Self-awareness of neuropsychological deficits in children and adolescents with epilepsy
In adult populations, neuropsychological deficits have been associated with lowered awareness of those deficits on the part of the injured person. Despite findings that children and adolescents with epilepsy show many neuropsychological deficits, no studies assessing self-awareness of those deficits have been conducted using these populations. The purposes of the present study were to: (a) create and validate a questionnaire that assessed self-awareness of neuropsychological deficits in children and adolescents; (b) verify the construct validity of the questionnaire using confirmatory factor analysis (CFA); (c) administer the questionnaire to populations of youth with chronic or newly diagnosed epilepsy and obtain a measure of self-awareness of deficits by comparing the questionnaire results to neuropsychological test results; (d) determine if parents' awareness of their children's deficits is comparable to the awareness of the child; and (e) investigate the relationship of depression and self-awareness in epilepsy populations. Using findings from recent literature and expert opinion, a 46-item self-awareness questionnaire (SAQ) was created to assess awareness of neuropsychological functioning in six domains (attention, psychomotor, visual-spatial, language, memory, and executive functioning). CFA of the SAQ was conducted on a sample consisting of general population school children (n = 365), youth with chronic epilepsy (n = 30), youth with newly-diagnosed epilepsy (n = 18), and siblings of children with new-onset epilepsy (n = 11). Children and adolescents with new-onset (n = 20) and chronic epilepsy (n = 30) completed the SAQ and neuropsychological tests measuring the 6 domains. Parent's awareness of the child's deficits (assessed with a parent version of the SAQ) was compared against the child's awareness. Participants with either high or low depression also were compared on awareness. The SAQ was found to have high reliability. CFA results indicated less than strong support for the 6 factor model, favoring a more parsimonious 1-factor solution. The chronic group showed more objective neuropsychological deficits and lowered awareness of those deficits than did the new-onset group. Parents and children were not shown to differ on appraisal of the children's deficits. High and low depression groups were not found to differ on awareness. These findings suggest that epilepsy is associated with lowered awareness, and that awareness deficits may worsen with chronicity. ^
Major Professor: Philip S. Fastenau, Purdue University.