SLPSystematic ReviewJournal of autism and developmental disorders2023

Factor associated with the occurrence of epilepsy in autism: a systematic review.

Eleni Zarakoviti, Roz Shafran, David Skuse and 6 others

PMID 35904650

WHAT IT FOUND

Autistic people with intellectual disability or low cognitive ability were most consistently reported to have co-occurring epilepsy.

Language and social difficulties also appeared often, but their link to epilepsy may reflect intellectual disability.

Key findings

01Lower cognitive level or intellectual disability was associated with epilepsy in 12 of 13 studies that considered it, including in four good-quality studies.

02Language difficulties were associated with epilepsy in three of four studies, but one study found no association.

03Greater social skills impairment was associated with epilepsy in all three studies that considered it.

STILL TO COME

How it was doneWhat they foundWhat it means for SLPs

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What it does not show

The review included only English-language studies published from 2000 onward, and the authors called the 2000 cut-off arbitrary. Study quality was mixed: most studies were moderate or weak, and only one in five was rated good. The review did not combine the study results into one overall estimate, so it could not produce a single number for each factor. Epilepsy diagnosis criteria were less strict than autism diagnosis criteria, which may have affected findings. Many factors were tested without adjusting for intellectual disability, so language, social and motor findings may not be independent of cognitive level. Studies with predominantly neurogenetic syndromes were separated from the main review, so the main findings do not describe that high-risk group in detail.

Declared interests

The paper lists Autistica, Young Epilepsy and Epilepsy Research UK as funders. No further author conflict-of-interest declaration appears in the supplied text.

The easy way to misread this

Do not conclude that language or social difficulties independently predict epilepsy. The review found associations, not causes, and the authors state it is unclear whether these factors are independent of intellectual disability.

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