Research Paper
Functional difficulties and school limitations of children with epilepsy: Findings from the 2009–2010 National Survey of Children with Special Health Care Needs

Presentations of preliminary results: Lukacs SL, Pastor PN, Kobau R, Helmers S. Epilepsy and functional difficulties of US children with special health care needs. Pediatric Academic Societies Annual Meeting. Washington, DC. May 6, 2013.
https://doi.org/10.1016/j.dhjo.2014.09.002Get rights and content

Abstract

Background

Epilepsy is a common serious neurologic disorder in children. However, most studies of children's functional difficulties and school limitations have used samples from tertiary care or other clinical settings.

Objective

To compare functional difficulties and school limitations of a national sample of US children with special health care needs (CSHCN) with and without epilepsy.

Methods

Data from the 2009–2010 National Survey of CSHCN for 31,897 children aged 6–17 years with and without epilepsy were analyzed for CSHCN in two groups: 1) CSHCN with selected comorbid conditions (intellectual disability, cerebral palsy, autism, or traumatic brain injury) and 2) CSHCN without these conditions. Functional difficulties and school limitations, adjusted for the effect of sociodemographic characteristics, were examined by epilepsy and comorbid conditions.

Results

Three percent of CSHCN had epilepsy. Among CSHCN with epilepsy 53% had comorbid conditions. Overall CSHCN with epilepsy, both with and without comorbid conditions, had more functional difficulties than CSHCN without epilepsy. For example, after adjustment for sociodemographic characteristics a higher percentage of children with epilepsy, compared to children without epilepsy, had difficulty with communication (with conditions: 53% vs. 37%, without conditions: 13% vs. 5%). Results for school limitations were similar. After adjustment, a higher percentage of children with epilepsy, compared to children without epilepsy, missed 11 + school days in the past year (with conditions: 36% vs. 18%, without conditions: 21% vs. 15%).

Conclusion

CSHCN with epilepsy, compared to CSHCN without epilepsy, were more likely to have functional difficulties and limitations in school attendance regardless of comorbid conditions.

Section snippets

Data source

The 2009–2010 NS-CSHCN is a nationally representative periodic survey designed to examine the health, functional status, and health care of CSHCN ages 0–17 in the US. In the 2009–2010 NS-CSHCN, a random-digit dial (RDD) sample of landline telephone numbers supplemented by a RDD sample of cell-phone numbers was used to identify households with children less than 18 years of age. A parent or guardian was the proxy respondent for each child. A screening interview (screener) consisting of five

Measures of Special Health Care Needs (SHCN), epilepsy, and comorbid conditions

Children were identified as having current epilepsy by a yes response to the following two questions: “Has a doctor or other health care provider ever told you that [child's name] had epilepsy or seizure disorder?” and “Does [child's name] currently have epilepsy or seizure disorder?” To better evaluate the association between epilepsy and children's functional difficulties, children were categorized into two groups: 1) children who currently had one or more of the following selected comorbid

Prevalence of epilepsy among CSHCN with and without comorbid conditions

Among all CSHCN aged 6–17, 3% were reported by parents to currently have epilepsy (Fig. 1). Approximately 1.6% of CSHCN were reported by parents to have epilepsy with one or more of the following comorbid conditions: intellectual disability, cerebral palsy, autism, or traumatic brain injury/concussion, and 1.4% were reported to have epilepsy without one of these conditions. Slightly more than 11% of CSHCN were reported to have one or more of the comorbid conditions, but not to have epilepsy.

Discussion

Findings from this large, nationally representative study of CSHCN indicate that children with epilepsy differed from other CSHCN not only in the prevalence of functional difficulties, but also in the percentage of children with limitations in school attendance. A higher percentage of CSHCN with epilepsy, compared to CSHCN without epilepsy, had difficulty in several areas of basic functioning including difficulties with communication. Higher rates of functional difficulties were reported for

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      However, CWE often face many challenges in school that are distinct from other healthy children [5]. Some researchers showed that CWE has a higher rate of cognitive impairment (focus and memory problems), school problems (school absenteeism and poor attendance), and learning disability than other healthy children, which impedes the growth of CWE and contributes to their poor academic performance[4,6,7]. In addition, compared with other children with chronic diseases, CWE face more barriers in school and have more needs for school support and cooperation[8].

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    Funding source: No external funding was secured for this study.

    Conflict of interest: The authors have no conflicts of interest or financial relationships to disclose.

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