Getting Ready For Back To School: Seizure Management for Students

By Eileen Frueh, Special to EpilepsyUSA

As many as 325,000 school-age children,ages 5–14, have epilepsy. Thankfully, with medication, surgery, a special diet,or vagus nerve stimulation, most go to school and fully participate in school activities. It is important for parents and schools to work together to create a safe and supportive environment for students with seizures to grow, learn and achieve their full academic potential.

Meeting the Teacher
Parents should take the time to meet with their child's teacher before the beginning of each school year to discuss what

For All Seizures: Keep calm Remain with the student until he or she is fully alert Do not offer food or drink Reassure the student after the seizure is over

For Absence Seizures: Make sure the student has not missed key parts of the lesson

For Simple Partial Seizures: Ensure the student is fully oriented to person, place and time before resuming activities Comfort and reassure the student if he/she seems confused or frightened

For Complex Partial Seizures: Speak to the student softy and calmly Reassure the student that he/she is safe Move harmful obstacles to ensure safety Allow wandering student to walk in a contained area Stay with the student until complete awareness of environment is regained Help reorient the student if he/she seems confused afterwards

For Generalized Tonic Clonic Seizures: Stay calm and reassure the student that he/she is safe Reassure the other children that the student will be fine shortly Ease the student gently to the floor and clear the area around him/her Cushion the student's head Turn the student gently on one side Do NOT put anything in the student's mouth Do NOT hold the student down Let the student rest until full consciousness returns

type(s) of seizures their child has, how to recognize them, how the teacher should respond to them, and how the teacher can prepare the other students so that they understand and accept the child. The Epilepsy Foundation offers several sample forms that can aid in this process.

Working with Your School Nurse
Many children with epilepsy control their seizures with antiseizure medications that must be taken from one to four times a day. In many states, the school nurse has the primary responsibility for administering these medications during school hours.

School nurses also work with the parents to develop seizure action plans, a tool that organizes and communicates the student's health care and educational needs. A seizure action plan helps ensure a safe environment for the student, while maximizing opportunities for learning and development.

The plan should be specific for each student and should include instructions for both basic first aid as well as appropriate emergency responses to ensure the child's safety in the event of an acute seizure emergency. Many action plans include the following instructions for what do do if someone is having a seizure.

Of course, each child is unique and parents should work with the school to create an individualized seizure action plan that outlines the specific needs of their particular child. Here are just some of the accommodations that parents may include in their children's seizure action plans, depending on the child's unique needs:

• The child should be seated at the front of the classroom
  so that the teacher can be more aware of his or her seizures and to diminish distractions
• The child should be escorted to the restroom and lunchroom
• When the child participates in activities on rises (e.g. choir), the child should stand on the lowest riser
• The child should have extra test time or untimed tests
• The child should be closely monitored during PE activities
• The child should stay indoors during recess onhot days
• The child should be allowed to wear a hat if needed to dim classroom lights

School nurses also play a key role in helping train teachers and staff to respond appropriately to seizures and in creating a positive environment among teachers, staff, and fellow students with respect to a child with epilepsy. This helps to minimize stigmatizing beliefs, reinforce the need for compassion, and support the student's positive self-image.

Seizures and School Work
Many children with epilepsy do well in school, but seizures can affect school performance in subtle ways.Seizures can affect a child's memory and processing skills. After a seizure, some children are unable to remember anything that happened the previous day or immediately afterwards. Medications can also affect a child's attention span and ability to concentrate.

The care of children with epilepsy is a mutual concern of parents, teachers, school administrators, nurses, and the child's health care providers. By working together, they can help the child achieve success in school life.

School Forms to Aid in Seizure Management can be downloaded at: http://www.epilepsyfoundation.org/living/children/education/schoolforms.cfm