Being aware when teaching students with epilepsy

Imagine that you are in the middle of teaching a class when a student begins behaving unusually. The child is staring blankly and moving their hands and mouth in a repetitive manner. What’s happening? If the child has epilepsy, these symptoms may be a sign they are having a seizure.

Teaching students with epilepsy is often no different to teaching any other kids. However, it is important for school staff to be aware of some of the possible issues that may arise if students at school have seizures. 

Your district should have a plan for what to do in the classroom if a child has a seizure - contact them for more information. 

Epilepsy is one of the most common neurological conditions among children in the US, so it is likely that you will teach a student with this condition at some point. In 2022, there were around 456,000 children with epilepsy in the US. 

If a child at your school has epilepsy and you do not yet have a protocol for this, it is valuable to develop teaching strategies for epilepsy students. Work with medical professionals, the school nurse, and the child themselves to develop a plan.

What is epilepsy?

Epilepsy is a term used to describe a wide variety of brain disorders which cause people to have seizures. Seizures are when there’s a sudden burst of disordered electrical activity in the brain. The seizures can cause many different symptoms. They range from tonic-clonic seizures (sometimes also known as generalized tonic-clonic - previously known as ‘grand mal’ seizures) where the child falls to the ground and convulses, to brief absence seizures (previously known as ‘petit mal’ seizures). This is where the child loses consciousness for a few seconds before carrying on what they were doing.

There are many different kinds of epilepsy and levels of severity. Many children with epilepsy are able to stay in control of their seizures using anti-seizure medications (ASMs), yet sometimes they may have breakthrough seizures. Some may use other treatments to manage their condition. 

Having epilepsy is associated with a number of issues for children, including:

• Some children with epilepsy may have comorbidities, such as autism or learning difficulties
• Absence from school due to seizures or medical appointments
• Side effects of anti-seizure medication 
• Memory loss and concentration problems
• Depression or anxiety
• Social isolation due to stigma from other students
• Acting out behaviors, hyperexcitability, or aggressiveness
• Some children with epilepsy may have comorbidities, such as autism or learning difficulties

Learn more: What causes epilepsy in children?

Considerations for teaching students with epilepsy

When a child with epilepsy starts at school, their parents or carers may get in contact with the school to discuss their condition (but be aware that some children may not have had their epilepsy diagnosed). 

As the child’s teacher, you can play a big role in helping the student adjust and get the most from their time in education. The following points can help if you are teaching students with epilepsy.

Teaching plan on epilepsy

Students with epilepsy may need some adjustments for learning and examinations. By speaking with the student, their parents and the school nurse, you can implement small changes that can make a big difference:

• Examinations: Sometimes the student may be tired because they've had seizures or are not sleeping properly. Being flexible with exam dates can help a lot. They can also benefit from having extra time during tests. Measuring for understanding rather than memory of facts is also beneficial.
• In the classroom: Children with epilepsy may sometimes struggle to concentrate - either because of the effects of seizures or because of medication. Double check that they have understood what you are saying, use repetition when necessary, and provide lesson printouts that they can read again later.
• Avoiding triggers: People with epilepsy can have seizure triggers, so being mindful of them can be a big help. Perhaps the best known are flashing lights (although this is believed to be relatively rare - so avoid these in the classroom. People with epilepsy often experience seizures when they are stressed, so it's useful to monitor how the student is coping with work. Other triggers than teachers should be aware of include tiredness, illness, menstrual cycle, missed medications and more.

First aid and seizure treatment plans at school

If a child in your class has epilepsy, it is valuable for them to have a seizure treatment plan worked out with the school nurse (you can download a template here). Check with your district first - and it might include:

• First aid: If a student has a seizure, try to 1) STAY with the student and begin timing the seizure, ensure they are 2) SAFE by moving dangerous objects away from them, loosening any tight clothing such as scarves from around their necks and putting something soft under their head, and move them on their 3) SIDE while keeping their airway clear. Do not put anything in their mouth.
• Is it an emergency? Most seizures are short, but you should call 911 if:
  • The seizures last five minutes or more
  • The person doesn't return to their usual state
  • The person is injured
  • They have repeat seizures
  • They have difficulty breathing
  • The seizure occurred in water
  • It’s their first ever seizure

Social aspects of teaching students with epilepsy

An important aspect of teaching strategies for epilepsy students is the social side of school. Sadly, bullying remains common for students with epilepsy. One study from 2009 reported that over 40% had experienced some kind of stigmatization. A more recent analysis suggested that the issue may be less about the child’s epilepsy itself, but more to do with other challenges children with epilepsy can experience, such as learning difficulties.

• Educating other children: It can be startling for children to see a classmate having a seizure. As their teacher, try to stay calm. It is helpful to provide age appropriate and fact based information so classmates understand what is going on.
• Physical education: As long as the child’s doctor and carers approve, it may be OK for children with epilepsy to partake in physical education - and it can be beneficial for their self esteem. What’s more, being active may reduce the frequency of seizures.
• Self-esteem and mood: Having epilepsy may affect a child’s self-esteem. It is not uncommon for them to experience depression and anxiety too. Teachers should be sensitive to these feelings and watch out for them. Praising them for concrete achievements can be very helpful.

Related: Tips for caring for a child with epilepsy

Teaching students with epilepsy

Teachers of children with epilepsy can have a significant impact on how that child develops. By taking some simple steps to accommodate their needs, learn about their condition and ensure other students understand what’s happening, you can really help children with epilepsy to shine. 

To learn more about epilepsy - and for lesson inspiration - read the Epsy blog to learn about different syndromes, treatment and fascinating facts about famous modern and historical people with the condition.