The complex relationships between epilepsy, special needs and educational performance
Epilepsy can present a number of challenges for the student and teacher. One of the biggest of these is the existence of associated conditions, such as autism and learning difficulties, that often go hand in hand with epilepsy. The occurrence of epilepsy is 20 times higher in those with learning difficulties than those without. The correlation between epilepsy and autism is higher still: between 20 and 40 per cent, depending which research you read. Approximately one in four individuals with autism develops epileptic seizures during puberty.
Epilepsy and education
These high rates of comorbidity between epilepsy and SEN have significant implications for young people and their education. Children with epilepsy may have associated developmental disorders which can affect their capacity to learn. These can include severe learning difficulties, autistic spectrum disorders (ASD), developmental delay and attention deficit hyperactivity disorder (ADHD). Increased anger and aggression, which can be associated with some ASD, can sometimes be attributed to the presence of frontal lobe epileptic seizures, so some challenging behaviours may have a biological cause.
Many children with profound and multiple learning difficulties also suffer from epilepsy. The impact of continual seizures on the development of the brain can result in a range of learning difficulties, including impairment of motor coordination skills, visual processing abilities and social skills. Seizures themselves can have a devastating effect on a child’s education and different seizure types may have different effects on school performance. For example, a child’s memory can be affected by a generalised tonic-clonic seizure. Absence seizures may occur several times a day and involve a brief trance like state which prevents a child from hearing or seeing what is happening, causing the child to miss significant chunks of learning. The child will recover immediately and the episodes may go unnoticed but their failure to respond in class may be mistaken for not concentrating.
Assessing individual needs
The relationships between complex epilepsy, SEN (such as ASD and ADHD) and other neurological conditions can take many different forms, and it is important to understand how they can affect a young person’s development. Many children with comorbidities exhibit a range of challenging behaviours which require sensitivity, understanding, support and intervention, while some with epilepsy and autism display dual impairments around their social communication and extreme repetitive behaviours that need structure, routine and mediation.
These children’s educational, emotional, cultural, physical and health needs must be assessed and supported through a holistic, multi-disciplinary approach so that their individual education plan, behaviour management plan and care plan can effectively and consistently meet all their specific needs.
It is crucial that all education staff are supported through training to have a thorough understanding of epilepsy and other related conditions. Furthermore, it is important to provide appropriate emergency medication and epilepsy awareness training in schools to ensure that staff know what to do and how to respond at all times. Our young people with epilepsy should be given every opportunity to fulfil their potential and we must help them to prepare for their roles as active citizens in our communities.
Noel Gibb is Principal of St Piers School and Further Education College in Surrey, part of Young Epilepsy: