Individuals with Seizure Disorder

Epilepsy and seizures affect 2.3 million Americans of all ages and 10 percent of the American population will experience a seizure in their lifetimes. A report from the Epilepsy Foundation found that approximately 181,000 new cases of seizures and epilepsy occur each year. A seizure is defined as an episode of abnormal motor, sensory, autonomic, or psychic activity as a consequence of sudden excessive electrical discharge from cerebral neurons.

Individuals with seizure disorders may be affected in one or more of the following ways:

Some may experience full seizures involving loss of consciousness and involuntary movements.
Others may experience lapses of consciousness, which are sometimes referred to as "staring spells."
The period immediately following a seizure will vary, depending on the type, duration and intensity of the preceding seizure.
- Symptoms during this time may last anywhere from 15 minutes to 2 or more hours and include confusion, fatigue, muscle weakness, headache, pain in the tongue or cheek (if inadvertently bitten during the seizure), and other various sensory impairments.
- Many individuals, specially those with complex partial seizures or temporal lobe epilepsy, are affected by memory deficits following a seizure.

Medication to control the seizures also has side effects that vary considerably depending on which drug therapy is implemented. Side effects can involve:

Impaired hand-eye coordination,
Blurred vision,
Decreased ability to concentrate,
Sleepiness,
Vertigo, and/or
Disorientation.

In addition, some medications may cause excessive drowsiness or fatigue, particularly in the early hours of the morning. The individual may also experience social isolation due to various reasons, such as the social stigma associated with seizure disorders, the embarrassment of undesirable attention and/or the lack of control during a seizure.

The educational potential is high for those with seizure disorders and is not diminished by the frequency of convulsions (assuming extensive memory damage does not occur.) Instructors should be aware, however, that the way in which course materials are developed and presented may inadvertently pose challenges to individuals with seizure disorders as well as those who have cognitive disabilities, such as head injuries or psychiatric disabilities. When minor memory deficits are present, difficulties in learning may be created when there is:

Lack of clear or consistent design in presentation;
An unorganized website;
An assignment in an unfamiliar format;
A nondescript syllabus;
Video, audio lectures or written notes which mix extraneous facts with required information; and
Rigid time restrictions, such as timed assignments and tests, specific appointments for live interaction, or time-responsive websites.

Accommodation Suggestions

There are several accommodations that can be taken to assist individuals with seizure disorders or cognitive disabilities. These include providing:

Coherent formatting of instructional materials;
Study aides and review sheets covering key concepts;
Text alternatives as a reference for auditory input (e.g. text outlines or notes for oral lectures);
Text versions of oral directions;
Untimed tests and examinations;
Text copies of key points or issues covered during onsite discussions;
Tests that use matching, fill in the blanks with a word bank, multiple choice, or true/false (these formats focus on seeing what the individual has learned instead of one's ability to rapidly retrieve and organize specific information); and
Formula sheets for math, science or economics from which the individual can select and apply the formula to the problem to be solved.

Photosensitive Epilepsy

The use of certain visual or audio frequencies can sometimes trigger seizures. According to the Epilepsy Foundation of America, over 100,000 people have a condition known as photosensitive epilepsy. For individuals with this condition, flashing light between the frequency of 2 - 55 Hertz (Hz) is most likely to induce seizure. A Hz is defined as "one cycle per second"; thus, 2 Hz is twice a second and 55 Hz is fifty-five times a second.

Tip: An easy way to determine if an image is blinking too fast would be to tap your foot and count "one one thousand, two one thousand, three one thousand." Then, count the number of times an image flashes on the screen. If the image flashes faster than your count, it may be a problem for a user with photosensitive epilepsy. If it flashes slower, it is probably okay.

Other potential hazards for individuals with photosensitive epilepsy include prolonged exposure to television or computer monitors, various alternating patterns of bright colors, and high-pitched sounds. Specific accommodations for individuals who experience photosensitive epilepsy include:

Providing information in an alternative audio format.
Avoiding, removing or turning off animations, blinking text, offensive color patterns and/or certain audio frequencies. But, if elements that flicker are used, they should change at a frequency of less than twice a second (2 Hz) or greater than 55 times a second (55 Hz).
Offering flicker free monitors such as an LCD display or flat screen, a glare guard and/or non-glare glasses for on-site labs or classes.
Allowing several breaks to be taken if they are expected to intake visual information for a prolonged time.

The next page will discuss Section 508 of the Rehabilitation Act and its relevance to accessibility of distance education.

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Section 508