Managing Migraine at School

Imagine trying to concentrate on a math problem while your head is throbbing, and bright lights feel like lasers piercing your eyes. This is a reality for many children, adolescents, and young adults who experience migraine. Migraine attacks are not just regular headaches. They are intense and debilitating episodes that can greatly impact school performance.^1,2

What is migraine?

Migraine can affect people of all ages, including children. Migraine attacks go beyond the typical headache. They often bring about symptoms like:^1,2

• Severe head pain
• Sensitivity to light and sound
• Nausea
• Visual disturbances known as auras

Migraine attacks can be triggered by a number of factors. For students, this might include:^1,2

• Bright lights and loud noises
• Caffeine
• Hormonal changes, like puberty and menstrual periods
• Screen time
• Stress
• Strong smells, like cigarette smoke
• Weather changes

How can migraine impact school performance?

When a migraine attack strikes, it can disrupt classroom concentration, participation, and attendance. If a student needs to stay home or miss class because of migraine, this might lead to falling behind on schoolwork. Frequent absences might mean having to make up missed classes, homework assignments, and tests. Migraine symptoms also make socializing and participating in sports and extracurricular activities hard.¹

In addition, the fear of a migraine attack can cause stress and anxiety, which are migraine triggers in and of themselves. This can further impact a student's ability to perform well in school.¹

How can you manage attacks at school?

So, what can students and parents do to manage migraine effectively while keeping up with school? The first step is to communicate with teachers, school nurses, and/or administrators about a student's condition. Tell them about triggers, symptoms, and accommodations that might be needed during a migraine attack.^1,4

For college students, the situation is a bit different. Some colleges have policies about class attendance. Some professors have their own rules about missing classes or exams. Look at the policies during enrollment and check with professors for each class. If you live in a dorm, consider speaking with your resident advisor (RA) in advance so they are aware of your history with migraine.

Here are some other strategies parents and students can do to manage migraine at school:^1,3,4

Strategy #1

Create a migraine kit. Pack a small bag with essentials like pain relief medicine (if prescribed and allowed in school), sunglasses, a water bottle, a snack, and any comfort items. Having this kit on hand can make managing migraine attacks at school easier.

Strategy #2

Check the school’s medicine policy. Most schools now have a "zero tolerance" policy regarding not just illicit drugs, but also over-the-counter and prescription medicines children and teens may need to take at school for their migraine.

If your child’s school allows students to keep their medicines with them and take them as necessary, it is best to leave them in the original prescription container with the label intact. Those labels tend to tear and wear when they are carried around, so protect them by putting a piece of clear tape over them.

Strategy #3

Designate a recovery space. Work with the school to identify a quiet and comfortable space where the student can rest during a migraine attack if needed.

Strategy #4

Ask for flexible deadlines. Request that teachers or college professors provide flexibility with deadlines during and after a migraine attack. This can reduce stress and help students catch up on missed assignments.

Strategy #5

Stay hydrated. Dehydration is a common migraine trigger. Encourage your child to carry a water bottle and drink water throughout the day.

Strategy #6

Be mindful of triggers. If you know what triggers migraine attacks for you or your child, take steps to reduce them if possible. For example, if bright lights trigger attacks, wear tinted glasses or use screen filters on electronic devices to reduce light sensitivity.

Strategy #7

Keep a migraine diary. Because triggers play such a large role in migraine attacks, consider keeping a migraine diary. This can be a helpful way to identify patterns and pinpoint specific triggers that might be contributing to migrains. By identifying these triggers, students can take proactive steps to avoid or manage them.

Strategy #8

Adopt healthy habits. Encourage students to maintain a healthy lifestyle. A regular sleep schedule, regular, balanced meals, staying hydrated, and keeping stress levels low can help prevent migraine triggers.

What are 504 plans and IEPs?

If migraine greatly interferes with a student's education, it might be necessary to explore 504 plans and individualized education programs (IEPs). These are legally mandated plans that provide accommodations and support for students with disabilities, including chronic health conditions like migraine disease. They are free and do not cost the parent or student anything.^3,5,6

504 plans

A 504 plan comes from Section 504 of the Rehabilitation Act. It ensures that a student with a qualifying disability (such as migraine) receives accommodations that allow them to get a free education. Accommodations might include:⁵

• Access to a quiet space for rest
• Flexibility with attendance
• Extra time on tests or assignments

504 plans do not change what a student learns. Instead, they address any obstacles that might prevent learning. 504 plans should be reviewed yearly in case changes need to be made.⁵

Each school handles 504 plans differently. Speak with your school’s administrator or 504 team about how to go about setting up a plan for your child. They will work with you to build a plan that is agreeable for everyone.⁵

Individualized Education Programs (IEPs)

IEPs are more comprehensive than 504 plans. An IEP is tailored for students who require specialized instruction due to a disability.⁶

While migraine disease alone might not need an IEP, it can be included as part of a broader plan if they greatly impact a student's educational performance. IEPs can be offered in the general school setting.⁶

Before an IEP can get started, you will need a referral and evaluation. This involves the student, parent, teacher, and healthcare professional (usually the student’s doctor or a school counselor). The evaluation process can include things like:⁶

• A conference with the parent(s) or guardian(s)
• A conference with the student
• Watching the student while in class to help assess performance, behavior, and their ability to complete tasks

Talk with your school’s administration about whether an IEP is right for your child and what they can offer.^3,6

How should you communicate with teachers?

Open communication is key. Tell your child’s teachers, school nurses, and/or administrators about triggers, symptoms, and possible accommodations that might be needed during a migraine attack.^1,3

Migraine can be a tough challenge for students. But with the right strategies and support, students can achieve academic success.^3,5,6