Children at school

All teachers need some knowledge of epilepsy since it is a relatively common disorder affecting about five persons in every 1,000 and begin in most cases in childhood or youth.

Discrimination can be found most often among those who know little about epilepsy. This includes teachers, administrators and also other children. Teachers might restrict the child with epilepsy from ALL activities, out of ignorance of what the child can or cannot do. Children may tease and bully those who are in any way different. Parents should inform the school that their child has epilepsy.

In most cases children with epilepsy can and should take part in all the usual excursions, camps and physical activities arranged by the school. It is vitally important for the teacher to encourage as much participation as possible, since the child needs access to the full range of childhood experiences.

There are two major areas for caution with the child who is continuing to have seizures. These are climbing and swimming. Climbing may need to be proscribed, while swimming, which should be encouraged, requires 'one to one' supervision all the time the child is in the water.

Practical management of the school child with epilepsy

Children with epilepsy need to be treated in just the same way as other children in regard to discipline, encouragement, and expectations for individual performance in school. Do not pamper such a child or allow him to manipulate you by means of his epilepsy. Normal activity, both mental and physical, will benefit the child with epilepsy, and promote his acceptance by his peers.

Talking to parents
If a child has epilepsy, it is important for teachers to obtain information from parents about his seizures, medications, and any necessary restrictions on activity. However, parents should be encouraged to place as few restrictions on the child as possible other than those essential for his safety.

Plan ahead with the child
If a child is having seizures at school, plan with him and his friends what practical steps to take if a seizure does occur in the classroom or playground. You may be able to help a child to recognise whether or not he has an 'Aura' or a warning signal before the seizure, by discussing with him his sensations just before the seizure begins. However it is important to realise that many people with major seizures do not experience any warning at all.

Recognising factors which may stimulate seizures
You may observe that seizures seem to occur in response to certain specific stimuli, such as watching T.V. or rhythmical repetitive activities. They may occur when the child is passive and unoccupied, overtired or unwell. Where an avoidable stimulus seems to bring on seizures, take steps to minimise the child's exposure to that stimulus without being too obvious about it. Discuss these matters with his parents, they may have practical advice to offer.

A friend to help in the classroom
If a child is having numerous absences or petit mal attacks during school, he will have problems knowing where the class is up to in the lesson. If he has a friend to help him 'find the place' he will be far less disadvantaged by the recurring blank patches in his awareness, and will have fewer problems Keeping up with the class.

Epilepsy - learning and behaviour
Some children with epilepsy may have difficulty with school work. They may appear drowsy, lack application and concentration, or have memory problems. There may be specific learning difficulties associated with reading or arithmetic. However these problems are fairly common in many children, and should not be immediately ascribed to epilepsy.

Some children with epilepsy may show behaviour disturbance relating to their epilepsy, or as a result of changes in their medications. Disturbed behaviour can occur in response to over-protection and spoiling at home or lack of discipline and poor acceptance to school.

The teacher's role
Teachers are in a unique position to observe and provide information about a child's seizures. Details of an initial seizure conveyed to parents and doctor can aid in the diagnosis of particular forms of epilepsy. In petit mal epilepsy transient loss of consciousness is often subtle, and lack of concentration or blank staring may be the only signs indicating that attacks are occurring. In relating information to parents it is best to describe carefully events observed before, during and after the seizure and to avoid the use of diagnostic labels, particularly if the child has not been diagnosed as having epilepsy. Any suspicion of seizures, or a marked change in the pattern of seizures at school should be reported to parents. Excessive drowsiness or poor concentration should be noted, as they may indicate inappropriate medication.

Explaining seizures to other children
If a seizure is witnessed by children at school the opportunity should be taken to offer a simple explanation of what has happened, and how to help. Reassurance can be given that seizure "don't hurt" and are not "catching".

Discussing and practising simple first aid measures with the class will help to develop a caring and accepting attitude. It is important to include the child with seizures in the explanation and first aid teaching.

The informed teacher's attitude towards epilepsy and to the child with seizures positively influences the rest of the class. Initially, major seizures may be frightening, but once their recognition and first aid is understood there is nothing to fear. A caring and accepting attitude encourages positive responses from both children and adults. All teachers should also be able to recognise seizures and know what to do if one occurs in the playground or classroom.