Epilepsies in Children and Young People: Investigative Procedures and Management
Scottish Intercollegiate Guidelines Network. (2021).
Edinburgh (Scotland): Scottish Intercollegiate Guidelines Network, (159), 1-112.
This guideline provides recommendations regarding the assessment of and interventions for children with epilepsy. It is designed for use by any health care professionals working with this population as well as children with epilepsy and their care partners.
Scottish Intercollegiate Guidelines Network
<div>“Given the higher prevalence of [Autism Spectrum Disorder (ASD)] in this population, clinical assessment of children with epilepsy should incorporate a high level of vigilance for features suggestive of ASD in the domains of social interaction and play, speech, language and communication difficulties, and [behavior] (p. 36; Good-practice Point, Level 2+, 3, & 4 Evidence).” <br><br>“The same screening tools can be used to assess ASD in at-risk children with epilepsy as those who do not have epilepsy. However, caution should be exercised in interpreting these tools and they should only be used in conjunction with a detailed developmental history (p. 36; Good-practice Point, Level 2+, 3, & 4 Evidence).” <br><br>“A diagnostic assessment, alongside a profile of the individual’s strengths and weaknesses, carried out by a multidisciplinary team which has the skills and experience to undertake the assessments, should be considered as the optimum approach for individuals suspected of having ASD (p. 37; Strong Recommendation, Level 2+, 3, & 4 Evidence).”</div>
<div>“In children and young people with epilepsy, the same screening measures can be used to identify those at risk of [Attention Deficit Hyperactivity Disorder (ADHD)] as those used with the general population. However, caution should be given to their interpretation and should be used in association with information from other sources, including a detailed developmental history and parental report of their child’s symptoms (p. 37; Good-practice Point, Level 1+ & 4 Evidence).” <br><br>“If, on the basis of preliminary assessment, it is suspected that a child or young person has ADHD associated with significant impairment, referral for specialist assessment by a child and adolescent mental health clinician or [pediatrician] with a specialist interest in this field is recommended (p. 37; Good-practice Point, Level 1+ & 4 Evidence).”</div>
<div>“Healthcare professionals should be aware that all children and young people with epilepsy are at increased risk of cognitive and academic impairments, even those with epilepsies considered to be more benign or well controlled (p. 38; Strong Recommendation, Level 2++, 2+, & 2- Evidence).”<br><br>“Healthcare and education professionals should seek information about the child or young person’s cognitive function and educational attainment. At regular intervals educational attainment should be obtained (p. 38; Good-practice Point, Level 2++, 2+, & 2- Evidence).” <br><br>“Where there is evidence that a child with epilepsy is not making appropriate academic attainments or is presenting with difficulties in cognitive functioning, healthcare professionals should first liaise with education professionals (including educational psychology and learning support staff) to discuss supports in place (p. 38; Good-practice Point, Level 2++, 2+, & 2- Evidence).” <br><br>“Healthcare professionals should routinely enquire about depression and anxiety symptoms in all children and young people with epilepsy (p. 39; Strong Recommendation; Level 2++ & 4 Evidence). <br><br></div>
<div>“Information should be given in an appropriate manner with sufficient time to answer questions (p. 52; Good-practice Point; Level 3 & 4 Evidence).”<br><br>“Information should be age appropriate, repeated over time and reinforced to ensure understanding (p. 52; Good-practice Point; Level 3 & 4 Evidence).” <br><br>“Patients should be given information to take home in the most suitable format, for example leaflets, factsheets or [specialized] material for people with learning disability, making adjustments for age and for patients from black and minority ethnic groups. All information and literature provided should be subject to regular review (p. 52; Good-practice Point; Level 3 & 4 Evidence).” <br><br>“Healthcare professionals should be aware that the cultural differences and belief systems of patients from black and minority ethnic groups may have an impact on levels of understanding, management of the condition and adherence to medication and treatment (p. 52; Good-practice Point; Level 3 & 4 Evidence).”</div>
