LIVING WITH EPILEPSY/SCHOOL: LEARNING AND BEHAVIOR –BILLY’S PSYCHOLOGICAL AND SOCIAL PROBLEMS

Mrs. Christiansen brought us a letter from Billy’s teacher.
“We have enjoyed having Billy in our kindergarten this year. He is a charming, adorable little boy. However, he did so poorly on his reading readiness test that we all feel that he should spend another year in kindergarten. We would like you to come in for a meeting with us at your convenience.”
“Doctor, should we tell her about Billy’s epilepsy? He hasn’t had a seizure since he started taking phenobarbital more than a year ago.”
The first thing we would recommend is that you and your husband meet with the teacher. Find out more about Billy’s problems in school. Have there been other problems, or did he just do poorly on the reading readiness test? Is he immature in other ways in school? How does his ability to learn games and other things compare to his peers? Does the teacher think that this is just a problem of maturity which would be solved by repeating kindergarten, or are there other problems as well?
Teachers usually have a great deal of experience in identifying school problems, and the teacher’s impressions can be of great help to you and to your physician in sorting out the problems and in finding the proper directions to proceed.
The second step would be to meet with us to get our advice about the teacher’s impressions and suggestions. Do we all agree with the school? Is Billy one of the younger children in the class who could benefit from another year? Is he immature in other social ways? Does he act more like a five-year-old than the usual six-year-old who is starting first grade? Is he intellectually slower than normal? Is he a child with a specific learning problem? We often cannot answer these last two questions without psychological testing.
Does every child who is like Billy need testing? We would say no, but whether a child does or does not need testing will depend on the opinion of the teacher and on our assessment. We are often asked to answer the question, “Is this neurological?” Our answer is always, “Yes. Learning problems are always neurological.” Learning resides in the brain, not in the foot or heart. If a child isn’t learning, it’s because he can’t or doesn’t use his brain as expected. This does NOT mean that Billy has a neurological problem or that he needs to see a neurologist. It means that all of us (including the teacher) need to assess the situation carefully and find the best educational strategy to manage the problem.
Those are the suggestions we would give to any parents who received that note from their child’s teacher. The only thing different about Billy is that he has seizures and is on phenobarbital. Yes, you should tell the teacher about Billy’s seizures. You might also ask her if she has seen any “daydreaming” or other evidence that he may have been having subtle seizures in school. We would also be concerned about the possible role of the phenobarbital. We would recommend checking the blood level of phenobarbital to see if it is too high and interfering with Billy’s learning. We would probably recommend changing to another anticonvulsant (if Billy needed to continue medication) to see if his performance improved. There is no way to be absolutely certain that the medication is not interfering with learning and behavior except to take the child off of that medicine and, if necessary, change to another medicine.
*247\208\8*

LIVING WITH EPILEPSY/SCHOOL: LEARNING AND BEHAVIOR –BILLY’S PSYCHOLOGICAL AND SOCIAL PROBLEMSMrs. Christiansen brought us a letter from Billy’s teacher.”We have enjoyed having Billy in our kindergarten this year. He is a charming, adorable little boy. However, he did so poorly on his reading readiness test that we all feel that he should spend another year in kindergarten. We would like you to come in for a meeting with us at your convenience.”"Doctor, should we tell her about Billy’s epilepsy? He hasn’t had a seizure since he started taking phenobarbital more than a year ago.”The first thing we would recommend is that you and your husband meet with the teacher. Find out more about Billy’s problems in school. Have there been other problems, or did he just do poorly on the reading readiness test? Is he immature in other ways in school? How does his ability to learn games and other things compare to his peers? Does the teacher think that this is just a problem of maturity which would be solved by repeating kindergarten, or are there other problems as well?Teachers usually have a great deal of experience in identifying school problems, and the teacher’s impressions can be of great help to you and to your physician in sorting out the problems and in finding the proper directions to proceed.The second step would be to meet with us to get our advice about the teacher’s impressions and suggestions. Do we all agree with the school? Is Billy one of the younger children in the class who could benefit from another year? Is he immature in other social ways? Does he act more like a five-year-old than the usual six-year-old who is starting first grade? Is he intellectually slower than normal? Is he a child with a specific learning problem? We often cannot answer these last two questions without psychological testing.Does every child who is like Billy need testing? We would say no, but whether a child does or does not need testing will depend on the opinion of the teacher and on our assessment. We are often asked to answer the question, “Is this neurological?” Our answer is always, “Yes. Learning problems are always neurological.” Learning resides in the brain, not in the foot or heart. If a child isn’t learning, it’s because he can’t or doesn’t use his brain as expected. This does NOT mean that Billy has a neurological problem or that he needs to see a neurologist. It means that all of us (including the teacher) need to assess the situation carefully and find the best educational strategy to manage the problem.Those are the suggestions we would give to any parents who received that note from their child’s teacher. The only thing different about Billy is that he has seizures and is on phenobarbital. Yes, you should tell the teacher about Billy’s seizures. You might also ask her if she has seen any “daydreaming” or other evidence that he may have been having subtle seizures in school. We would also be concerned about the possible role of the phenobarbital. We would recommend checking the blood level of phenobarbital to see if it is too high and interfering with Billy’s learning. We would probably recommend changing to another anticonvulsant (if Billy needed to continue medication) to see if his performance improved. There is no way to be absolutely certain that the medication is not interfering with learning and behavior except to take the child off of that medicine and, if necessary, change to another medicine.*247\208\8*

Share and Enjoy:
  • Print
  • Digg
  • Sphinn
  • del.icio.us
  • Facebook
  • Mixx
  • Google Bookmarks
  • Blogplay

Your email will never published nor shared. Required fields are marked *...

*

*

Type your comment out: