Learning Challenges
Most children with epilepsy have similar intellectual abilities to children without epilepsy. However, children with epilepsy have a greater chance of experiencing learning challenges than their peers.
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Paying attention and concentrating
Understanding instructions
Using information
Describing things to other people
Remembering things
Working out how to do something new
Organizing thoughts or tasks
Feeling you have no energy to do things
Feeling muddled or confused
Feeling sad or tearful
Feeling short tempered or grumpy
Working out sums
Writing or copying figures
Developmental delays
CAUSES
Frequency of seizures
A child who is experiencing frequent seizures, may not fully recover between seizures.
Location of seizure activity in the brain
When seizures are focused in a particular area of the brain, they may also affect functions controlled in that part of the brain
Type of seizures
When a child loses consciousness during a seizure, their mental functioning can be disrupted for up to several days.
Absence seizures appear to disrupt short-term memory for information presented immediately before the seizure.
Tonic-clonic seizures are followed by a period of drowsiness or inattentiveness.
Research has shown a correlation between cognitive/behavioural problems and focal dyscognitive seizures (previously called complex partial seizures).
Medication side effects
Some anti-seizure medications may make some children tired, less alert, or hyperactive.Someone taking more than one anti-seizure medication is more likely to experience negative side effects than someone taking a single anti-seizure medication.
Herbal remedies can interact with prescribed medications in ways that will disrupt learning.
Age of onset
When a child begins to have seizures while their brain is still developing, the seizures can interrupt that stage of development.
Other related conditions
There are a number of other conditions that are more likely to occur in people with epilepsy than the general population, including Attention-Deficit Hyperactivity Disorder (ADHD), Learning Disabilities, and Autism Spectrum Disorders.
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People with epilepsy often struggle with memory.
Here are some strategies for parents and teachers:
Get the child’s attention early. Children can’t remember what they don’t pay attention to in the first place.
Establish routines to help children know the when and where of activities.
Help the child learn memory strategies. For example, when you teach left and right, have them hold both hands up in the shape of an L. The hand with the forward-facing L is the left one. To help them remember how to read a word with two consecutive vowels, tell them, “When two vowels go walking, the first does the talking.”
Ask the child questions about events that encourage them to remember details. When you talk about a recent movie, for instance, ask “What was your favourite part?” or “What did the hero do?” Fill in the details if they cannot provide them.
If the child has to memorize material, have them break the material down into manageable parts and work on the most difficult sections first.
Find ways to relate the content you’re discussing to things the child already knows. Connect new information to the child’s own life and interests.
Bring in concrete examples for the child to explore so the content becomes a meaningful part of their experience.
Use hands-on activities. Children remember content better when they experience it for themselves.
Use tools that best suit the child. If a child has verbal memory problems, use pictures, photographs, illustrations, videos, or diagrams. Encourage them to create images or “pictures in their head. If a child has visual memory problems, use verbal or descriptive strategies.
Repeat information. Children remember information better if they have practice using it more frequently. Integrate lots of review in your teaching. Provide the child with activities that will allow them to practice previous information often.
Writing things down in order to remember them is a practice called “external memory.” Teaching the child to keep an assignment notebook and a student calendar can help them remember to do things. Teach older children to use aids such as timers on watches that signal them to do specific events or to use a calendar app on tablets and smart phones.
Children retain information better if they actively think through new information, rather than simply repeating it.
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Children with epilepsy are more likely to have attention deficits than children without epilepsy.
Causes
Although the cause is unclear, the reasons may include the location of lesions in the brain that cause epilepsy and medication side effects.
Treatments
Better seizure control can help improve attention.
Treatment options include:
Surgery
Medication
Cognitive rehabilitation
Strategies for Parents
Provide your child with a quiet area to do their homework.Reduce visual and noise distractions while your child works on a task.
Alternate recreation and work.
Use a blank sheet to cover the working sheet and move it to reveal one question at a time. This helps reduce visual distractions.
When your child engages in an activity for a longer period of time, encourage them.
If your child is hyperactive as well, integrate movement (e.g. jumping, drawing) into learning.
Strategies for Educators
Create a school intervention plan to inform teachers and school management about the child’s needs. Revisit the plan after six months.
Contact teachers, school staff, and parents monthly to discuss the child’s progress.
Cut back on optional courses or coursework to provide the student with more time to work on essential course material.
Stay close to the child while providing explanations and use their material to give examples.
Remove class distractions whenever possible.
Encourage the student to actively participate in the class. This will help maintain their attention.
Establish a signal with the student so you can alert each other when the child is unfocused or is having difficulty in the class.
Use the student’s first name in examples.
Keep instructions short.’
Break long instructions into shorter segments.
Present the segments one at a time for each step in the activity instead of all together at the beginning.
Evaluate the child using a series of short tests over several days instead of one long test.
Place the child’s desk at the front of the class, close to the teacher and far from distracting windows and doors.
Pair the student with a partner who could help, with whom they have a good relationship.
If the student struggles with hyperactivity as well as attention deficit, assign the student tasks that will get them moving around (e.g. bring items to the teacher’s desk, take messages to the office).
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Strategies for Parents
Establish a routine.
Teach your child to use a calendar and a diary.
Develop time management strategies.
Teach your child to use an alarm to help them remember when it’s time to start a task.
Write down the steps to complete tasks, review it with your child, and make it available for your child when they complete the tasks.
Encourage your child to initiate tasks on their own.
Teach your child to break down tasks into a series of steps before they begin.
Help your child gather the things needed to complete a task before they begin the first step.
Strategies for Teachers
Keep instructions short.
Break long instructions into shorter segments.
Present the segments one at a time for each step in the activity instead of all together at the beginning.
Highlight the most important instructions in tests.
Provide your student with more time to complete tests and other evaluations.
Read test questions aloud or allow your student to read the questions to you.
Teach your student exam strategies (e.g. leaving tougher questions for the end of the exam, highlighting important information, using process of elimination for multiple choice questions.)
The information on this page was adapted from the Spark sheets “Helping Children with Organization and Planning”, “Epilepsy and Learning Challenges”, “Epilepsy and ADHD”, and “Epilepsy and Memory” (Epilepsy Ontario, 2015).
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