INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #80 Language Problems and Confounding Variables Contributing to Social Withdrawal in Pediatric Patients with Epilepsy Szimonetta Mulati, Boston Children's Hospital, Boston, United States Song Dam, Bosoton Children's Hospital, Boston, United States Alena Hornak, Boston Children's Hospital, Boston, United States Katrina Boyer, Boston Children's Hospital, Boston, United States Clemente Vega, Boston Children's Hospital, Boston, United States Moshe Maiman, Boston Children's Hospital, Boston, United States Phillip Pearl, Boston Children's Hospital, Boston, United States Alyssa Ailion, Boston Children's Hospital, Boston, United States Category: Epilepsy/Seizures Keyword 1: epilepsy / seizure disorders Keyword 2: language Keyword 3: mood disorders Objective: Children with epilepsy exhibit higher rates of withdrawal (the tendency to evade others to avoid social contact), internalizing problems (anxiety, depression), and reduced quality of life [1]. Given the negative impact that withdrawal and internalizing problems have on child development, life outcomes, and its economic burden, efforts to prevent these disorders are considered a public health priority. Previous findings indicated that verbal ability is highly associated with withdrawal, such that individuals with greater language problems exhibit higher withdrawal. The present study investigates whether problems in specific language domains including naming and verbal fluency may be related to withdrawal in youth with temporal lobe epilepsy (TLE) to cater intervention services targeting specific language skills to improve quality of life. Participants and Methods: Retrospective medical records review identified 41 children with TLE and neuropsychological assessment (Age: M=13.67, SD = 4.73) at Boston Children’s Hospital who underwent surgical intervention. We included all patients with completed parent ratings of emotional-behavioral status on the Behavior Assessment System for Children, 3rd Edition (BASC-3) and underwent assessment of intelligence using the age-appropriate Wechsler scale and language skills including naming from the Boston Naming Test (BNT) and verbal fluency from the Delis-Kaplan Executive Function System (D-KEFS) (n=29). We investigated correlations among BASC-3 withdrawal subscale and overall verbal reasoning abilities, naming, and verbal fluency skills to better understand the relationship between language difficulties and withdrawal. We also examined possible confound and covariate variables including gender, age at surgery, age at onset of seizures, lesional MRI, side of lesion, and presence of hippocampal sclerosis. Results: Covariate analyses revealed that age of seizure onset was associated with verbal IQ (VIQ) and withdrawal (r=.57, p<.05; r=-.49, p<.05). Right sided lesion laterality was associated with withdrawal (r=.37, p<.05). No other confound or covariate variables were significant. Verbal IQ and naming were both associated with categorical fluency (r=.57, p<.05; r=.38, p<.05). Surprisingly, VIQ and naming were not associated with withdrawal with or without confounding and covariate variables included. A partial correlation controlling for side of lesion indicated a trend in which category fluency is negatively associated with withdrawal (r= -.35, p=.08), such that withdrawal symptoms were lower in individuals with better categorical fluency skills. Conclusions: Preliminary findings indicate children with TLE are at higher risk for withdrawal if they have a right-sided lesion, seizure onset in later adolescence, and possibly reduced categorical fluency. Prior literature suggests right sided lesions are associated with apathy, and we found right TLE patients were more socially withdrawn. Prior research has also found that hippocampal sclerosis is related to apathy, however we did not find any relationship between hippocampal sclerosis and withdrawal, suggesting the need for replication with a larger sample. Verbal reasoning, vocabulary, and naming was positively related to fluency, and thus may indirectly improve withdrawal symptoms. Current results could inform future interventions that target adolescents with right TLE and address language problems including fluency skills to reduce withdrawal and improve quality of life for children affected by epilepsy.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)

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

Final Abstract #80

Language Problems and Confounding Variables Contributing to Social Withdrawal in Pediatric Patients with Epilepsy

Szimonetta Mulati, Boston Children's Hospital, Boston, United States
Song Dam, Bosoton Children's Hospital, Boston, United States
Alena Hornak, Boston Children's Hospital, Boston, United States
Katrina Boyer, Boston Children's Hospital, Boston, United States
Clemente Vega, Boston Children's Hospital, Boston, United States
Moshe Maiman, Boston Children's Hospital, Boston, United States
Phillip Pearl, Boston Children's Hospital, Boston, United States
Alyssa Ailion, Boston Children's Hospital, Boston, United States

Category: Epilepsy/Seizures

Keyword 1: epilepsy / seizure disorders
Keyword 2: language
Keyword 3: mood disorders

Objective:

Children with epilepsy exhibit higher rates of withdrawal (the tendency to evade others to avoid social contact), internalizing problems (anxiety, depression), and reduced quality of life [1]. Given the negative impact that withdrawal and internalizing problems have on child development, life outcomes, and its economic burden, efforts to prevent these disorders are considered a public health priority. Previous findings indicated that verbal ability is highly associated with withdrawal, such that individuals with greater language problems exhibit higher withdrawal. The present study investigates whether problems in specific language domains including naming and verbal fluency may be related to withdrawal in youth with temporal lobe epilepsy (TLE) to cater intervention services targeting specific language skills to improve quality of life.

Participants and Methods:

Retrospective medical records review identified 41 children with TLE and neuropsychological assessment (Age: M=13.67, SD = 4.73) at Boston Children’s Hospital who underwent surgical intervention. We included all patients with completed parent ratings of emotional-behavioral status on the Behavior Assessment System for Children, 3rd Edition (BASC-3) and underwent assessment of intelligence using the age-appropriate Wechsler scale and language skills including naming from the Boston Naming Test (BNT) and verbal fluency from the Delis-Kaplan Executive Function System (D-KEFS) (n=29). We investigated correlations among BASC-3 withdrawal subscale and overall verbal reasoning abilities, naming, and verbal fluency skills to better understand the relationship between language difficulties and withdrawal. We also examined possible confound and covariate variables including gender, age at surgery, age at onset of seizures, lesional MRI, side of lesion, and presence of hippocampal sclerosis.

Results:

Covariate analyses revealed that age of seizure onset was associated with verbal IQ (VIQ) and withdrawal (r=.57, p<.05; r=-.49, p<.05). Right sided lesion laterality was associated with withdrawal (r=.37, p<.05). No other confound or covariate variables were significant. Verbal IQ and naming were both associated with categorical fluency (r=.57, p<.05; r=.38, p<.05). Surprisingly, VIQ and naming were not associated with withdrawal with or without confounding and covariate variables included. A partial correlation controlling for side of lesion indicated a trend in which category fluency is negatively associated with withdrawal (r= -.35, p=.08), such that withdrawal symptoms were lower in individuals with better categorical fluency skills.

Conclusions:

Preliminary findings indicate children with TLE are at higher risk for withdrawal if they have a right-sided lesion, seizure onset in later adolescence, and possibly reduced categorical fluency. Prior literature suggests right sided lesions are associated with apathy, and we found right TLE patients were more socially withdrawn. Prior research has also found that hippocampal sclerosis is related to apathy, however we did not find any relationship between hippocampal sclerosis and withdrawal, suggesting the need for replication with a larger sample. Verbal reasoning, vocabulary, and naming was positively related to fluency, and thus may indirectly improve withdrawal symptoms. Current results could inform future interventions that target adolescents with right TLE and address language problems including fluency skills to reduce withdrawal and improve quality of life for children affected by epilepsy.