Psychosocial Implications of Epilepsy

Expectations of the child with epilepsy

Lowered expectations of the child with epilepsy can be very detrimental. It may send a message to the child that s/he is not able to succeed, which may eventually cause the child to accept these lessened expectations. Parents and teachers must set realistic and attainable goals for children.

Children with epilepsy demonstrate the same variation in academic performance as children without epilepsy. Thus, the expectations for children with epilepsy should be the same as those for the rest of the class.

Effects of being diagnosed with epilepsy

Early onset of epilepsy in children is associated with increased problems. When children are diagnosed with epilepsy, there is a period of adjustment involving new medications, doctors appointments, various types of testing, etc. During this time, the child’s behaviour and personality may change as the child struggles with the newly diagnosed condition.

Children often feel embarrassed after experiencing a seizure in public. They may feel isolated because they are “different,” which may lead to feelings of low self-esteem and low self-worth. Children who are having difficulty adjusting to their seizures may exhibit hyperactivity, anxiety or aggression, which may further distance them from their peers.

Effects of seizures and medications

Teachers may perceive the child with epilepsy as unmotivated, not comprehending the cognitive effects that medications or seizures may have on a child. Anti-epileptic medication may impair concentration, lead to poor processing ability, lower alertness, cause drowsiness, and cause hyperactivity. Children who take several medications may have an increased risk of behavioural and cognitive side effects. Therefore, doctors usually prefer to treat children with only one medication (monotherapy) to decrease the side effects associated with the use of multiple medications.

The disruption of seizure activity itself may also affect a child’s learning process by causing that child to miss important pieces of the lesson. The type of seizure a child has may also affect learning. Different parts of the brain are responsible for different functions, such as speech development, visual processing and spatial arrangements. Seizures may affect some brain functions, depending upon the area of the brain in which the seizures originate.

Even when children appear to be seizure-free, they may still be experiencing seizure activity in their brain, called interictal discharges. These interictal discharges may cause inability to focus, difficulty taking in new information, and/or behavioural disturbances.

Effects of overprotection

Many parents and teachers are overprotective of children with epilepsy. This may be very damaging since all children – including those with epilepsy – need to have a vast number of experiences for healthy psychosocial development.

Teachers have an important role in preventing other children from having lasting negative reactions toward the child who experiences seizures. Teachers should not expect any less from a child with epilepsy.

Allowances, however, must be made for classes missed for medical appointments and for recovery following a seizure if necessary. The effects of medication must also be considered. One way to reduce the child’s anxiety is for the teachers to reassure both the parents and the child that s/he will take proper care of the child during the seizure.

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