Managing epilepsy at school
Aug 07, 2007
TEN-YEAR-OLD Alex was in class one afternoon when he suddenly got an epileptic seizure and fell down. As he lay unconscious and shaking, saliva flowed from his mouth. Terrified, his classmates took off. The teachers rushed him to hospital. But even after he was treated, his classmates did not want t
By Carol Natukunda
TEN-YEAR-OLD Alex was in class one afternoon when he suddenly got an epileptic seizure and fell down. As he lay unconscious and shaking, saliva flowed from his mouth. Terrified, his classmates took off. The teachers rushed him to hospital. But even after he was treated, his classmates did not want to sit with him for fear of catching the disease.
Epilepsy is caused by abnormal functioning of the brain, and may lead to loss of consciousness or normal behaviour. Like in Alex’s scenario, some children and teachers believe epilepsy is contagious and hesitate to help the victim. This creates stigma, and in most cases, the child may not want to go back to school.
According to the 2002 survey by the Uganda National Bureau of Statistics, there are about 26,000 people with epilepsy in Uganda. It is not clear how many students have this problem. But according to the 2003 Uganda Education Statistics abstract by the education ministry, there are 805 school-age children who are mentally impaired. “This could include epilepsy cases,†says an official at the ministry’s Special Needs Department.
How can epilepsy be managed?
Paul Njuki, an expert in child language and language disability, says the greatest challenge facing children with epilepsy in school is stigma. He says people a have negative attitude towards epilepsy because of the cultural beliefs surrounding the problem.
“Teacher training does not give teachers sufficient orientation into this problem. Most teachers, therefore, react the way they do because they do not know how to handle children faced with such challenges,†Njuki explains.
“Children suffering from epilepsy do not attend school regularly and teachers do not spare time to bridge the gap. Eventually, such children drop out because they are seen as retarded,†he adds.
Njuki recommends a comprehensive programme conducted by mental health professionals that can help schools understand mental health challenges. This can be done by organising sensitisation days in which children and teachers are sensitised on mental health issues.
With sensitisation, the problem can be controlled early. Njuki says the problem often begins with ‘absence seizure’ (day dreaming) in class. A persistent episode of not being attentive and day dreaming is a warning sign that calls for assessment.
In the 2007 school edition titled epilepsy torch, the Uganda Epilepsy Support Association gives the following tips on how schools can manage the disease.
Tips for parents:
Meet with the class teacher as soon as your child joins a school. Explain the condition to the teacher and be willing to train other pupils and staff about epilepsy. This will help to ensure that teachers and students are prepared to deal with a seizure. The teacher’s attitude about epilepsy influences the child’s self-perception and attitude of his/her peers.
Stress that epilepsy is not contagious. Focus on handling a seizure and the types of seizures.
State how you always handle the situation, your expectations and contributions.
Provide information with regard to the medication your child is taking and obtain the teachers commitments to administer it when needed. Ask that your child be treated the same as his or her peers.
Tips for teachers
Accept the child. The Government encourages inclusive education, where every child can be placed in any school
Foster a culture of acceptance in the school. Encourage the children to appreciate, play and revise with children with epilepsy. Children with epilepsy and their families need to feel comfortable enough to tell the teachers about the disease. Tell them it is not their own making that they have epilepsy. This will boost their confidence.
The headteacher should ensure first aid training for teachers and pupils. They should have knowledge on epilepsy and what it is, seizure management, types of seizures and factors that trigger them off.
Concentrate on what the child can do and develop realistic expectations. If they are interested in sports, allow them; but if they cannot deliver as much as other children, do not be hard on them. This may put them on pressure to do well, resulting in an increase in seizures.
Do not allow the child to think of him/herself as invalid or use epilepsy as an excuse to avoid difficult situations. Encourage the child to engage in activities she or he would have done had he or she not had a seizure.
Other children may react by feeling fearful, upset, or confused after witnessing a seizure or learning that a classmate has a seizure disorder. This may cause the child to be teased and can end up doing more harm. Teachers can prepare the class on what to expect and how to deal with a seizure. This will help them become more supportive.
Inform the class about epilepsy
If there is a student with epilepsy, the teacher should introduce the students to epilepsy and discuss it. It may not be necessary to refer to the actual child in your class who has epilepsy; unless you have consulted with the child and parents.
If the child denies having seizures or gets upset, the teacher should respond with understanding of the child’s feelings. If it seems difficult to continue a discussion with the child, the subject should be left for a while and brought up later.
Teachers play a central role in the acceptance and self-development of the child who has seizures. When teaching about epilepsy, emphasise that it is treatable and is not contagious. Avoid using the word ‘epileptic’; use the ‘child with epilepsy’. Emotional and educational needs of a child with epilepsy are essentially the same as for other children.
When epilepsy occurs:
Kajumba Mayanja, a lecturer of mental health and a clinical psychologist at Makerere University Institute of Psychology, says:
Loosen clothing around the child’s neck.
Put something soft under child’s head. Move the child away from hard, sharp objects
Turn the child on one side to keep airway clear.
Do not put anything in the child’s mouth or give liquids or medicines during or immediately after the seizure. Do not hold the child’s tongue; it cannot be swallowed.
Do not restrain movement. Do not hold the child down, this can result in injury. After many seizures, there may be confusion and the person should not be left alone.
Reassure the child when consciousness returns that everything is okay. It is not necessary to call an ambulance if it is known that the child has epilepsy, and the seizure ends after a short time.
Call for emergency aid, if it is the child’s first seizure, if multiple seizures occur, if they last longer than five minutes, or if the child seems injured. After the seizure, lay the person on the side to maintain an open airway and prevent the person from inhaling any secretions.
Dealing with the stigma for children with epilepsy
Educate yourself and the others about epilepsy.
Find a doctor or counsellor whom you trust and do not be worried of the stigma. Epilepsy should not be a barrier to employment or school.
Additional reporting by Jamesa Wagwau
TEN-YEAR-OLD Alex was in class one afternoon when he suddenly got an epileptic seizure and fell down. As he lay unconscious and shaking, saliva flowed from his mouth. Terrified, his classmates took off. The teachers rushed him to hospital. But even after he was treated, his classmates did not want to sit with him for fear of catching the disease.
Epilepsy is caused by abnormal functioning of the brain, and may lead to loss of consciousness or normal behaviour. Like in Alex’s scenario, some children and teachers believe epilepsy is contagious and hesitate to help the victim. This creates stigma, and in most cases, the child may not want to go back to school.
According to the 2002 survey by the Uganda National Bureau of Statistics, there are about 26,000 people with epilepsy in Uganda. It is not clear how many students have this problem. But according to the 2003 Uganda Education Statistics abstract by the education ministry, there are 805 school-age children who are mentally impaired. “This could include epilepsy cases,†says an official at the ministry’s Special Needs Department.
How can epilepsy be managed?
Paul Njuki, an expert in child language and language disability, says the greatest challenge facing children with epilepsy in school is stigma. He says people a have negative attitude towards epilepsy because of the cultural beliefs surrounding the problem.
“Teacher training does not give teachers sufficient orientation into this problem. Most teachers, therefore, react the way they do because they do not know how to handle children faced with such challenges,†Njuki explains.
“Children suffering from epilepsy do not attend school regularly and teachers do not spare time to bridge the gap. Eventually, such children drop out because they are seen as retarded,†he adds.
Njuki recommends a comprehensive programme conducted by mental health professionals that can help schools understand mental health challenges. This can be done by organising sensitisation days in which children and teachers are sensitised on mental health issues.
With sensitisation, the problem can be controlled early. Njuki says the problem often begins with ‘absence seizure’ (day dreaming) in class. A persistent episode of not being attentive and day dreaming is a warning sign that calls for assessment.
In the 2007 school edition titled epilepsy torch, the Uganda Epilepsy Support Association gives the following tips on how schools can manage the disease.
Tips for parents:
Tips for teachers
Other children may react by feeling fearful, upset, or confused after witnessing a seizure or learning that a classmate has a seizure disorder. This may cause the child to be teased and can end up doing more harm. Teachers can prepare the class on what to expect and how to deal with a seizure. This will help them become more supportive.
Inform the class about epilepsy
When epilepsy occurs:
Kajumba Mayanja, a lecturer of mental health and a clinical psychologist at Makerere University Institute of Psychology, says:
Call for emergency aid, if it is the child’s first seizure, if multiple seizures occur, if they last longer than five minutes, or if the child seems injured. After the seizure, lay the person on the side to maintain an open airway and prevent the person from inhaling any secretions.
Dealing with the stigma for children with epilepsy
Additional reporting by Jamesa Wagwau