Executive functioning in childhood epilepsy: parent-report and cognitive assessment.

There is considerable interest in the assessment of executive function (EF) in pediatric clinical populations but only a few well-standardized measures exist. We examined EF in 53 children aged 8 to 18 years with recent onset epilepsy (31 males, 22 females) and 50 control children (23 males, 27 females) using the Behavior Rating Inventory of Executive Function (BRIEF) and the Delis-Kaplan Executive Function System (D-KEFS). Thirty children had localization-related epilepsy and 23 had idiopathic generalized epilepsy; average duration of 10 months (SD 4y 1mo) and onset age of 11 years 6 months (SD 3y 6mo). The study sample was characterized by good seizure control, with 40 participants taking one antiepileptic drug (AED), one taking two AEDs, and 12 not treated pharmacologically. Children with epilepsy showed greater executive difficulties on both measures than children in the control group. The BRIEF and D-KEFS were significantly correlated, and an 'at-risk' group identified from the BRIEF was more significantly impaired on the D-KEFS than a 'low risk' group. The BRIEF was also a better predictor of performance on the D-KEFS than the Child Behavior Checklist. These findings indicate that children with recent onset epilepsy show significant difficulties in E F, and demonstrate the utility of parent ratings (BRIEF) in the assessment of EF.