Research Department, Young Epilepsy, Lingfield, Surrey, United Kingdom; Gillberg Neuropsychiatry Center, University of Gothenburg, Gothenburg, Sweden.
Epilepsia. 2014 Dec;55(12):1910-7. doi: 10.1111/epi.12826. Epub 2014 Oct 20.
To provide population-based data on the performance of school-aged children with epilepsy on measures of academic achievement and factors associated with this performance after controlling for IQ.
Eighty-five (74%) of 115 children with "active" epilepsy (experienced a seizure in the past year and/or on antiepileptic drugs [AEDs]) underwent psychological assessment including measures of IQ, aspects of working memory and processing speed. Sixty-five of the 85 were able to complete subtests on the Wide Range Achievement Test-Fourth Edition (WRAT-4). Paired sample t-tests were conducted to compare subtest scores. Factors associated with academic performance after controlling for IQ were examined using linear regression.
Seventy-two percent of the children, who could complete subtests on the WRAT-4, displayed "low achievement" (1 standard deviation [SD] below test mean) and 42% displayed "underachievement" (1 SD below assessed IQ) on at least one of the four WRAT-4 subtests. The mean scores on the Math Computation subtest and Sentence Comprehension subtest were significantly lower than scores on the Word Reading (p < 0.05) and Spelling (p < 0.001) subtests. Younger age at seizure onset was associated (p < 0.05) with decreased scores on three of the four WRAT-4 subtests after controlling for IQ. Difficulties with auditory working memory were associated with difficulties on reading comprehension (p < 0.05), and parent-reported difficulties with school attendance were associated with decreased scores on the Spelling and Word Reading subtests after controlling for IQ (p < 0.05).
Difficulties with academic achievement are common in school-aged children with "active" epilepsy. Much of the difficulties can be attributed to lowered global cognition. However, specific cognitive deficits, younger onset of first seizure, and school attendance difficulties may contribute to difficulties independent of global cognition. There is a need to screen all children with "active" epilepsy for difficulties in school achievement, to identify contributory factors and to identify efficacious interventions for ameliorating such difficulties.
提供基于人群的数据，了解学龄期癫痫儿童在学业成就方面的表现，以及在控制智商后与该表现相关的因素。
85 名（74%）“活跃”癫痫儿童（过去一年有癫痫发作和/或服用抗癫痫药物[AED]）接受了心理评估，包括智商、工作记忆和处理速度的各个方面的测试。85 名儿童中有 65 名能够完成第四版广泛成就测试（WRAT-4）的分测验。采用配对样本 t 检验比较分测验分数。使用线性回归分析控制智商后与学业成绩相关的因素。
72%能够完成 WRAT-4 分测验的儿童在至少一个 WRAT-4 分测验中表现出“低成就”（低于测试平均值 1 个标准差），42%表现出“学业不良”（低于评估智商 1 个标准差）。数学计算分测验和句子理解分测验的平均分明显低于阅读分测验（p<0.05）和拼写分测验（p<0.001）。发病年龄越小，在控制智商后，四个 WRAT-4 分测验中的三个分测验的分数越低（p<0.05）。听觉工作记忆困难与阅读理解困难相关（p<0.05），家长报告的上学困难与拼写和阅读分测验分数降低相关（p<0.05）。
“活跃”癫痫的学龄儿童学业困难较为常见。大多数困难归因于总体认知能力下降。然而，特定的认知缺陷、首次发作年龄较小和上学困难可能会导致独立于总体认知的困难。需要对所有“活跃”癫痫儿童进行学业成就困难筛查，以确定促成因素，并确定改善这些困难的有效干预措施。
