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癫痫对学习和行为的影响以及所需支持:儿童、家长和学校工作人员的观点。

Impact of epilepsy on learning and behaviour and needed supports: Views of children, parents and school staff.

机构信息

Research Department, Young Epilepsy, Lingfield, Surrey, RH7 6PW, UK; Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London, WC1N 3JH, UK.

Child Development Centre, Crawley Hospital, West Green Drive, Crawley, RH11 7DH, West Sussex, UK.

出版信息

Eur J Paediatr Neurol. 2022 Sep;40:61-68. doi: 10.1016/j.ejpn.2022.08.001. Epub 2022 Aug 20.

Abstract

BACKGROUND

There is limited data on the views of young people with epilepsy, their parents and school staff regarding the impact of epilepsy on learning and behaviour in school. The purpose of the study was to gain an understanding of the impact of epilepsy on learning and behaviour and needed supports according to children with epilepsy, their parents and supporting school staff.

METHODS

School-aged children (n = 20) with 'active epilepsy' (taking anti-seizure Medications (ASMs) for epilepsy), their parents (n = 68) and school staff (n = 56) were interviewed or completed surveys. The quantitative data was analysed using descriptive statistics and responses were compared for children attending mainstream and special schools using chi-square analyses. The answers to open questions were answered using thematic analyses.

RESULTS

The majority (53%) of children with epilepsy felt that epilepsy affected their learning including aspects such as memory, attention and concentration but also physical and emotional wellbeing including increased tiredness and lowered self-confidence. In addition, children brought up possible negative aspects of taking ASMs including increased irritability and emotional reactivity. The children also mentioned that epilepsy in school was associated with stigma and restrictions. The majority (85%) of parents agreed that epilepsy affects the child's learning/behaviour while more staff agreed that epilepsy affects learning (61%) than behaviour (45%). Most parents agreed that that their child's school provided the appropriate resources to support their child's learning (79%) and 72% agreed that they were satisfied overall with the support their child received at school. However, parents of children attending special schools were more likely to agree that the child's school provided appropriate resources to support their child's learning (p = 0.034) and be satisfied with the support their child received in school (p = 0.02), than parents of children attending mainstream schools. With respect to current or desired supports, analysis of the children's responses indicated that they want access to supportive environments outside the classroom, accommodations in tests/exams and increased support from trusted adults. Parent responses included approaches that promote child wellbeing, environmental accommodations, a high ratio of adult support and a consideration of the child's communication needs. Staff views regarding optimal strategies included a high level of adult support for the child, environmental accommodations, use of multimodal learning, adapting communication and approaches that promote psychological wellbeing.

CONCLUSIONS

The majority of children perceived that epilepsy affected their learning and behaviour in school including leading to specific learning difficulties, but also negative impacts on emotional and physical wellbeing. Levels of parental satisfaction with supports were significantly higher in special schools compared with mainstream schools. Children, parents and staff highlighted a number of supports which they felt can support the child with epilepsy's learning but also emotional wellbeing.

摘要

背景

关于青少年癫痫患者、其父母和学校工作人员对癫痫在学校学习和行为方面的影响,目前数据有限。本研究的目的是了解癫痫对学习和行为的影响,以及癫痫患儿、其父母和支持学校工作人员所需的支持。

方法

对 20 名患有“活动性癫痫”(服用抗癫痫药物(ASMs)治疗癫痫)的学龄儿童(n=20)、其父母(n=68)和学校工作人员(n=56)进行了访谈或完成了调查。使用描述性统计分析对定量数据进行了分析,并使用卡方分析比较了在主流和特殊学校就读的儿童的反应。使用主题分析回答了开放性问题的答案。

结果

大多数(53%)癫痫患儿认为癫痫影响了他们的学习,包括记忆力、注意力和注意力集中等方面,也影响了他们的身体和情绪健康,包括疲劳增加和自信心降低。此外,患儿还提到了服用 ASMs 的一些可能的负面影响,如易怒和情绪反应过度。患儿还提到,癫痫在学校会带来耻辱感和限制。大多数(85%)家长认为癫痫会影响孩子的学习/行为,而更多的工作人员认为癫痫会影响学习(61%)而不是行为(45%)。大多数家长(79%)认为他们孩子的学校提供了支持孩子学习的适当资源,72%的家长对孩子在学校得到的支持总体上表示满意。然而,特殊学校患儿的家长更有可能认为孩子的学校提供了适当的资源来支持孩子的学习(p=0.034),并对孩子在学校得到的支持感到满意(p=0.02),而主流学校患儿的家长则不然。关于目前或期望的支持,对儿童反应的分析表明,他们希望在课堂之外获得支持性环境、考试/考试中的适应和增加可信赖成年人的支持。家长的反应包括促进儿童幸福感、环境适应、高成人支持比例以及考虑儿童沟通需求的方法。工作人员对最佳策略的看法包括为儿童提供高水平的成人支持、环境适应、使用多模式学习、调整沟通方式以及促进心理健康的方法。

结论

大多数患儿认为癫痫影响了他们在学校的学习和行为,包括导致特定的学习困难,但也对他们的情绪和身体幸福感产生了负面影响。特殊学校的家长对支持的满意度明显高于主流学校。儿童、家长和工作人员强调了一些支持措施,他们认为这些支持措施可以支持癫痫患儿的学习,也可以支持他们的情绪健康。

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