Epilepsy in Education: Practical Ways to Keep Pupils Safe, Included and Understood Epilepsy is often described as a hidden disability; however, for many students it’s only hidden until it becomes visible.
Madeline Bolton-Smith
A pupil may appear to be daydreaming, confused, withdrawn, tired, forgetful or distracted. Another may have a tonic clonic (convulsive) seizure that is frightening for everyone nearby. In both situations, adults’ responses can shape not only the pupil’s safety, but also their confidence, dignity and sense of belonging.
Madeline Bolton-Smith is the author of Diary of an Epileptic, a personal account of living with epilepsy from adolescence into adulthood. She writes from lived experience to raise awareness of epilepsy, hidden disability, mental health and practical, compassionate support in education and everyday life.
I was diagnosed with epilepsy at thirteen, after months of absence seizures were mistaken for daydreaming and poor attention. The tonicclonic seizures usually happened overnight, so initially I was diagnosed with concussion after being discovered unconscious the next morning. After beginning medication, my grades slipped, my confidence fell, and my teachers sometimes assumed I wasn’t trying hard enough. One of the most important lessons for education practitioners is this: when a student changes, ask what else may have changed. A drop in attainment, concentration or behaviour may be a sign that something medical, emotional or neurological is happening beneath the surface.
Recognise that seizures do not always look dramatic Not all seizures involve falling or convulsing. Absence seizures can look like brief lapses in awareness. A pupil may stare, stop speaking mid-sentence, lose their place, make small uncontrolled movements, seem confused afterwards or resume an activity without understanding what they have missed. Focal seizures can affect awareness, speech, movement, memory, emotions or sensory processing. If these moments are misread as rudeness, laziness or inattention, the student may internalise that judgement.
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A useful starting point is curiosity rather than correction. Staff might ask: How often is this happening? Does it occur at particular times of day? Is the child unusually tired afterwards? Are they missing instructions? Do they seem embarrassed or disorientated? Accurate observation can be invaluable for families and clinicians. Put an Individual Healthcare Plan at the centre of support Every learner with epilepsy who may be affected in school should have a clear, accessible Individual Healthcare Plan. This should be written with the pupil, parents or carers, relevant healthcare professionals and school staff. It should explain seizure types, triggers, medication, emergency protocol, recovery needs and reasonable adjustments. It should be reviewed whenever epilepsy changes, not only once a year. For some pupils, this plan may include emergency medication and instructions about when to call 999. Staff expected to administer rescue medication must be trained. However, most seizures stop on their own and do not require an ambulance. Knowing the plan for each child reduces panic and helps staff respond calmly.
Protect dignity during and after a seizure During a convulsive seizure, staff should follow the learner’s plan: keep them safe from injury, move hazards away, time the seizure, don’t restrain them, don’t put anything in their mouth, and support breathing and recovery as trained. Afterwards, the student may be confused, exhausted, emotional, nauseous, sore or embarrassed. They may not remember what happened. Privacy matters. So does tone of voice. After any seizure, avoid public questioning or dramatic reactions. A quiet space, reassurance and time to recover can make a significant difference as the brain always feels incredibly “bruised” after a tonic-clonic seizure. If classmates have witnessed the seizure, staff may need to offer calm, ageappropriate reassurance while protecting the student’s confidentiality. Understand the impact on learning Epilepsy can affect learning in many ways. Seizures may cause missed information, memory gaps or fatigue. Medication may affect concentration, processing speed, mood, appetite or memory. Night-time seizures can leave a student exhausted the next day. Practical adjustments can include written instructions, lesson summaries, check-ins after absence seizures, rest breaks, flexible deadlines after seizure clusters (multiple seizures over 24-48 hours), access to notes, exam access arrangements where appropriate, and sensitive communication between home and school. The goal is not to lower expectations, but to remove barriers.
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Include, do not overprotect Risk assessment should support participation, not become a reason for unnecessary exclusion. Learners with epilepsy may need adjustments for PE, swimming, science practicals, school trips or unstructured times, but they should not be automatically removed from opportunities. Inclusion also means tackling stigma. Pupils may fear being seen as different, fragile or embarrassing. Whole-school awareness, delivered sensitively and with the student’s consent, can help peers understand epilepsy without making one child feel exposed.
Five practical actions for education settings 1. Ensure relevant staff know the learner’s seizure types, triggers, first aid plan and recovery needs 2. Record seizures accurately, including duration, signs, possible triggers, recovery time and any injuries 3. Review learning support after seizures, medication changes or changes in attendance, concentration or mood 4. Plan ahead for trips, PE, exams, transitions and staff absence so support does not depend on one adult 5. Ask the student what helps them feel safe, included and respected.
A final thought A young person with epilepsy is not simply a medical risk to be managed. They’re a student trying to belong whilst living with uncertainty. The best support combines safety, curiosity, flexibility and dignity. When adults respond with understanding rather than assumption, they can change the experience of school for a child with epilepsy.
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