20th May 2011 at 01:00
The problem: One of our pupils has epilepsy, is autistic and has significant learning difficulties. His seizures are controlled but he can be aggressive. He is at risk of permanent exclusion - how can we avoid this?

What you said

"He may be at risk of exclusion, but his teachers and fellow pupils are in danger from him. It is up to the authority to find a more appropriate place for him."


"The whole caboodle (of problems) could be the cause, but some epilepsy medicines can lead to aggressive behaviour."

Miss Pious

The expert view

As this pupil has significant learning difficulties, he will not be able to communicate well or manage his anxiety. He will communicate his fear, frustration and needs in inappropriate ways - by hitting others or self- harming. Aggression can be attributed to frontal lobe epileptic seizures, so some of the challenging behaviour may have a biological cause.

As a result of his autism, he is likely to have high levels of anxiety, which can be associated with changes in routine, unfamiliar staff and hypersensitivity to noise and other sensory issues.

The occurrence of epilepsy is 20 times higher in those with learning difficulties than those without. The co-morbidity (that is, how they affect each other) between epilepsy and autism is higher still, so it is not surprising the pupil is presenting challenging behaviours.

Consider sign-language systems such as Makaton or Signalong to communicate non-verbally with him, as verbal language could cause confusion and anxiety. At first sign of anxiety show him pictures of enjoyable activities or safe spaces. You could also provide a visual "now and next" board to communicate his routine and any necessary changes.

Give him time to process requests and repeat if necessary, ensuring there is a proper end to an activity and that the activity is suitable for the time available.

Also, think about providing appropriate emergency medication and epilepsy awareness training in school.

Jon Sharpe is principal of St Piers School and Further Education College at the National Centre for Young People with Epilepsy. This week is National Epilepsy Week. For details, visit For more behaviour advice, go to

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