Schools are places where myths thrive. A rumour with no basis in fact can become "truth" in just one or two retellings - and this is as true in the staffroom as in the playground.
It is this filter of distortion that epileptic children have to contend with. The condition affects around 50 million people worldwide and is one of the most common childhood neurological disorders; among the general population, it is also three times more prevalent than multiple sclerosis and cerebral palsy. Despite this, epilepsy remains in the shadows, mired in misinformation and fear.
So what are the facts? Epilepsy can affect anyone, at any age and from any walk of life, but around half of all cases begin in childhood. In the UK, 63,400 children under the age of 18 have the condition, and it affects more than five times that number in the US. According to the Australian Bureau of Statistics, nearly 800,000 people in that country will be diagnosed with the condition at some point during their life. And the challenges faced by children with epilepsy are similar around the globe: lack of understanding of the condition, discrimination and stigma.
As epilepsy is a complex condition that can be difficult for even the medical profession to diagnose and treat, it is not surprising that teachers often lack knowledge in this area. If you don't know that there are more than 40 types of seizure, how can you be sure what to look for and how should you respond? Some seizures may go unnoticed, while others may be attributed to wilful behaviours, meaning that children can be left to struggle alone.
Conversely, a lack of training also leads many teachers to overcompensate when they identify a student who has epilepsy, which can mean that the child is excluded from activities, unnecessarily admitted to hospital or sent home when they could return to class after a seizure.
If simple management processes are in place, teachers can better identify the right course of action for individual students, enriching their education, including them in decisions and making savings for local health services.
Those processes cover two key areas: educational management and seizure management. Although proper training is required to truly understand the complexities of the condition, here is a quick starter guide to these key areas.
Epilepsy and classroom performance
It is not surprising that epilepsy, as a condition of the brain, can affect a child's learning and development, so it is important to have a good understanding of the child's learning profile. A full assessment by an educational psychologist is the best way to get a detailed understanding of their needs, but the key areas to look out for are:
- Memory difficulties.
- Reduced speed of processing.
- Attention difficulties.
Children with epilepsy do not necessarily require special intervention to support them in these areas, but will benefit from any targeted support that aims to maintain and develop these skills. Having a good understanding of the student's weaknesses will give you an opportunity to play to their strengths. So, for example, if auditory working memory is particularly weak, learning tasks should use visual memory skills to compensate. It is also vital to be aware of the child's emotional well- being.
What to do if a child has a seizure
Epileptic seizures are usually brief, and most stop after a couple of minutes without any need for assistance. Although most seizures don't require intervention, some may last five minutes or more. Many children are prescribed emergency or "rescue" medication to treat such prolonged seizures.
Seizures often occur without warning, so it is vital that everyone involved with the child knows how to keep them safe. For every child with epilepsy, an individual healthcare plan should be in place, which should include instructions about the use of rescue medicines.
If a child has a seizure where they lose consciousness and convulse, remain calm and follow these simple steps:
- Note the time when the seizure started.
- Clear the area to allow the child to move freely and safely.
- Administer rescue medication according to the child's emergency protocol (usually after five minutes).
- Reassure and monitor the child.
- Call an ambulance if the seizure continues for five minutes after giving medication.
Other seizures may result in the child becoming confused or having a reduced level of alertness, with or without additional symptoms such as strange sensations, visual or auditory disturbance and bizarre movements. When these seizures occur it is important to remain calm, guide the child away from any hazards, stay with them and reassure them.
Emma Tingley works for Young Epilepsy. For information about epilepsy and the charity's UK schools programme, or to download free resources, visit youngepilepsy.org.uk.