title: Developmental stage affects cognition in children with recently-diagnosed symptomatic focal epilepsy.
abstract: This study explored the impact of developmental stage on cognitive function in children with recently-diagnosed epilepsy. In keeping with a neurodevelopmental framework, skills in a critical developmental period were expected to be more vulnerable than those stable at the time of seizure onset. We studied children with early-onset (EO) symptomatic focal epilepsy (onset: 3-5 years; n=18) and compared their performance with that of the group with late-onset (LO) epilepsy (onset: 6-8 years performance of; n=8) on a range of cognitive tasks. Performance of both groups was compared with normative standards. 'Critical' and 'stable' classifications were based on developmental research. Nonparametric analyses revealed that skills in a critical developmental period for the group with EO epilepsy fell below normative standards (Phonological Processing: p=.007, Design Copying: p=.01, Visuomotor Precision:, p=.02) and fell below the performance of the group with LO epilepsy (Design Copying: p=.03, Visuomotor Precision: p=.03). There were no differences between the group with EO epilepsy and the group with LO epilepsy on measures of receptive vocabulary and memory, which were proposed to be in a stable developmental period across both groups. Auditory span, as measured by Word Order, was reduced for both the group with EO epilepsy (p=.02) and the group with LO epilepsy (p=.02) relative to normative standards, but the groups did not differ from each other. These results are consistent with a prolonged period of critical development for this skill. These findings support the notion that skills in a critical phase of development are particularly vulnerable following the onset of symptomatic focal epilepsy in childhood.
authors.affiliation: Australian Centre for Child Neuropsychology Studies, Murdoch Childrens Research Institute, Melbourne, Australia; RCH Mental Health, The Royal Children's Hospital, Melbourne, Australia; School of Psychology and Psychiatry, Monash University, Victoria, Australia. Electronic address: linda.gonzalez@rch.org.au.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Gonzalez
authors.affiliation: Australian Centre for Child Neuropsychology Studies, Murdoch Childrens Research Institute, Melbourne, Australia; School of Psychology and Psychiatry, Monash University, Victoria, Australia.
authors.forename: Upeka S
authors.initials: US
authors.lastname: Embuldeniya
authors.affiliation: Department of Neurology, The Royal Children's Hospital, Melbourne, Australia.
authors.forename: A Simon
authors.initials: AS
authors.lastname: Harvey
authors.affiliation: Australian Centre for Child Neuropsychology Studies, Murdoch Childrens Research Institute, Melbourne, Australia; RCH Mental Health, The Royal Children's Hospital, Melbourne, Australia.
authors.forename: Jacquie A
authors.initials: JA
authors.lastname: Wrennall
authors.affiliation: School of Psychology and Psychiatry, Monash University, Victoria, Australia; Psychology Department, Sunshine Hospital, Melbourne, Australia.
authors.forename: Renee
authors.initials: R
authors.lastname: Testa
authors.affiliation: Australian Centre for Child Neuropsychology Studies, Murdoch Childrens Research Institute, Melbourne, Australia; RCH Mental Health, The Royal Children's Hospital, Melbourne, Australia; School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Anderson
authors.affiliation: Australian Centre for Child Neuropsychology Studies, Murdoch Childrens Research Institute, Melbourne, Australia; School of Psychology, University of Birmingham, UK.
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Wood
mesh_terms: D017668:Age of Onset; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D004828:Epilepsies, Partial / Q000150:complications* / Q000175:diagnosis; D004827:Epilepsy / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male
keywords: Age at onset; Cognition; Critical periods; Development; Pediatric epilepsy; Symptomatic focal epilepsy