Associations Between Attention Regulation, Working Memory, and Academic Skills Among Pediatric Patients with Epilepsy

Abstract

Deficits in working memory (WM), processing speed (PS), attention, and executive functioning (EF) are commonly observed among children with epilepsy (CE), which may contribute to the elevated rate of academic underachievement. The goal of this study was to examine the associations between functions associated with frontal-subcortical circuitry, including attention, WM, PS, and EF with academic skills, after accounting for intellectual functioning and seizure factors among CE. Retrospective review of medical records was conducted to obtain seizure history (history of status epilepticus, age of onset, seizure frequency, months seizure free by cognitive testing) and antiepileptic drug (AED) use of 46 pediatric patients (26F, Mage = 12.34 years; SD = 3.08), who were diagnosed with epilepsy. Patients were administered a neurocognitive test battery to assess for overall intellectual functioning, WM, PS, EF, and academic skills (word reading, math calculation, spelling). Caregivers completed the Child Behavior Checklist to assess for overall attention problems. Among seizure factors, the number of high- and lower-cognitive-risk AEDs prescribed was associated with different academic skills. Despite controlling for intellectual functioning and the high- and lower-cognitive-risk AED use, WM was positively associated with spelling achievement, and attention problems were negatively associated with academic skills. In contrast, EF and PS were not significant correlates when AEDs and intellectual functioning were controlled. WM and attention functioning are potential areas to target in early interventions and educational planning to reduce risks of academic underachievement associated with CE. Types of AEDs prescribed should also be considered in academic accommodations given potential effects on cognitive functioning.