It is estimated that between 1% and 2% of the population have epilepsy.

Seizures can be controlled in greater than 70% of people by the use of anti-epileptic medication, and in a large percentage of children, the seizures resolve after a few years.

People can develop epilepsy at any stage of their lives but a large number have their first seizure(s) during childhood or adolescence. Therefore, from time to time teachers will have students with epilepsy, or newly diagnosed students with epilepsy.

Who is affected?

Students with epilepsy may face challenges unknown to other students. These may be major obstacles or minor inconveniences depending on factors such as:

• How often seizures occur
• The type and severity of seizures
• Medications - type and dose
• Associated issues with cognition or behavior
• Social and psychological adjustment
• The level of understanding of epilepsy by school staff
• The attitudes and level of knowledge of other students and peers
  
  

  Negative reactions from peer groups and teachers to epilepsy can adversely affect the child with a seizure disorder.

Epilepsy is not a condition to be feared. It is important for teachers to have a general understanding of the condition, its various forms, physical, psychological and treatment effects.

It is important to understand that seizures are often fully controlled with medication. Under certain circumstances, a seizure is likely to occur - often caused by 'triggers'. There are some common triggers, and some individual triggers.

Likely Seizure Triggers include:

• Missing medications
• Stress - physical or emotional
• Poor diet and eating habits
• Lack of sleep
• Inactivity and boredom
• A small percentage of people with epilepsy are sensitive to strobe lights and patterns - these can be caused by television, videos, computer screens, and flashing lights
• Hormonal changes (females)
• Alcohol and drugs

Be aware of seizure triggers

Memory and Concentration

Are crucial for learning, and sometimes people with epilepsy have difficulties with memory and concentration. Possible causes of poor memory and concentration are:

1.Side effects of medications
Sometimes medications may affect the students ability to learn. This is often related to the dose of the medication. Some common side effects include:

• Concentration, short term memory loss
• Hyperactivity, drowsiness, fatigue
• Hand, eye, balance, speech problems, unsteadiness, dizziness
• Nausea, vomiting, weight gain/loss
• Depression, aggressiveness, anti-social behaviours
• Liver damage, anemia

If the student seems excessively sleepy or lacking in energy, parents should be informed.

For further medication information, click here

2.Seizures
Seizures are often brief, but the effects can be lasting. The after effects of seizures include tiredness, drowsiness, headaches, nausea, and mood changes.

All of these effects can reduce the ability to concentrate and remember and can occur for hours after a seizure. The best remedy is often a short sleep after a seizure.

Also, unrecognised seizure activity in the brain may be interfering with learning.

If seizures are causes by some underlying condition of the brain - albiet minor - this may involve the area of the brain associated with memory, or may change the way the brain handles information.

To review different seizure types, click here

3.Psychosocial issues
Epilepsy is a chronic disorder and may have similar effects on children as would other chronic diseases.

Seizures are unpredictable. Many people report that the most frightening thing about seizures is their unpredictability. Therefore, it may be even more difficult to adapt to epilepsy than to other more predictable chronic conditions.

Even a child whose epilepsy is controlled with medication may still be anxious about having another seizure, especially in the presence of peers.
Fear and anxiety can be quite common and can also lead to depression. It is important to observe the child for changes in behaviour and loss of interest in activities.

Overprotection and restrictions on activities can also affect a persons self-esteem and make them feel 'different'.

Independence and social acceptance are important - so it is encouraged the student lead as normal life as possible - balancing safety and common sense vs risk.

Teacher attitudes may influence the extent to which students with epilepsy participate in sport and extra-curricular activities. A student with epilepsy must never swim alone and sports such as highboard, scuba diving and rock climbing are best avoided. The student who is denied the opportunity to participate may well have feelings of social isolation and rejection reinforced. Restrictions should be discussed with the student and family.

Historically epilepsy has been wrongly surrounded by myths and misunderstanding. People with epilepsy still sometimes face common misconceptions of insanity, intellectual disability and an inability to achieve.

Some of history's greatest achievers had epilepsy - Napoleon, Alexander the Great, Julius Caesar, Vincent van Gogh, Charles Dickens, Agatha Christie and Fyodor Dostoyevski to name just a few. Yet the myths still survive. They can be changed through education that encourages openness and an understanding of the disorder.

A childs perception of their epilepsy largely depends on others reactions to it

Suggested teaching strategies.

1. Co-operative Learning
   Group work develops listening and talking skills, encourages interaction with peers in problem solving and allows students to ask questions and learn from each other.
   
2. Task Analysis
   The breaking down of specific tasks into their most basic steps establishes teaching and learning stages that will need to be achieved if the student is to succeed. Task analysis can be applied to any learnng or social situation.
   
3. Cueing
   Proves effective especially with listening activies. Tell the student, ahead of time, of the purpose of the activity. Give a quick summary of the passage and ask comprehension questions before reading the passage. Knowing the purpose of the activity will help keep the student on task.
   
4. Reviewing
   A review of the processes used in solving a complex task can be very helpful for the student.
   
5. Repetition
   Leads to the consolidation of skills learnt in mastering a task. Unconsolidated skills are not likely to be generalised to other learning tasks.
   
6. Mnemonics
   Uses verbal, visual and symbolic techniques as memory aids. The acquisition of facts and procedural knowledge is governed by memory and the most effective measures for memory development are rehearsal related.

Unexpected disclosure in the classroom

In open classroom discussion of epilepsy, teachers may be faced with the unexpected disclosure by a student that they have epilepsy.

If this occurs, the teacher should guide the discussion to ensure that it is supportive. This can effectively illustrate that epilepsy is both real and manageable, and should not affect the judgements we make about people. The teacher should be careful not to encourage a level of disclosure that the student may, on reflection, regret.

If the disclosing student agrees, during a later session, they may wish to share with the group the type of epilepsy they have, the effect of medication and what they would like others to do if they see them having a seizure.

Unexpected disclosure in private

In the event of an unexpected disclosure in private the teacher can invite the student to talk about it.

Ask the student if they feel the condition and/or medication is affecting their learning and, if so, ask what you can do to help. Discuss who else might need to know, such as teaching staff and friends, and explore reasons for and against disclosure.

Ask the student whether they would like the opportunity to talk to the class about epilepsy and what they would like you to do if a seizure occurs. Assess degree of coping and if necessary arrange counselling. Thank the student for the disclosure and offer further assistance at any time.

Things to Remember

Children with epilepsy have the same range of intelligence and ability as other children.

Missed schooling can impact on learning and important peer socialising.

Be aware that seizures can also create feelings such as anxiety and depression, poor self image and social problems - all which can affect school performance.

Some neurological disorders that can cause epilepsy can also result in learning difficulties.

Medications may also impact on the students level of concentration, attention and memory function.

The physical display of different seizures may have an effect on a student's self-perception and consequent behaviour. Some types of seizures may be frightening to the uninformed onlooker. Appropriate understanding reactions from class mates and teachers can have a considerable positive effect on a student with epilepsy.

The time that teachers spend with students places them in a unique position to observe and provide information about a student's seizures.

Seizures are not to be feared

Most seizures last approximately 1- 3 minutes although there may be a period of confusion after the seizure.

Sometimes confusion after a seizure can be quite prolonged, from minutes up to several hours.

People are often exhausted and need rest or sleep after a seizure, especially a tonic clonic seizure.

Seizures cannot be stopped or slowed by restraint. The brain almost always stops the seizures naturally. Let the person have the seizure and then apply first aid if necessary.

It is physically impossible to swallow the tongue. There is no need to insert anything into the mouth. This is dangerous and fingers may be bitten or teeth broken.

Most people usually have no memory of all or most of the event.

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