Epilepsy-related clinical factors and psychosocial functions in pediatric epilepsy.

PURPOSE: The aim of this study was to identify the different influencing patterns of demographic and epilepsy-related variables on various aspects of psychosocial function in pediatric epilepsy. METHOD: Five hundred ninety-eight patients with pediatric epilepsy between the ages of 4 and 18 years (boys=360, 60% and girls=238, 40%) and their parents participated in the study. Parents completed the Social Maturity Scale (SMS), the Korean version of the Child Behavior Checklist (K-CBCL), and the Korean version of the Quality of Life in Childhood Epilepsy Questionnaire (K-QOLCE) to assess daily living function, behavior, and quality of life. The Children's Global Assessment Scale (CGAS) was completed by clinicians to assess general adaptive function. Demographic variables, such as age and sex of child, and epilepsy-related clinical variables, including seizure type, seizure frequency, duration of epilepsy, and number of medications, were obtained from medical records. RESULTS: Demographic and epilepsy-related clinical variables had a strong influence (22-32%) on the cognition-related domain such as general adaptive function, school/total competence, and quality of life for cognitive function while a comparatively smaller effect (2-16%) on the more psychological domain including behavioral, emotional, and social variables. Younger age, shorter duration of illness, and smaller number of medications showed a strong positive impact on psychosocial function in pediatric epilepsy, particularly for adaptive function, competence, and quality-of-life aspects. CONCLUSION: Given the wide range of impact of demographic and clinical variables on various facets of psychosocial functions, more specific understanding of the various aspects of factors and their particular pattern of influence may enable more effective therapeutic approaches that address both the medical and psychological needs in pediatric epilepsy.

Playing with Others: Head Start Children's Peer Play and Relations with Kindergarten School Competence.

Time-sampled observations of Head Start preschoolers' (N = 264; 51.5% boys; 76% Mexican American; M = 53.11 and SD = 6.15 months of age) peer play in the classroom were gathered during fall and spring semesters. One year later, kindergarten teachers rated these children's school competence. Latent growth models indicated that, on average, children's peer play was moderately frequent and increased over time during preschool. Children with higher initial levels or with higher slopes of peer play in Head Start had higher levels of kindergarten school competence. Results suggest that Head Start children's engagement with peers may foster development of skills that help their transition into formal schooling. These findings highlight the importance of peer play, and suggest that peer play in Head Start classrooms contributes to children's adaptation to the demands of formal schooling.

Childhood ADHD With and Without Co-occurring Internalizing/Externalizing Problems: Prospective Predictions of Change in Adolescent Academic and Social Functioning.

OBJECTIVE: Internalizing and externalizing problems predict poor academic and social outcomes. However, ADHD co-occurs with internalizing and externalizing problems and is itself a risk factor, thus preventing precise inferences. This study evaluated childhood anxiety, depression, and aggression as predictors of change in adolescent academic and social outcomes, including moderation by childhood ADHD. METHODS: 182 ethnically-diverse 5- to 11-year-old youth with (54.7%) and without (45.3%) ADHD completed a separate baseline and 6- to 7-year prospective follow-up assessment, consisting of parallel measures across youth psychopathology, academic functioning (i.e., academic achievement, school competence), and friendship quality domains. RESULTS: Whereas childhood ADHD inversely predicted academic competence, depression and aggression uniquely predicted worsening friendship quality. Interestingly, anxiety was unrelated to change in academic and friendship outcomes; similarly, neither ADHD, depression, nor aggression predicted change in objectively-measured academic achievement from a standardized assessment. CONCLUSION: Implications for intervention and prevention are considered, including school-based approaches, within a developmental psychopathology framework.