Epilepsy is one of the most common neurological disorders in childhood. Children with epilepsy have long been found to have a higher incidence of emotional problems than children with other chronic physical disorders; however, research identifying causes of poor psychosocial adaptation to childhood epilepsy is lacking. The proposed research is an extension of a current study comparing child and family adaptation to epilepsy with child and family adaptation to asthma. Subjects in the study currently in progress are 254 children (128 with epilepsy and 126 with asthma), their parents, and teachers. The main goal of the proposed study is to collect a second set of data on these same families, 4 years after the first set was collected, in an effort to identify predictors of poor child adaptation. Children will be ages 12 through 16 years at the time of the second data collection. Child adaptation will be measured on several dimensions using the Child Behavior checklist, the Teacher's Report Form, the Piers-Harris Self- Concept Scale, and the Children's Depression Inventory. Hypothesized predictors of child adaptation will be family demands, family adaptive resources, parent and child attitudes, parent and child coping patterns, parent adaptation, and family adaptation as well as selected demographic, health condition (including seizure or asthma frequency, neurological status, and medication compliance), and school variables. The natural history of change in child adaptation and associated variables in the epilepsy and asthma samples will be described using standard descriptive statistics. Distributions of changes in the two samples will be compared using ordinal categorical techniques and other appropriate statistics (e.g., Kolmogorov-Smirnov). Multivariate logistical or linear regression analyses will be employed to determine those factors at time one that predict changes in adaptation at follow-up and to identify the differences in predictors of child adaptation to epilepsy and asthma. Comparing predictors of child adaptation to epilepsy with those of asthma should allow for the identification of factors that are associated with the higher incidence of emotional problems found in children with epilepsy. Results of this study will be used to develop strategies to facilitate child and family adaptation to childhood epilepsy that can be tested in clinical trials.
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