Children with epilepsy are at risk for academic underachievement. Intelligence is the single largest predictor of academic achievement. Aspects of executive functioning have been found to contribute significantly to academic achievement, including attention and working memory. Performance based executive functioning measures have a poor correlation with everyday executive functioning, and as such, the use of collateral information is warranted. Epilepsy variables have been found to contribute to academic achievement and executive functioning.

The current study sought to explore the relationship among epilepsy variables and parent-reported and performance-based executive functioning in 60 pediatric participants with epilepsy. A comprehensive test battery comprised of an intelligence measure (WISC-4), an academic achievement measure (WJ-3), a performance-based executive functioning measure (Tower subtest) and a parent-rated executive functioning measure (BRIEF).

Epilepsy variables including hemisphere, lobe of onset, age of onset, weekly seizure frequency, and medication load were hypothesized to contribute significantly to executive functioning. Epilepsy variables were not significantly related to performance on parent-reported executive functioning and one performance-based executive functioning measure (Tower subtest). Age of onset was significantly related to performance on another performance-based executive functioning measure (WISC-4 Working Memory Index), such that participants with a younger age of onset scored worse than participants with an older age of onset. Medication load was significantly related to performance on the Working Memory Index, as participants on more medications scored worse than participants on one or no medications.

The current study examined a moderator analysis positing that an interaction between intelligence and an executive functioning composite, comprised of parent-reported and two performance-based executive functioning measures would be significantly related to mathematics, reading, and writing achievement. This hypothesis was not supported. The executive functioning composite exhibited a main effect on mathematics achievement above and beyond intelligence. The executive functioning composite was not significantly related to reading and writing achievement. Epilepsy variables were not significantly related to achievement.