School activities

Schools must make every reasonable effort to include children and young people with epilepsy in all parts of school life, including:

• practical lessons,
• sports and activities,
• day trips,
• residential visits,
• education off site, and
• work experience placements.

Under the disability discrimination laws, schools have a duty to include children with epilepsy, unless there is “material and substantial justification”. This means the school must include children with epilepsy in all activities, unless it would be too costly or disruptive. Schools must make changes, called “reasonable adjustments” so that pupils with disabilities can be included in activities. This may reasonably include changing the venue or activities.

• More information about disability discrimination

Practical lessons 

Certain subjects, for example science, food technology and PE, have safety issues for all pupils. Some children with epilepsy may require additional safety measures.

Science

Use of protective equipment, for example aprons, safety spectacles, gloves etc should be properly enforced for all pupils. Effective use of safety equipment, eg test tube racks and clamps, or division of tasks between group members could be considered.

Food technology

Cooker guards can be fitted to cooker hobs, and microwave cooking techniques can be used in lessons if appropriate. Pupils should not carry hot pans, and should be encouraged to use the back hotplates/burners.

Technology

Activities involving the use of hot or sharp objects, tools or machinery should be assessed on an individual basis. The assessment should take into account the pupil’s seizure type and frequency, and the specific activities involved.  

Sports and activities

Sports and activities should be assessed on an individual basis, in consultation with the child and their parents and with reference to the individual healthcare plan. Pupils with epilepsy should participate in all activities along with other pupils, unless medical advice is to avoid a certain activity.

Contact sports

Advice should be sought from the pupil’s epilepsy specialist regarding the safety of contact sports. It may not be advisable for the pupil to play contact sports if their epilepsy was originally the consequence of a head injury.

Swimming

Most people with epilepsy can swim safely, but some extra safety precautions may be needed. Issues to consider are seizure type and frequency, and it may be necessary to seek advice from the child’s doctor. Adequate supervision is essential.

Examples of safety precautions follow.

• Never allow a child with epilepsy to swim alone.
• Ensure that adequate supervision is in place; one-to-one supervision may be necessary. A buddy system, where all swimmers supervise each other in pairs, avoids the child with epilepsy being singled out.
• Make all lifeguards and supervisors aware of the pupil’s epilepsy.
• Do not allow the pupil to swim if unwell.
• Avoid overcrowded situations.
• If practical, make sure the pupil swims where they can easily be helped out of the water.

NOTE Swimming in the sea, lakes or very cold water is dangerous. Be sensible, and only allow swimming in controlled areas with lifeguards present.

How to deal with a seizure in the water

Absence and partial seizures do not usually need emergency action, but care needs to be taken that the pupil’s mouth and nose remain above the water. Protect the pupil from danger and, when they recover, check if they need to get out of the water. They may not realise what has happened or they may feel groggy.

Basic guidelines

• From behind, hold the pupil’s head above water.
• If possible, move the pupil to shallow water, holding their head above water.
• Do not restrict movement or place anything in their mouth.
• Once abnormal movement has stopped, move the pupil to dry land.
• Place the pupil on their side to recover if necessary.
• Stay with the pupil until they feel better.

Call an ambulance if:

• you believe the pupil has swallowed or inhaled water, or
• the pupil goes from one seizure to another without gaining consciousness, or
• the seizure lasts longer than is usual, or for more than five minutes if you are unsure, or
• the pupil has been injured.

Water sports

This covers a wide variety of activities and guidance varies with the particular sport. Consult the Association for Physical Education for extra guidance.

Cycling and horse riding

Busy roads can be dangerous to all pupils, but there may be additional factors to consider for a pupil with epilepsy. Good practice can help keep all pupils safe, including those with epilepsy.

• Avoid busy traffic.
• Ensure pupils are always accompanied.
• Ensure cycle helmets / riding hats are worn at all times.

Climbing and hiking

Heights can be a danger to people with epilepsy, and climbing may be dangerous to a pupil whose seizures are not controlled. Schools should consider the risks and possible benefits, and seek advice from the pupil’s parents and doctor if necessary. Hiking and rambling are usually safe for people with epilepsy, as long as they are accompanied by someone who knows what to do in the event of a seizure.

For all types of activities, more guidance is available from the Department for Children, Schools and Families (DCSF), in the guide Health and Safety of Pupils on Educational visits download this document.  

Out of school activities and visits

All pupils should be included in out-of-school activities if possible. There may be extra considerations for pupils with epilepsy, and these should be considered when planning the activity so that any necessary adjustments can be made.

Risk assessments must be carried out for all out-of-school activities and this process should consider additional needs such as supervision, access requirements and medicines. Drawing up a risk assessment will also identify reasonable adjustments that need to be made to include all pupils in activities. A risk assessment should specify action to be taken in an emergency, including where help could be obtained.

If a member of staff trained in first aid or administering medicine is not available for an out of school visit, the school should make alternative arrangements. This may mean training extra members of staff, or including other people on the trip such as a school nurse. Asking the parent of a child with epilepsy to come on the visit is not an ideal solution, and the school should only suggest this if there are no other reasonable arrangements that can be made.

• The pupil’s individual healthcare plan and medication should be available on the activity.
• If emergency treatment is likely to be needed, a person trained to give this should be a member of the party. This may mean additional members of staff need to receive training.
• An emergency pack containing items such as a mobile phone and a light cover to maintain the pupil’s dignity during delivery of emergency medication, contact numbers and the address of the local hospital, may be appropriate.

Residential visits

Additional factors may need to be considered for residential visits, for example:

• some pupils with epilepsy have seizures at night;
• excitement, fatigue and irregular eating or sleeping patterns may trigger a seizure; and
• medicines normally taken outside school hours may need to be administered.

Discos and theatre visits

Around five per cent of people with epilepsy are photosensitive and may be affected by flickering light or patterns. People with photosensitive epilepsy may have seizures triggered by strobe or flashing lights, as in a disco, some theatre shows or in some films. Before going to see a film or visiting the theatre, check with the pupil and their parents to find out if they have photosensitive epilepsy. If the pupil does have photosensitive epilepsy, enquire from the theatre or cinema about the use of flashing light effects.

• More information about photosensitive epilepsy 

• Epilepsy awareness project for primary schools