Patterns of language and auditory dysfunction in 6-year-old children with epilepsy

Figures & data

Table I.  Speech and language test battery for 6-year-old children with epilepsy and reference children.

Domain	Variables	Speech and language tests	Type of measure
1	Oral motor function:
	Positions	Nelli	Ordinal scale 0–5
	Movements	Nelli	Ordinal scale 0–5
	Articulation: positions	Nelli	Ordinal scale 0–5
2	Articulation: patterns	Nelli	Ordinal scale 0–5
	Phonology	Word/sentence repetition	Ordinal scale 0–5
	Emerging literacy: phoneme blending	ITPA	Stanine 1–9
	Emerging literacy: letter naming	20 letters	No. of correct
3	Grammar: expressive morphology	ITPA	Stanine 1–9
	Grammar: receptive morphology and syntax	TROG	No. of blocks
	Vocabulary: receptive (semantics)	PPVT	Stanine 1–9
4	Vocabulary: expressive: word retrieval	ITPA	Stanine 1–9
	Vocabulary: expressive: rapid picture naming	Rapid Confrontation Naming (RCFN)	No. of mistakes; Time (seconds)
	Vocabulary: auditory analogy	ITPA	Stanine 1–9
	Narratives: story retelling	Nelli	No. of partial events, ordinal scale 0–5
5	Pragmatics (communication)	CCC	Pragmatic composite, raw scores
6	Auditory short term memory: digit span	ITPA	Stanine 1-9
	Auditory ability:
	attention	Dichotic listening	Per cent correct, CV pairs
	perception level		Per cent correct, C, V, CV
	discrimination		^a
	ear advantage		Laterality index

^a=Number of consonants and vowels correctly repeated <10% of times given.

C = consonants; V = vowels; CV = consonant-vowel syllables; ITPA = Illinois Test of Psycholinguistic Abilities; TROG = Test for Reception Of Grammar; PPVT = Peabody Picture Vocabulary Test; CCC = Children's Communication Checklist.

Table II.  Epilepsy group. Results presented individually for each child: number of variables with low scores (≤ the score which was reached by the 10th percentile of the reference group with the lowest achievements within each domain, intelligence, epilepsy variables and ear preference.

Child code number	Type of seizures/syndrome	Type and site of epileptiform activity	Oral motor ability/articulation (a total of 3 variables)	Phonology/literacy (a total of 4 variables)	Grammar/semantics (a total of 3 variables)	Word retrieval/narrative ability (a total of 4 variables)	Communicative ability (a total of 1 variable)	Auditory attention/memory (a total of 2 variables)	Number of subtests with low scores/child	FSIQ	VIQ	PIQ	Ear adv CV	Ear adv vow	Ear adv cons
6	Partial	Left parieto-temporo-occipital	3	3	3	2	1	1	13	66	90	46	LEA	LEA	LEA
7	Partial	Left, centro-parietal	2	4	1	2	0	1	10	80	80	85	REA	REA	REA
10^a	Partial	Left, medio-temporal	1	2	2	2	0	1	8	77	85	74	REA	REA	REA
4	Partial	Right, temporal	1	2	0	3	0	2	8	74	89	63	LEA	LEA	LEA
8	Partial	Right, parietal	1	2	0	0	0	1	4	90	96	85	LEA	LEA	LEA
12	Partial BCECTS	Right	2	1	0	0	0	0	3	114	116	107	REA	NEA	REA
1	Partial	Alternating temporal	3	2	0	2	0	0	7	84	97	72	REA	REA	REA
5	Partial	Frontal	2	1	0	0	0	1	4	104	113	93	REA	REA	REA
15^a	Partial	EEG normal	1	0	3	5	1	0	10	112	107	102	REA	REA	REA
19	Partial	EEG normal	1	0	0	0	0	0	1	112	110	111	REA	REA	REA
3	Gen/CAE	3 Hz sp-w	2	1	2	2	0	1	8	93	104	81	LEA	LEA	LEA
9^a	Gen/CAE	3 Hz sp-w	1	0	0	0	0	0	1	106	109	100	REA	REA	NEA
14^a	Gen/CAE	3 Hz sp-w	1	0	1	2	0	0	4	92	101	84	NEA	REA	NEA
16	Gen/CAE	3 Hz sp-w	0 ^c	0 ^c	0	0	0	1	1	104	123	81	REA	REA	REA
20	Gen/CAE	3 Hz sp-w	2	1	0	3	0	2	8	103	107	97	REA	REA	REA
13^d	Gen/M-A	Poly sp-w	2	3	2	4	1	2	14	64	72	64	^c	^c	^c
2	Undeterm	Poly sp-w	1	2	0	1	0	2	6	97	102	92	LEA	LEA	LEA
11	Undeterm/LKS	Multifocal	1 ^b	3 ^b	1	4	0	2	11	90	91	91	REA	REA	REA
17	Undeterm	Left frontal	1	2	0	0	0	1	4	106	112	97	LEA	LEA	NEA
18	Undeterm	Sp-slow w	1	0	0	0	0	0	1	128	135	113	REA	NEA	NEA
Epilepsy group%			95	70	40	60	15	65
Reference group%			50	53	37	27	13	27

^a=Bilingual.

^b=Refused to perform some tasks because of severe difficulty.

^c=Not possible to assess due to a ligament of the tongue.

BCECTS = benign childhood epilepsy with centrotemporal spikes; CAE = childhood absence epilepsy; cons = consonants; CV = consonant-vowel syllables; Ear adv = ear advantage; EEG = electroencephalogram; FSIQ = full-scale IQ; Gen = generalized; LEA = left ear advantage; LKS = Landau Kleffner syndrome; M-A = epilepsy with myoclonic astatic seizures; NEA = no ear advantage; PIQ = performance IQ; REA = right ear advantage; sp = spikes; undeterm = undetermined whether focal or generalized; VIQ = verbal IQ; vow = vowels; w = waves.^d=Not possible to assess due to poor cooperation.

Table III.  Auditory attention, perception and discrimination measured with the dichotic listening test in 19 6-year-old children with epilepsy and 29 reference children. Comparison between groups (Mann-Whitney U-test).

	Epilepsy group			Reference group
Variables	n	Median	Min-max	n	Median	Min-max	P
Auditory attention
% correct CV pairs	19	1	0–13	29	3	0–36	0.018
Auditory perception level
% consonants right ear	19	35	14–53	29	41	20–68	0.126
% consonants left ear	19	33	14–51	29	29	20–64	0.673
% vowels right ear	19	59	9–91	29	72	42–96	0.019
% vowels left ear	19	52	16–86	29	57	29–91	0.435
% CV right ear	19	28	7–50	29	31	7–69	0.167
% CV left ear	19	21	9–46	29	20	11–57	0.941
Auditory discrimination
n<10% correct consonants right ear	19	2	0–4	29	1	0–4	0.015
n<10% correct consonants left ear	19	2	0–4	29	2	0–4	0.895
n<10% correct vowels right ear	19	0	0–2	29	0	0–1	0.796
n<10% correct vowels left ear	19	0	0–1	29	0	0–2	0.292

n=number; min = minimum value; max = maximum value; CV = consonant–vowel.