INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #38 Executing Functioning and Social Communication in Children with Co-Occurring Epilepsy and Autism Without Intellectual Disability Eleftheria Fithian, Children's National Hospital, Washington, United States Chloe Hooker, Children's National Hospital, Washington, United States Ashley Muskett, Children's National Hospital, Washington, United States Christy Casnar, Children's National Hospital, Washington, United States Leigh Sepeta, Children's National Hospital, Washington, United States Madison Berl, Children's National Hospital, Washington, United States Category: Epilepsy/Seizures Keyword 1: epilepsy / seizure disorders Keyword 2: autism spectrum disorder Keyword 3: executive functions Objective: Children with epilepsy (EPI) have increased rates of autism spectrum disorders (ASD) relative to the general population, and children with ASD have increased rates of epilepsy. The link between ASD and EPI is thought to relate to shared neurobiology associated with intellectual disability (ID). However, there are children with ASD and EPI who do not have ID. This study will compare the profile of two neuropsychological domains—executive functioning (EF) and social communication (SC)—that are commonly impaired in EPI and ASD. We hypothesize that non-ID children with both disorders (EPI+ASD) will be more impaired across EF and SC domains than children diagnosed with epilepsy only or ASD only. Participants and Methods: 42 EPI+ASD participants were matched with 42 EPI and 42 ASD participants based on IQ and age. No participants had an ID diagnosis. All participants completed a standardized IQ measure with VIQ>70 and parent ratings to assess SC (Social Responsiveness Scale (and 2^nd edition; SRS-2) and EF (Behavior Rating Inventory of Executive Function (and 2^nd edition; BRIEF-2). Neuropsychological data and relevant medical information were gathered from Children’s National clinical research databases. Group differences were analyzed using one-way Analysis of Variance (ANOVA) and chi-squared analyses. Results: There were no significant age or IQ differences across groups for the 126 participants (mean VIQ: 92.6, range 70-139 mean age:11.3, range 5-18). There were more males in the ASD groups (71% ASD; 69% EPI+ASD; 50% EPI, p<.05). Most epilepsy characteristics were similar between EPI groups (59% abnormal MRI, 80% focal; age _{seizure onset} = 4.8 years). EPI (mean #ASM_EPI: 1.76) took more antiseizure medications (ASMs) than EPI+ASD (mean #ASM_EPI+ASD: 1.28, p<0.05). ASD and EPI+ASD took a similar number of psychiatric medications (mean #: 0.82) which were both greater than EPI (mean #=0.20, p<0.05). Average age of ASD diagnosis was similar for ASD groups (~10 years). A main effect (p<0.05) was found on the SRS-2 and BRIEF-2; EPI had no mean elevated concerns for SC or EF. Both ASD and EPI+ASD had elevated concerns (T>65) for most scales. ASD scored higher on all subscales of the SRS-2 and BRIEF-2 than the EPI group (p’s<0.05). EPI+ASD scored higher than EPI on the Inhibit, Shift, Emotional Control, and Plan/Organize subscales of the BRIEF-2 and all subscales except Social Motivation on the SRS-2 (p’s<0.05). ASD scored significantly higher than EPI+ASD on two SRS-2 subscales: Social Awareness and Social Motivation. Conclusions: Children with epilepsy and ASD have greater SC and EF impairment than children with epilepsy alone despite taking fewer ASMs, taking more psychiatric medications, and having similar epilepsy characteristics. However, the SC and EF of the EPI+ASD group were not uniformly worse than children with ASD alone. According to parent report, children with epilepsy and ASD have less severe social motivation and awareness impairment. Taken together, these findings suggest that non-ID children with epilepsy and ASD have unique profiles. Future studies should further explore differences in functioning beyond parent reports, delve into specifics of medications, and include other domains such as language.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #38

Executing Functioning and Social Communication in Children with Co-Occurring Epilepsy and Autism Without Intellectual Disability

Eleftheria Fithian, Children's National Hospital, Washington, United States
Chloe Hooker, Children's National Hospital, Washington, United States
Ashley Muskett, Children's National Hospital, Washington, United States
Christy Casnar, Children's National Hospital, Washington, United States
Leigh Sepeta, Children's National Hospital, Washington, United States
Madison Berl, Children's National Hospital, Washington, United States

Category: Epilepsy/Seizures

Keyword 1: epilepsy / seizure disorders
Keyword 2: autism spectrum disorder
Keyword 3: executive functions

Objective:

Children with epilepsy (EPI) have increased rates of autism spectrum disorders (ASD) relative to the general population, and children with ASD have increased rates of epilepsy. The link between ASD and EPI is thought to relate to shared neurobiology associated with intellectual disability (ID). However, there are children with ASD and EPI who do not have ID. This study will compare the profile of two neuropsychological domains—executive functioning (EF) and social communication (SC)—that are commonly impaired in EPI and ASD. We hypothesize that non-ID children with both disorders (EPI+ASD) will be more impaired across EF and SC domains than children diagnosed with epilepsy only or ASD only.

Participants and Methods:

42 EPI+ASD participants were matched with 42 EPI and 42 ASD participants based on IQ and age. No participants had an ID diagnosis. All participants completed a standardized IQ measure with VIQ>70 and parent ratings to assess SC (Social Responsiveness Scale (and 2^nd edition; SRS-2) and EF (Behavior Rating Inventory of Executive Function (and 2^nd edition; BRIEF-2). Neuropsychological data and relevant medical information were gathered from Children’s National clinical research databases. Group differences were analyzed using one-way Analysis of Variance (ANOVA) and chi-squared analyses.

Results:

There were no significant age or IQ differences across groups for the 126 participants (mean VIQ: 92.6, range 70-139 mean age:11.3, range 5-18). There were more males in the ASD groups (71% ASD; 69% EPI+ASD; 50% EPI, p<.05). Most epilepsy characteristics were similar between EPI groups (59% abnormal MRI, 80% focal; age _{seizure onset} = 4.8 years). EPI (mean #ASM_EPI: 1.76) took more antiseizure medications (ASMs) than EPI+ASD (mean #ASM_EPI+ASD: 1.28, p<0.05). ASD and EPI+ASD took a similar number of psychiatric medications (mean #: 0.82) which were both greater than EPI (mean #=0.20, p<0.05). Average age of ASD diagnosis was similar for ASD groups (~10 years). A main effect (p<0.05) was found on the SRS-2 and BRIEF-2; EPI had no mean elevated concerns for SC or EF. Both ASD and EPI+ASD had elevated concerns (T>65) for most scales. ASD scored higher on all subscales of the SRS-2 and BRIEF-2 than the EPI group (p’s<0.05). EPI+ASD scored higher than EPI on the Inhibit, Shift, Emotional Control, and Plan/Organize subscales of the BRIEF-2 and all subscales except Social Motivation on the SRS-2 (p’s<0.05). ASD scored significantly higher than EPI+ASD on two SRS-2 subscales: Social Awareness and Social Motivation.

Conclusions:

Children with epilepsy and ASD have greater SC and EF impairment than children with epilepsy alone despite taking fewer ASMs, taking more psychiatric medications, and having similar epilepsy characteristics. However, the SC and EF of the EPI+ASD group were not uniformly worse than children with ASD alone. According to parent report, children with epilepsy and ASD have less severe social motivation and awareness impairment. Taken together, these findings suggest that non-ID children with epilepsy and ASD have unique profiles. Future studies should further explore differences in functioning beyond parent reports, delve into specifics of medications, and include other domains such as language.