At every level of schooling,from kindergarten to graduate school, people with epilepsy may face challenges unknown to other students. Whether these challenges are major obstacles or small inconveniences depends on many factors. Some of these factors are related to the student's epilepsy:

• Seizure frequency
• Seizure severity
• Dosage and type of seizure medicine
• Associated problems with thinking or behavior
• Social and psychological adjustment

Other factors, which are indirectly related to the epilepsy, include:

• The level of understanding of epilepsy by teachers and school officials
• The attitudes and level of knowledge of other students

What are the first goals?

Like all students, those with epilepsy should feel safe, accepted, and academically stimulated in school. Whether these goals are achieved depends on other people's understanding of epilepsy, their ability to respond to seizures, and their beliefs about the abilities of students with epilepsy. How others-teachers, classmates, and administrators-respond will make a great difference in how the student with epilepsy feels about himself or herself.

How can these others be helped in their responses?

Epilepsy education and awareness should be part of the school curriculum whenever one or more students at school have epilepsy. Because seizures are unpredictable, anyone at school may need to respond to a seizure. If first responders are not well prepared, the result may not only be medical complications, but also greater embarrassment or fear for the student. These negative feelings could increase stress, that may affect school performance or even make seizures more frequent.

Epilepsy education usually involves bringing in outside speakers from a local Epilepsy Foundation affiliate or a nearby epilepsy center. The topics include:

• First aid for someone having a seizure
• Basic information about epilepsy and its treatment
• The problems of living with epilepsy
• How to improve the school environment for people with disabilities

These programs help to increase the support and nurturing of students with epilepsy.

Ideally, epilepsy education should begin before there is a crisis at school, rather than after a seizure has caught everyone by surprise. Therefore, the parents of a child with epilepsy (or college students themselves) should consider notifying the school before classes start. Discussion of the best response to a seizure can be supplemented with specific instructions from the student's doctor and input from the school nurse and health educator.

How can the student's school performance be improved?

Sometimes the side effects of seizure medicines or issues of thinking or behavior related to seizures themselves will interfere with a student's school performance. In this situation, it is helpful to have the student's neuropsychologist and other mental health professionals advise teachers on how to help the student get the most out of school. If the student has not been assessed by a neuropsychologist, the school may recommend it.

What other problems can arise at school?

Students with epilepsy sometimes run into other problems:

• They may be discouraged or forbidden from participating in certain activities or sports. Then they feel left out and inferior.
• Despite guidance from the student's doctor or neuropsychologist, the school may not adapt the learning program to meet the student's needs.
• Older students may be advised against certain career pathways or be actively discriminated against.

What's the solution?

In these situations, parents or the student are called on to be their own advocates. Legal action may occasionally be necessary. In the United States, students' rights to an appropriate education are supported by three pieces of federal legislation:

• The Individuals with Disabilities Education Act of 1990 requires each state and local educational agency to provide children with a free, appropriate public education.
• Section 504 of the Rehabilitation Act of 1973 prohibits discrimination on the basis of disability in educational programs that receive federal funds.
• The Americans with Disabilities Act prohibits discrimination by public and private schools, colleges, and universities.

Topic Editor: Steven C. Schachter, M.D.
Last Reviewed:12/15/06