What? I Don’t Get What You Mean: Understanding Language in Childhood Epilepsy
language , self-other differentiation , theory of mind , childhood epilepsy
Research suggests that children with epilepsy may have impaired language and social competence. Little is known about their language profile or whether language is associated with social cognition in this population. The main goal of this dissertation is to understand language and its association with social cognition in pediatric epilepsy. Chapter 2 provides an overview of etiology and seizure classification and how clinical variations (e.g., diagnostic variables) contribute to the heterogeneous nature of pediatric epilepsy. The systematic review of 83 studies in chapter 3 indicates a failure to distinguish developmental periods (e.g., middle-childhood vs. adolescence) when assessing language in pediatric epilepsy, little consideration for specific etiology (e.g., symptomatic) and seizure type (e.g., generalized seizures), and minimal assessment of morphology and phonology. The meta-analysis of 13 studies in chapter 4 shows that children with epilepsy are at increased risk for language impairments and highlights a need for research focusing on semantic or syntactic language in children with generalized seizures. Chapters 5 and 6 considered these aspects of language while investigating social perspective taking in children with generalized seizures. Chapter 5 results indicate that children with epilepsy demonstrate deficits in semantic and syntactic language and social perspective taking compared to their same aged peers. Chapter 6 examines language and social perspective taking in a social problem-solving context in children with generalized seizures and children with and without language problems. The results showed that children with epilepsy demonstrate language comparable to children with language problems and that they show the worst social perspective taking for the two easiest aspects of social problem solving (problem identification and strategy generation) compared to children with and without language problems. Language accounts for some, but not all, of the difficulties that children with generalized seizures experience in social perspective taking during social problem-solving. Research and clinical implications of the four studies are discussed in chapter 7. The research reported on here indicates that more research is needed to determine profiles of language specific to clinical variation in childhood epilepsy. Moreover, interventions designed to promote social perspective taking are needed to strengthen the interpersonal relationships of these children.