Abstracts

Rationale: To determine the prevalence, nature and predictors of social skills impairment in children with epilepsy.Methods: This was a cross-sectional, cohort survey of children with epilepsy, aged 3-17 years, with an estimated developmental quotient of >70, and their nearest aged sibling. The parent or caregiver completed the Social Skills Rating System, Child Behavior Checklist (CBCL) and a brief general health questionnaire for both the child with epilepsy and his/her sibling, the Impact of Child Neurological Disability (ICND) questionnaire for their child with epilepsy, and a Family Assessment Measure (FAM) III. Epilepsy-specific variables including seizure type, frequency, age at onset number of AEDs used, co-morbid learning disability, intractability, etiology and family history of epilepsy were recorded for each case.Results: Completed questionnaires were returned from 101/132 (77%) eligible families. While children with epilepsy had poorer social skills (p<0.05) and lower assertion (p<0.006) than their siblings, the proportion with clinically-significant social skill deficits was low and did not differ between groups (13% vs 7%, p=0.12). Neurological factors were related to social skills, but only the presence of a learning disability (OR 8.64, 95% CI 1.87-39.98) and abnormal family function (OR 8.75, 95% CI 1.42-53.83) were strongly predictive of social skills impairment. Social skill problems were associated with Externalizing behaviors in both children with epilepsy and siblings, but Internalizing behavior was a correlate only in children with epilepsy. Lower social skills were moderately correlated with epilepsy-specific and global quality of life (p<0.001).Conclusions: While most children with epilepsy are functioning well from a Social Skills perspective, those with epilepsy are less assertive than their siblings. In those with epilepsy, social skills impairment correlated with poorer quality of life and greater impact of neurological disability on personal development and relationships with family and peers. Learning disability and poorer family function were predictive of social skills impairment.