A longitudinal study of 127 children with epilepsy aged 8-12 years and their mothers, designed to identify factors contributing to behavior problems, is reported from the Indiana University School of Nursing, Indianapolis; the Minnesota Comprehensive Epilepsy Program, Minneapolis; and the Harvard School of Public Health, Boston. Variables that accounted for 30% of the variation in child behavior problems included female gender, seizure frequency, family stress, and family social support. Family stress and seizure frequency were positively related whereas family social support was negatively associated with behavior problems. Children experiencing behavior problems had poorer seizure control and came from troubled families with mothers receiving inadequate support from relatives. 
COMMENT. Family variables and seizure frequency are important correlates of behavior problems in children with epilepsy. Neurological dysfunction may predispose children to both epilepsy and psychiatric disturbance, but family stress may have a stronger influence on child adjustment than seizure severity. In addition to treatment with anti-epileptic drugs, attention to family relationships is important in clinical management of childhood epilepsy.