD040677/HD/NICHD NIH HHS/United States
R01 MH084961/MH/NIMH NIH HHS/United States
R01 NS044280/NS/NINDS NIH HHS/United States
L30 NS047067/NS/NINDS NIH HHS/United States
L40 DC008088/DC/NIDCD NIH HHS/United States
R21 MH092615/MH/NIMH NIH HHS/United States
P30HD040677/HD/NICHD NIH HHS/United States
K23NS065121-01A2/NS/NINDS NIH HHS/United States
R01 NS44280/NS/NINDS NIH HHS/United States
M01 RR020359/RR/NCRR NIH HHS/United States
Children with epilepsy (EPI) have a higher rate of ADHD (28–70%) than typically developing (TD) children (5–10%); however, attention is multidimensional. Thus, we aimed to characterize the profile of attention difficulties in children with epilepsy.
Seventy-five children with localization-related epilepsy ages 6–16 and 75 age-matched controls were evaluated using multimodal, multidimensional measures of attention including direct performance and parent ratings of attention as well as intelligence testing. We assessed group differences across attention measures, determined if parent rating predicted performance on attention measures, and examined if epilepsy characteristics were associated with attention skills.
The EPI group performed worse than the TD group on timed and complex attention aspects of attention (p<.05), while performance on simple visual and simple auditory attention tasks was comparable. Children with EPI were 12 times as likely as TD children to have clinically elevated symptoms of inattention as rated by parents, but ratings were a weak predictor of attention performance. Earlier age of onset was associated with slower motor speed (p<.01), but no other epilepsy-related clinical characteristics were associated with attention skills.
This study clarifies the nature of the attention problems in pediatric epilepsy, which may be under recognized. Children with EPI had difficulty with complex attention and rapid response, not simple attention. As such, they may not exhibit difficulty until later in primary school when demands increase. Parent report with standard ADHD screening tools may underdetect these higher order attention difficulties. Thus, monitoring through direct neuropsychological performance is recommended.
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