Epilepsy, learning and behaviour

Children with epilepsy may have problems with memory, attention, concentration and processing information. As a result, they are more likely to have difficulties with learning and educational achievements.

Epilepsy and treatments for epilepsy may also cause social and behaviour problems in some children. These can include things like hyperactivity, aggression and challenging behaviour.

Talking to your child’s school can help to make sure they get support in place to help with their learning.

Epilepsy can affect learning and behaviour in a number of ways.

The effect of seizures

Your child’s behaviour and ability to learn may be affected in the period of time before, during and after a seizure.

Before a seizure

In the hours or days before a seizure, some children may get a ‘funny feeling’, or act confused, anxious or irritable. The medical word for this is ‘prodrome’.

During a seizure

If your child has focal seizures, they may behave in unusual ways during the seizure. These behaviours may include gagging, lip smacking, running, screaming, crying, or laughing. Your child will have no control over these behaviours during the seizure. They won’t always be aware of what they are doing.

If your child has absence seizures, these can be hard to spot. Sometimes they can be mistaken for daydreaming and not paying attention in class. Make sure your child’s teacher is aware of how they may behave during these seizures.

After a seizure

Children can feel confused, sleepy or have problems with vision or speech after a seizure. Your child’s awareness and memory may be affected too. This can last for several hours afterwards. Some children may feel anxious or unhappy for hours or days later.

The more seizures a child has, the more it will impact their learning. For example, some children may have hundreds of short absence seizures in a day.

This will have a major effect on their ability to interact with the world around them. This can lead to learning difficulties. Talk to the school about how they can support with this.

The cause or type of epilepsy

Some children have epilepsy caused by a brain disorder. As well as causing epilepsy, the disorder may also lead to problems with their development, behaviour and learning.

Children with some types of epilepsy have a lot of epileptic activity in their brain, even when they don’t appear to be having seizures. This can happen while awake or asleep. If this happens a lot, it can directly affect a child’s memory and how they learn.

Some types of epilepsy are known to have a particular link with learning or behaviour problems.

Epilepsy treatment

Epilepsy medicines can cause side effects with mood, behaviour or ability to learn. These may include hyperactivity, irritability, aggression, and problems with memory, concentration or understanding. Some epilepsy medicines are more likely than others to cause these problems.

In general, the higher the dose and the more epilepsy medicines that your child is on, the more likely they are to have these side effects.  If epilepsy medicines control your child’s seizures, they may have positive effects on learning and behaviour.

If your child is suitable for other treatments, like epilepsy surgery, this could mean less side effects related to medication.

Weighing up the risks, side effects and benefits of any treatment can be hard. Talk to your epilepsy specialist or healthcare team if you need help with this.

Time off school and education

Your child may miss periods of school and education due to their seizures and epilepsy. They may need time off to go to medical appointments or to recover from seizures.

This will impact learning and participation in the wider aspects of education. There is information below about how schools can help support your child with this.

Related conditions

Children with epilepsy often have other conditions that can affect learning and behaviour. These may include:

• Attention deficit hyperactivity disorder (ADHD)
• Autism spectrum disorder (ASD)
• Mental health problems such as depression and anxiety
• Developmental co-ordination disorder (dyspraxia)

Sleep

Epilepsy can also cause sleep problems. These include interrupted and reduced sleep. Some learning and memory functions are restored during sleep, so poor sleep can affect this.

Sleep problems can have a real impact on behaviour and how well your child can learn when they are awake.

The social and emotional impact of epilepsy

Having epilepsy can have an effect on your child’s emotional wellbeing. They might feel frightened about having seizures, or worry about being different from other children.

They might feel isolated from their friends. Other children might be unkind about their epilepsy if they don’t understand it. All these things could affect your child’s mood and behaviour.

It’s important that the school is aware of these difficulties that your child might be facing. This can help them to provide the appropriate support with your child’s learning, behaviour and wellbeing.

The first thing is to work out where the behaviour is happening and who with. It may be worth exploring what’s happening in different settings. If it’s happening all the time, there may be a medical cause.

Here are some questions to help you work out where the problem might be.

• Where is it happening?
• What does their teacher or other staff say about their behaviour in school?
• Are there any particular triggers for the behaviour?
• What helps with the behaviour and what has been tried?
• Are they being bullied?
• Has it started happening at the same time as a change of epilepsy medicine?
• Has there been a change in seizure control at the same time?
• Are there any seizure triggers that might be avoided?
• Are they getting stressed? Do they need help with staying more relaxed?

Knowing what is affecting your child’s behaviour will mean you can find the best way to help and support them.

Learning difficulties often go unrecognised in children with epilepsy. It’s important to talk to the school if you think your child is struggling with learning or behaviour.

Speak to their class teacher or the person at the school in charge of special or additional needs. This person might be called:

• A Special Educational Needs & Disabiltities Coordinator (SENDCO or SENCO) in England and Northern Ireland
• An Additional Support for Learning (ASL) Assistant or Practitioner in Scotland
• An Additional Learning Needs (ALN) co-ordinator in Wales

Tell them about the problems you think your child is having, and ask how they can support them. Some schools may not realise how epilepsy can affect learning.

Show them the information on this page, or tell them about our free online course for teachers. Schools legally have to make ‘reasonable adjustments’ to help students with a disability. This includes long-term conditions like epilepsy. This might mean providing extra support or aids, or giving more time to complete work.

Your child’s school should work with you to draw up an Individual Healthcare Plan for your child. These help schools to support children with medical conditions.

There is evidence that many schools are not providing this for children with epilepsy, so do ask if your school hasn’t mentioned this. We have an example Individual Healthcare Plan template you can download and use.

The school may also draw up something called an Individual Education Plan, or an Individual Development Plan in Wales.

This sets out your child’s goals for the school year and describes what support the school needs to provide for them to achieve these.

We have information for schools on supporting pupils with specific learning and behaviour issues.

Some children may need more support with their learning or behaviour than the school can offer on its own. This could be because their needs are complex, or because the school doesn’t have the right resources.

If this is the case for your child, you or the school can apply for extra support from the local authority. They will do an assessment to find out whether your child needs extra support, and if so, put a plan in place. This may be called:

• An Education, Health and Care plan (EHCP) in England
• A Statement of Special Educational Needs in Northern Ireland
• An Individual Development plan in Wales
• A Co-ordinated Support Plan in Scotland

We have more information about extra support for special educational needs and disabilities.

Tell your child’s epilepsy doctor or specialist nurse if you have noticed problems with their learning or behaviour.

They might review whether a change in their epilepsy medicines would help. Your child’s doctor should also give you advice on getting more support. This may involve a referral to other health professionals who can help in these areas.