Neuropsychological Predictors of Academic Underachievement in Pediatric Epilepsy: Moderating Roles of Demographic, Seizure, and Psychosocial Variables
Open Access
- 29 September 2004
- Vol. 45 (10), 1261-1272
- https://doi.org/10.1111/j.0013-9580.2004.15204.x
Abstract
Summary: Purpose: Academic underachievement is common in pediatric epilepsy. Attempts to identify seizure and psychosocial risk factors for underachievement have yielded inconsistent findings, raising the possibility that seizure and psychosocial variables play a complex role in combination with other variables such as neuropsychological functioning. This study cross‐validated a neuropsychological measurement model for childhood epilepsy, examined the relation between neuropsychological functioning and academic achievement, and tested the degree to which demographic, seizure, and psychosocial variables moderate that relation. Methods: Children with chronic epilepsy (N = 173; ages 8 to 15 years; 49% girls; 91% white/non‐Hispanic; 79% one seizure type; 79% taking one medication; 69% with active seizures) completed a comprehensive neuropsychological battery. Children diagnosed with mental retardation were excluded. Results: Structural equation modeling identified a three‐factor measurement model of neuropsychological function: Verbal/Memory/Executive (VME), Rapid Naming/Working Memory (RN/WM), and Psychomotor (PM). VME and RN/WM were strongly related to reading, math, and writing; PM predicted writing only. Family environment moderated the impact of neuropsychological deficits on writing (p ≤ 0.01) and possibly for reading (p = 0.05); neuropsychological deficits had a smaller impact on achievement for children in supportive/organized homes compared with children in unsupportive/disorganized homes. Conclusions: These findings lend partial support for our theoretical model showing direct effects of neuropsychological function on achievement and the moderating role of family factors. This study suggests that a subgroup of children with epilepsy (those who have not only neuropsychological deficits but also disorganized/unsupportive home environments) are particularly at risk for adverse academic outcomes. Implications for intervention are discussed.This publication has 59 references indexed in Scilit:
- Prognosis of Epilepsy: A Review and Further Analysis of the First Nine Years of the British National General Practice Study of Epilepsy, a Prospective Population‐Based StudyEpilepsia, 1997
- Developmental skills related to writing and reading acquisition in the intermediate gradesReading and Writing, 1994
- Idiopathic epilepsy and school achievement.Archives of Disease in Childhood, 1994
- Biologic factors as predictors of social outcome of epilepsy in intellectually normal children: A population-based studyThe Journal of Pediatrics, 1993
- Working memory in children with specific arithmetical learning difficultiesBritish Journal of Psychology, 1991
- Learned Helplessness in Diabetic YouthsJournal of Pediatric Psychology, 1990
- Academic Achievement of Children with EpilepsyEpilepsia, 1986
- School achievement and absence in children with chronic health conditionsThe Journal of Pediatrics, 1985
- Attributional style and depressive symptoms among children.Journal of Abnormal Psychology, 1984
- Use of neuropsychological tests to identify high school students with epilepsy who later demonstrate inadequate performances in life.Journal of Consulting and Clinical Psychology, 1984