The Case of Daydreaming or a Falling Sickness?

In 2.5 years of my practice as an educational psychologist, majority of the referrals i received had only concern: "Child's weak in academics" or "Child takes no interest in academics" or if the matter has worsen: "Child has failed in previous Grades". Sometimes these complaints are accompanied by behavioral issues- which are bound to happen because if child is not comprehending anything in the classroom, he has to do something to "spend" his time in class/school. As a psychologist to figure out the cause and then to help a child, takes some time and a lot of effort. 

Recently, i received a referral about a child who needs counseling with his academics as well as his punctuality. His academics were weak in the grade he was, and got worse when due to irregularity and (Ofcourse) weak academics he was detained in the same grade. He was absent in most of the days entire year. However, his parents came to request on his behalf for his promotion. His parents who hardly came entire year despite several calls of teachers, seems very concerned as soon as child was detained (Natural, right?)

According to parents, child had an epileptic seizure almost 6 years ago, he had his treatment followed by termination stage. According to them it's time that he's fully recovered; However, the news of detention might pull his seizures back and they were afraid he might relapse. (Parents reassured several times that child has completely out grown his seizures and has been stable since a very long time). Provided that, there was no record of any medical application, test reports or any written/verbal form of communication with any teachers/headmistress (even of previous grades) where his medical issue/history was conveyed. Listening to parents' concern it was mutually decided that next class' burden might stress him even more, so I as a psychologist will help him understand his current situation and take a decision himself.

I had a meeting with his teachers who reported that his irregularity and being lost suddenly in class is a major concern. Irregularity wasn't even answered even when parents came, except a vague answer: "Flu, fever, seasonal stuff etc". His sudden loss in class during lecture, or suddenly losing track while doing written work was questionable. His past record showed a gradual decline, probably an aftermath of what happened 6 years ago? Could it be due to the medication he was on? If yes, He's not on medication any more, is it the side effects? Is it the relapse God forbid? If yes, What kind?

Caesar's seizure referred as falling sickness (Shakespear's character) is not a sign but a moment that collect the multiple meanings we may take of a disability. 

After probing into further details, and going in details myself i found that the child was suffering from what we call "Absence Seizures" also known as petit mal seizures. They are a type of generalized onset seizures (begins in both sides of the brain simultaneously). These type of seizures lasts from 1-30 seconds, beginning and ending abruptly. Their occurrence is so brief that they might be mistaken for daydreaming and goes undetected for a really long time. In a day, a child might have 10, 20, 50 or even 100 absence seizures. They're most common in children from age 4 to 14, they outgrow by the age of 18 and do not need medication as an adult. However if the onset is 10 or above 10 years of age, then even as an adult medications are recommended

Absence seizures are characterised by sudden, brief loss and returning to consciousness right away. A child may look like staring blankly into space for few seconds, causing lapses in awareness. No first aid is needed for absence seizures. These seizures do not cause any long term problems. Children with these seizures are otherwise normal however, they're a trouble in learning and concentrating in academics and school generally. Furthemore, complications of Social isolation or behavioral problems are common. This is why prompt treatment is important. 

A child may have absence seizures repeatedly for years before being headed to a doctor for medications. The child may have "staring spells" without thinking of them as a medical problem. This however affect child's ability to perform in academics. An EEG is a test most often used to diagnose these seizures, followed by anti-seizure medicines. Child requires proper sleep, rest and diet, support in managing the stress of academics or social aspect of his life and exercising regularly. 

You and I, are in no position to diagnose anyone with these seizures, however having knowledge about problems a child in your class, home, or neighbour might have- will not only lessen his distress but also guidance in right direction for consultancy will also be fruitful. These absence seizures are mostly mistaken with daydreaming (note that a child from his day dreaming might come back any second if called upon, but a seizure cannot be interrupted). Several of my students in university asks for internship venues to have an exposure- Let me spoil it for you: You might not get to see atypical cases internship or you might get to see such a case right as your first case in a new job. Internships/Exposure does help you a lot only if you're equipped with knowledge enough and deep down inside a concern to help people out there.

For everybody out there, It's not your fault that the child has a problem. It's dawned upon you to go out, seek help and be out of stigma "Log kia kahenge". Many a times parents are afraid to speak about since people might say their only son or a daughter/Children are defected. What's pathetic is to make sure that a child gets disability by not given necessary help out of the fear "Log Kia Kahenge".

Seek help, Make environment favorable for your child's health and academics. 

[PS., Due to confidentiality i cannot reveal detailed aspects of the case. The primary purpose was to help spread awareness about "Absence Seizures". You may ask questions if any, in comments below]