Consultancy

Epilepsy Explained for Teachers and Teaching Assistants


 

What is Epilepsy?
Approximately 6 school age children in every 1,000 have epilepsy and 80% of these attend ordinary schools. Regular medical attention, accurate information and appropriate counselling will minimise problems, however, there are a few areas where difficulties may arise.

Types of Seizures
Tonic clonic seizures - A teacher will usually swiftly recognise a major convulsive tonic clonic seizure where the child loses consciousness and experiences a jerking of limbs. However, it is important to remember that there are other forms of seizures.

Absences - These are brief interruptions of consciousness and may be hard to detect. Teachers should be aware of this possibility if a child suddenly seems unusually inattentive or looks vacant.

Partial seizures (focal) - These seizures can be simple or complex. Simple partial seizures produce no loss of awareness but strange sensations (e.g. unusual smells, a sense of fear, stomach discomfort) may be experienced, along with sudden jerky movements of part of the body. With complex partial seizures, some loss of awareness occurs and sometimes purposeless or bizarre behaviour which may be mistaken for silliness. The seizures will tend to take the same form each time. Some children’s seizures may not be obvious at school occurring only at home during sleep, so it may be some time before the true nature of the seizure is recognised.

Treatment
Medication in tablet, capsule or liquid form will completely control epilepsy in 80% of cases. It is important for the child and everyone else involved to understand that medication is not a cure for the epilepsy, but a means of controlling it and may have to be taken regularly for several years. Most medication can be taken out of school hours.

A very small percentage of children with partial seizures may be suitable for surgery. This can be successful in controlling epilepsy without causing any additional problems but a detailed assessment is necessary before such an operation can be advised.

What causes Epilepsy?

What are the effects of Epilepsy?

What are the implications for the school?
If a major seizure occurs at school, the teacher should remain calm and deal with it in accordance with the instructions provided by the parents/medical staff. Reassurance of the child who has epilepsy and other children present is vital to minimise any panic.

A child with epilepsy should be absent as little as possible and early agreement should be reached between teachers, doctor, parents and child as to the appropriate management of the epilepsy. The family or teacher may often try to protect the child from stress if this is thought to precipitate seizures. However, stress is an inevitable part of everyday life and it is productive in the long term to try and teach the child the skills that are necessary to cope with stress.

Blanket restrictions may be placed upon a child with epilepsy, (e.g. he/she may be barred from laboratory work, sports activities) but the risks to each child should be assessed on the basis of detailed knowledge of that child’s epilepsy. If the child’s seizures are completely controlled or only occur during sleep, no restrictions are necessary. If seizures occur during the day, practically all activities can be safely undertaken with adequate supervision.

Top Ten Tips for Teachers and Teaching Assistants

Learning and achievement
Some teachers may have low expectations of pupils with epilepsy and inadvertently treat them differently. If seizures are controlled and no other disabilities are present, there is no reason for a child to underachieve. Research has suggested that some children with epilepsy perform less well at school than a formal assessment of their abilities would suggest. A multi-disciplinary team, including an educational psychologist, would need to assess why, as there are many possible explanations:

  • Frequent seizures may cause poor school attendance, especially if a child is removed from school every time a seizure occurs;

  • Frequent absences, which may be hard to detect, can impair learning;

  • A child with severe epilepsy may have periods of disorganised brain activity, not sufficient to cause a seizure, but which may impair learning;

  • Most children with epilepsy are of average intelligence, but children with learning disabilities have a high incidence of eipilepsy;

  • If the epilepsy was caused by a localised injury to the brain, this may cause other educational problems (eg a poor verbal recall if the dominant half of the brain - usueally the left - is affected, or poor practical skills if the non-dominant side is affected);

  • Incorrect/excessive drug treatment can impair school performance, especially if it causes drowsiness. However, it is hard to distinguish between the effects of the drugs and those due to the on-going epileptic activity in the brain.

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Where can I get further information about Epilepsy?