A-Level Rest Breaks

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Carey1792

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Hi,

Our daughter is currently taking her A-Levels.

She does the exams in a room on her own and allowed rest breaks but this is limited to a maximum time of 30 minutes. After 30 minutes she either had to carry on regardless of how she feels or abandon the exam - a few days she opted to carry on although not able to work to her full potential. We have been told by the college that the 30 minute limit has been the case for a few years having been set by the JCQ (Joint Council for Qualifications).

I realise that exam conditions change over time however, is anyone else who is taking A-Levels this year or perhaps has done the past few years been limited to 30 minutes or has the maximum time for rest breaks been longer/unlimited? (her GCSE arrangements were for unlimited breaks - although COVID meant they didn't happen)

I can find no information about this 30 minute maximum rest break (on the JCQ website or anywhere else) which seems to us have been arbitrarily made up.

Thanks for passing on your experience.
 
You can find no information because it isn't the case! Your daughter should get as much time as she needs to complete the exam. The clock will be stopped when, for example, she needs to treat a hypo, and should only start again when she has fully recovered. This won't necessarily be when BGs return to in range because the brain is often the last organ to recover.
 
Carey1792 said:
Hi,

Our daughter is currently taking her A-Levels.

She does the exams in a room on her own and allowed rest breaks but this is limited to a maximum time of 30 minutes. After 30 minutes she either had to carry on regardless of how she feels or abandon the exam - a few days she opted to carry on although not able to work to her full potential. We have been told by the college that the 30 minute limit has been the case for a few years having been set by the JCQ (Joint Council for Qualifications).

I realise that exam conditions change over time however, is anyone else who is taking A-Levels this year or perhaps has done the past few years been limited to 30 minutes or has the maximum time for rest breaks been longer/unlimited? (her GCSE arrangements were for unlimited breaks - although COVID meant they didn't happen)

I can find no information about this 30 minute maximum rest break (on the JCQ website or anywhere else) which seems to us have been arbitrarily made up.

Thanks for passing on your experience.
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There are a few teachers here so they may have an answer but otherwise you could contact the Diabetes UK helpline tomorrow, the number is at the top.
 
Can you give a bit more background as to what's going on with her blood sugar such that she needs a break at all? I assume she's able to eat/drink something sweet while doing the exam if she needs it? She's in her own room so presumably can have a CGM alarm set too?
 
We have a letter from the hospital which states that breaks need to be a minimum of 45 minutes AFTER blood sugars have returned to normal, as this is how long it takes the brain to recover. No problem for GCSEs so if people get nasty about A Levels then the letter will get whipped out again (plus DSN if necessary). Could you maybe ask for something like this to see if it helps?
My daughter didn’t need breaks in the end but it’s a comfort to know that they are there if necessary. She did have a room on her own and extra time (for autism), both of which were very useful!
 
Sally71 said:
a minimum of 45 minutes AFTER blood sugars have returned to normal, as this is how long it takes the brain to recover.
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I would imagine this is rather specific to each person, 45min sounds like a very long time, I wonder where they came up with this number?

In my experience of doing exams without any allowances for taking breaks and the like (GCSEs, A-Levels, University), and no CGM, I never needed anything like this long if I did feel I'd let myself go low (and I always needed extra food during exams, I'd always eat beforehand and during the exam.) I'd have thought that 5min would be closer to the mark if you have fast acting carbs available and your blood glucose is not see-sawing when you start (i.e. not massive amounts of IoB). Obviously we're all different though.
 
@SimonP I think the 45 minutes is for full function. Yes, we often feel better well before that but I think there are tiny deficiencies still correcting themselves that we’re not aware of. That’s why they have that rule for driving. In an exam where every point counts, it’s sensible to wait until everything is firing on all cylinders.

Also, if it were to say 20 minutes and someone had a bad/persistent hypo, they might be pushed to re-start before they’re ready. Better too long than too short a time 🙂
 
Some years ago there was an International (European) consortium on diabetes* and one of their reports stated for a PROVEN MEDICAL FACT that any hypo that got down to 3.3 absolutely 100% affected the brain whether the person suffering it, or any observer, medically qualified or not, thought it did or not, cos they'd repeatedly proved it clinically.

I'm not aware there has been any such repudiation of this, since.

* The gang that Dr David Cavan was recruited to, after all his involvement with BERTIE, where he left BDEC to go to. (In Strasbourg or somewhere else in that part of the world?)
 
SimonP said:
I would imagine this is rather specific to each person, 45min sounds like a very long time, I wonder where they came up with this number?

In my experience of doing exams without any allowances for taking breaks and the like (GCSEs, A-Levels, University), and no CGM, I never needed anything like this long if I did feel I'd let myself go low (and I always needed extra food during exams, I'd always eat beforehand and during the exam.) I'd have thought that 5min would be closer to the mark if you have fast acting carbs available and your blood glucose is not see-sawing when you start (i.e. not massive amounts of IoB). Obviously we're all different though.
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Well yes it probably does depend a bit on how low you go, how quickly etc, but I thought it was generally accepted that it can take anything up to 45 minutes for the brain to regain full function. And you don’t want to be forced to resume doing something as important as an exam if your brain isn’t quite there yet. Pretty sure 45 mins is the law for how long you have to wait to drive again after a hypo, so why not for exams too?
 
Fair enough, I understand needing to potentially leave a long period for the extreme cases (for driving I guess it's to avoid someone undertreating a hypo and then going hypo again in short order), I was simply expressing my opinion that I don't really think that much time is necessary for an exam in order to be back and firing on all cylinders unless you really have messed up your dosing/food/injected into a blood vessel/etc.

I would hope anyone who goes low in an exam treats it straight away but then doesn't just sit there waiting for 45min because that's the "time required to be back at full cognitive function".

With that said, it's my opinion, and if there is research backing this 45min up I'd be more than happy to read it (though would still question whether that long is actually necessary based on personal experience.)

Of course I may well be wrong, YMMV, we're all different, etc.
 
SimonP said:
I would hope anyone who goes low in an exam treats it straight away but then doesn't just sit there waiting for 45min because that's the "time required to be back at full cognitive function".
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As @Inka said above, we may not be aware that our brain is still affected, so rushing to carry on with an exam just because you perceive that you feel Ok isn’t sensible.
I went for a walk today, in the heat. I hadn’t 'really messed up my dosing or food, or injected into a vein', in fact I'd been extra careful to lower basal this morning, and knock off a unit at lunchtime. But the excess energy expended and the heat made me unexpectedly hypo, (much in the same way that I can hypo if I’m at the computer concentrating hard on something). After treating with jelly babies, I carried on walking, but every now and again for the next ten minutes or so, one leg wouldn’t behave as I’d expect, causing a stumble, and after about 20 minutes I was only just holding ground in the mid 3s, rather than getting my BG back over 4, so I had to retreat the hypo. After that, it felt Ok to me, but I think had I been doing a walking competition, I’d still have been losing ground even when I felt I was walking better. So I can only assume it would be the same for my brain. You often only get one shot at getting the grade you need to get into you Uni of choice, or whatever, so why make it harder for someone?
 
If you're allowed to take it then fair enough do so, the original post was talking about 30min being available, my suggestion is simply that this should be enough time. I'm obviously in the minority here, I'm sorry I added anything to the thread.
 
Don't be daft @Simon P ! You have demonstrated exactly what the European Consortium said ie ' always affects the brain - whether you think it has or not!'
 
Carey1792 said:
Hi,

Our daughter is currently taking her A-Levels.

She does the exams in a room on her own and allowed rest breaks but this is limited to a maximum time of 30 minutes. After 30 minutes she either had to carry on regardless of how she feels or abandon the exam - a few days she opted to carry on although not able to work to her full potential. We have been told by the college that the 30 minute limit has been the case for a few years having been set by the JCQ (Joint Council for Qualifications).

I realise that exam conditions change over time however, is anyone else who is taking A-Levels this year or perhaps has done the past few years been limited to 30 minutes or has the maximum time for rest breaks been longer/unlimited? (her GCSE arrangements were for unlimited breaks - although COVID meant they didn't happen)

I can find no information about this 30 minute maximum rest break (on the JCQ website or anywhere else) which seems to us have been arbitrarily made up.

Thanks for passing on your experience.
Click to expand...
I am not sure where the 30 min has come from, and whether it is a figure that the school has used as an interpretation of the rules. In the light of the requirement to wait 45 min before driving again after a hypo has recovered to in range, I have always encouraged students to take as long as they need. In my experience they always wanted to get back o what they are doing, but are likely not to perform as well after a hypo. I would certainly recommend contacting the helpline for more advice.

It would also be worth a review of her current management over this weekend before her next paper. Is she wearing a sensor? If so has it got alerts before a hypo turned on? If so JBs should help head off a hypo. If she is going high can she adjust her insulin doses prior to the exams.

I know that it is difficult to predict what will happen to BGs with stress. Some people go up and others go down. The joys of Diabetes!
 
Thank you everyone for the feedback so far.

Our daughter has an omnipod and libre 2. Her blood sugars are usually pretty well managed. However, pre exam nerves can send her blood sugars either way (when I did the OP it had been a hyper and then yesterday a long hypo which delayed the start - at least the delay does not come into the 30 mins).

I have spoken to people who work for the exams boards she is using. They say they do not require a 30 minute limit.

We shall continue to speak to the college over the coming days. Even if we can't get the rule changed in time for our daughter we are determined to make sure next years group are treated correctly.
 
Carey1792 said:
Thank you everyone for the feedback so far.

Our daughter has an omnipod and libre 2. Her blood sugars are usually pretty well managed. However, pre exam nerves can send her blood sugars either way (when I did the OP it had been a hyper and then yesterday a long hypo which delayed the start - at least the delay does not come into the 30 mins).

I have spoken to people who work for the exams boards she is using. They say they do not require a 30 minute limit.

We shall continue to speak to the college over the coming days. Even if we can't get the rule changed in time for our daughter we are determined to make sure next years group are treated correctly.
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I am glad that your daughter took time to settle before she started after the hypo.

I suspect that the time limit implemented in the school May have more to do with the time that the invigilator has available/paid for, or the knock on of a delay for their exams following on. Well done for persisting with this for future students.

If the school’s time limit that they set had any direct impact one of your daughter’s exams do write a formal letter and get it logged with the school, so that special considerations can be made. In the letter it would be useful to explain what happened, and perhaps get it checked by her PDSN. It is better done now, rather than waiting for results. It then does not appear to be logged just as a result of not being happy with the grade. Also keep a copy in case it is needed in correspondence with university/college/workplace if results prevent her from achieving her plans.
 
The advice when driving is to wait 45 minutes after recovering from a hypo before restarting.
Seems like it's a standard length of time.
I agree I "feel" better before then but that doesn't mean my brain will be firing on all cylinders
 
helli said:
The advice when driving is to wait 45 minutes after recovering from a hypo before restarting.
Seems like it's a standard length of time.
I agree I "feel" better before then but that doesn't mean my brain will be firing on all cylinders
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The NHS, any charity which has anything to do with diabetes and the DVLA all say the same, so there must be some scientific background to it, DSN told us as if it was a fact. So it makes sense to apply it to exams too. If the school don’t want to allow suitable breaks then they are discriminating.
Also, what if the hypo itself goes on beyond 30 minutes? My daughter had a few horrendous ones when she was younger, 3.6, have some glucose and wait 15 minutes, test again and it’s dropped to 3.2, more glucose and another 15 mins, dropped to 2.9 and daughter now feeling absolute rubbish and starting to get a bit panicky, more glucose and another 15 minutes and we’re at 3.6 now yay going in the right direction at last but still not over 4, etc etc. It can happen, and 30 minutes in that situation is nowhere near long enough. Exam breaks should be as long as takes you to fully recover.
 
She should tell anyone NOT as if it is a fact - she should tell everyone because it IS A FACT. 🙂
 
@Carey1792, Please accept my apologies for 'coming to the party' so late but I've only joined today.

I'm guessing that your daughter has finished her exams by now, and I pray that she received the grades that she was expecting.

As a point of interest, for anyone else that finds themself/ves in a similar situation, Diabetes.org.uk do offer a .pdf file entitled Type 1 diabetes and exams, which can be downloaded here: https://www.diabetes.org.uk/resources-s3/2018-11/1201C_Type 1 diabetes and exams_DIGITAL.pdf

It contains some very valuable information.

Edit: I've just come across a webpage from Oxford Cambridge and RSA website where there's an article entitled "Supporting students with diabetes in the exam room", which also has some valuable links in it, which can be viewed here: https://ocr.org.uk/blog/supporting-students-with-diabetes-in-the-exam-room/

PROBABLY the best link is one to the JCQ (Joint Council for Qualifications), which has various links to downloadable .pdf (Portable Document Format) files, and the link offered above. You can download the relevant files here: https://www.jcq.org.uk/exams-office...ecial-consideration/regulations-and-guidance/
 
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