# The Comprehension of Grammatical Structures in a Pediatric Population with ASD and Epilepsy: A Comparative Study

## TL;DR

Children with both autism and epilepsy struggle more with understanding grammar than those with only one condition, affecting their language skills and quality of life.

## Contribution

This study identifies the unique impact of comorbid ASD and epilepsy on grammatical comprehension in children.

## Key findings

- Children with both ASD and epilepsy showed worse grammatical comprehension than those with only ASD or only epilepsy.
- There was a significant and proportional association between variables in grammatical structure comprehension.
- Neurological damage from epilepsy in children with ASD limits their oral language understanding and core language development.

## Abstract

Autism Spectrum Disorder (ASD) and epilepsy represent a comorbidity that negatively influences the proper development of linguistic competencies, particularly in receptive language, in the pediatric population. This group displays impairments in the auditory comprehension of both simple and complex grammatical structures, significantly limiting their performance in language-related activities, hampering their integration into social contexts, and affecting their quality of life. The main objective of this study was to assess auditory comprehension of grammatical structures in individuals with ASD and epilepsy and compare the results among the three groups. A non-experimental cross-sectional study was designed, including a total of 170 participants aged between 7 and 9 years, divided into three groups: a group with ASD, a group with epilepsy, and a comorbid group with both ASD and epilepsy (ASDEP). The comprehension of grammatical structures was assessed using the CEG and CELF-5 instruments. Statistical analyses included MANOVA and ANOVA to compare scores between groups to verify associations between study variables. The results indicate that the group with ASD and epilepsy performed worse compared to the ASD and epilepsy-only groups, respectively. Additionally, a significant and directly proportional association was observed among all variables within the measures of grammatical structure comprehension. The neurological damage caused by epilepsy in the pediatric population with ASD leads to difficulties in understanding oral language. This level of functioning significantly limits the linguistic performance of these children, negatively impacting their quality of life and the development of core language skills.