Epilepsy is a complex disorder characterized not only by seizures but also by the cognitive, psychological and social consequences of the condition. Research shows that most children living with epilepsy experience some type and degree of cognitive challenge. Age of seizure onset, frequent seizures and being on multiple medications can all contribute.
Several learning challenges have been identified in children with epilepsy.
Learning challenges in children with epilepsy
Learning challenges often go unrecognized and consequently are not supported.
It is estimated that up to one-half of children with living epilepsy have some type of learning challenge.
Learning challenges in children with epilepsy range from those who have widespread cognitive difficulties to those who have only mild and very specific learning challenges. The most common learning challenges include:
- Attention, particularly with sustaining attention
- Slow or variable speed of processing information
- Memory (combining, retaining and transferring newly learned information)
- Intellectual functioning
Attention
Inattention or difficulties with sustaining attention over time is a common concern for children living with epilepsy. Difficulties with attention are often seen before the onset of seizures.
Approximately one third of children with epilepsy will meet criteria of attention deficit hyperactivity disorder (ADHD). This rate is much higher than the 5% of children in general who meet criteria for ADHD. For children living with epilepsy, the inattentive subtype of ADHD is most common. Unlike classical ADHD, equal numbers of girls and boys with epilepsy have ADHD.
Stimulant medications can be prescribed and benefit approximately 70% of children with epilepsy who also have ADHD. This rate is similar in children who have classical ADHD.
Processing speed
Approximately 40% of children with active epilepsy display slow or inconsistent processing of information and variable responding. These issues can impact the child’s ability to work quickly and methodically and results in learning gaps.
Memory
Difficulties with consolidating or combining, retaining and transferring newly learned information is a common complaint for children living with epilepsy. Issues can include:
- Short term memory (e.g., forgetting to do chores, to bring home schoolwork or something that was just said)
- Autobiographical memory (e.g., difficulty remembering special events or trips that the child went on)
- Word retrieval issues (e.g., getting out the words that they want to, when they want to)
Intellectual abilities
Intellectual abilities refer to general cognitive abilities, including thinking, reasoning or remembering.
While many children living with epilepsy display fairly typical intellectual abilities compared to their peers, a greater number experience mild, moderate or significant difficulties..difficulties. Approximately one quarter of all children with epilepsy will experience significant intellectual difficult and meet criteria for an intellectual or developmental disability. This includes children with epilepsy whose seizures are well controlled with medication.
Academic learning and progress
More than two thirds of parents and teachers report that their child with epilepsy has difficulties with academic progress. Approximately half of all children living with epilepsy under achieve in one or more academic subjects.
Secondary issues
Learning challenges can cause frustration and feelings of differences for the child and impact their motivation, emotional well-being, social competence and self-esteem. It is hard for a child who sees their peers doing things they cannot do or sees them working at a faster pace.
Learning challenges should be addressed early so that your child can receive support as soon as possible and develop to their best potential.
To help your child, you can:
- Discuss any concerns you have about your child’s cognitive development with your child’s doctor or neurologist and find out how you might obtain help in supporting your child with any challenges that they are experiencing.
- Educate your child’s school about epilepsy including the cognitive consequences of the condition.
- Discuss your concerns with your child’s teacher or school principal and ask them about assessments (e.g., speech and language assessment, occupational therapy assessment, psychoeducational assessment) and resources or supports which may be applicable.
- An assessment will help you understand your child’s cognitive and academic abilities and identify specific learning strengths and needs. The results may help you obtain supports at school.
- Highlight to your child what their strengths are and what they can do.
- Talk about how everyone has strengths and limitations; they are what make us unique.
- Explore how your child is feeling so that you can determine how to help deal with any challenges.
- For younger children, find a supportive playgroup environment for your child to play and learn in.
- Advocate to create a supportive environment in school with your child's teacher and classmates to make school easier for your child.