Abstracts

Rationale: Difficulties with social functioning are reported in children with epilepsy. There have been no prior studies on how teachers perceive the social skills of children with epilepsy. We, therefore, assessed social behavior in children with epilepsy as reported by their teachers, who observed them in their social interactions on a daily basis over time. Methods: Twenty three teachers of children 9-11 years old with established epilepsy who spent at least 50% of there time in a normal classroom were asked to complete the Social Skills Improvement System (SiSS). The questionnaire assesses total social skills (communication, cooperation, assertion, responsibility, empathy, engagement and self-control), total problem behaviors (externalizing, bullying, hyperactivity/inattention and autism spectrum), and academic competence. Total scores and subscales were compared to normative data using a one-sided t-test and Sidak correction for multiple comparisons. Results: All teachers (100%) completed the SiSS. They reported significantly poorer total social skills (p= 0.017) compared to normative published data. Specifically, they noted lower levels of assertion (p= 0.056) and less engagement (p= 0.002). Teachers described difficulties initiating behaviors such as asking others for information, introducing oneself, responding to the actions of others, joining in activities in progress, initiating conversations, making friends and interacting well with other. Teachers did not document increased problem behaviors however they noted increased autism spectrum symptoms (p= 0.058). They described children with epilepsy as interacting poorly, not taking part in conversations, making odd gestures and becoming upset at changes in routine or having nonfunctional routines. Their responses also indicated lower academic competence (p= 0.001). Conclusions: In addition to prior studies on parent reports, this study demonstrates that teachers also observe significantly poorer social skills and academic performance in children with epilepsy. The association with autism spectrum symptoms emphasizes a need for studies to determine the role that both epilepsy and autism spectrum variables play in the poor social skills of these children. Our findings, limited by a small sample, suggest that social difficulties in children with epilepsy are also recognized within the school environment. They also set the groundwork for understanding social difficulties these children experience with their peers in the classroom environment.