Contributions of Executive Functioning Skills to Reading Comprehension in Children and Adolescents with Epilepsy

Abstract

Children with epilepsy have a high rate of cognitive difficulties, especially with regards to executive functioning deficits. Seizure variables such as age of seizure onset, seizure frequency, and number of antiepileptic medications have been found to contribute to cognitive functioning. Children with epilepsy also present with a greater number of academic achievement problems than the normative population. Components of executive functioning have been found to contribute to academic achievement. Specifically, reading comprehension relies on such executive functioning skills as working memory, planning, organizational skills, and self-monitoring.;The current study sought to examine the contributions of executive functioning abilities to reading comprehension in 60 pediatric participants with epilepsy. Executive functioning was measured by both parent-report and performance-based measures. Seizure variables such as seizure frequency, age of seizure onset, and number of antiepileptic medications were also explored in order to determine their contribution to reading comprehension in this population.;Prior to the examination of reading comprehension skills, a principal component analysis of the Behavior Rating Inventory of Executive Function (BRIEF) in 122 children with epilepsy was completed. Results revealed that for individual items a five-component solution best explained the data and the derived Inhibit, Emotional Control, Working Memory, and Organization of Material subscales demonstrated the strongest agreement with the respective ones in the original BRIEF. At the subscale level, the findings from the principal component analysis supported a two-factor solution. The Monitor subscale, however, did not load predominantly on either the Behavioral Regulation Index or the Metacognition Index.;Following the analysis of the BRIEF, the contribution of executive functioning skills to reading comprehension was examined. A hierarchical regression analysis was conducted with the Trail Making Test Part B z-score, Digit Span Backward subtest scaled score, and the BRIEF Behavioral Regulation Index T-score. These three variables contributed 43.8% of the variance to the Reading Comprehension standard score. Together these findings have implications for clinical interventions that should be utilized within this population. We conclude that remediation for executive dysfunction may also assist in reading comprehension improvement.