Mental health intervention for a child with developmental and/or epileptic encephalopathy with spike-wave activation in sleep (D/EE-SWAS)

Abstract

Children with Developmental and Epileptic Encephalopathies experience neurodevelopmental problems from both the epileptic activity and the underlying cause of the condition. Children with Developmental and/or Epileptic Encephalopathy with spike-wave activation in sleep (D/EE-SWAS) experience cognitive and behavioral regression/stagnation that occurs in tandem with marked spike-wave activation in sleep (SWAS). Children with epilepsy often have co-occurring mental health problems that are often not recognized or supported. There is increasing evidence these co-occurring mental health problems can be treated with psychological interventions. The mental health and cognitive difficulties that accompany SWAS have a significant impact on child and family quality of life. There is limited data on the treatment of mental health difficulties for children with D/EE-SWAS. We describe the use of the Mental Health Intervention in Children with Epilepsy (MICE) in a child with D/EE-SWAS who had experienced significant cognitive regression and behavioral difficulties. The intervention was delivered with the child’s parents via video and consisted of 19 sessions delivered by an assistant psychologist. The focus of the intervention was reducing behaviours of concern via evidence-based behavioural parenting strategies. The intervention resulted in clear progress towards parental chosen goals (Goal Based Outcomes) and a reduction of symptoms on validated measures of behavior. Qualitative feedback via parental interview was that the intervention was very useful, giving the parents everyday strategies that they could effectively employ with the child in the home environment. This case demonstrates that a mental health intervention based on behavioural parenting strategies can be useful for children with D/EE-SWAS.