Neurological Comorbidities in Children with Seizure Disorders Attending a General Neurology OPD in an NGO Setting: An Occupational Therapy Perspective

Background: Children with seizure disorders frequently present with comorbid neurological and developmental conditions that extend beyond seizure control and directly impact daily functioning. From an occupational therapy perspective, these comorbidities influence participation in self-care, play, and schooling, particularly in resource-limited nongovernmental organization (NGO) settings where structured functional assessment is often lacking. Objective: To examine the functional impact of neurological comorbidities in children with a history of seizures attending a general neurology outpatient department (OPD), with emphasis on occupational performance and participation. Methods: A cross-sectional observational study was conducted in an NGO-based general neurology OPD. A total of 182 children aged 0 to 18 years with a history of seizures were screened over 9 months. In addition to clinical evaluation, an occupational therapy-focused assessment was undertaken, including domains of activities of daily living (ADL), play, school participation, fine motor skills, sensory processing, and behavior using structured OPD-based screening tools. Results: Of the 182 children, 137 (75.3%) demonstrated at least one neurological comorbidity, and 92 (50.5%) had multiple comorbidities. Functional limitations were identified in 129 children (70.9%). ADL dependence (feeding, dressing, toileting) was present in 84 children (46.1%), particularly in those with motor impairments and developmental delay. Fine motor and hand function difficulties were observed in 76 children (41.8%), affecting writing, object manipulation, and play skills. Sensory processing issues were noted in 61 children (33.5%), contributing to behavioral dysregulation and poor task engagement. School participation challenges were reported in 97 children (53.3%), including poor attention, learning difficulties, and increased absenteeism. Play deficits, including reduced social interaction and limited age-appropriate play skills, were seen in 88 children (48.3%). Children with early-onset seizures showed significantly greater functional impairment across domains ( p < 0.01). Despite this, only 28 children (15.4%) had prior exposure to occupational therapy services. Conclusion: A high proportion of children with seizure disorders in NGO-based neurology OPDs exhibit significant functional limitations affecting daily occupations. These findings highlight the need to shift from a seizure-centric model to a function- and participation-oriented approach. Early integration of occupational therapy services, including ADL training, sensory regulation, school readiness, and caregiver education, is essential to optimize outcomes in this population. Publication History Article published online: 15 July 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical and Scientific Publishers Private Limited A-13A, Graphix Tower 1, 6th floor, Sector 62, Noida 201309, Uttar Pradesh, India