District Wins Manifestation Determination: Student's Premeditated Assault Not Caused by Keppra Side Effects

A 15-year-old student with Moyamoya Disease assaulted a classmate the day after the 2016 presidential election, and her parent argued the attack was caused by side effects of her anti-seizure medication Keppra. The ALJ upheld Sequoia Union High School District's manifestation determination, finding the assault was premeditated over several hours and driven by political and racial tensions — not impulsive drug-induced behavior. All of the student's requests for relief were denied.

What Happened

A 15-year-old girl with Moyamoya Disease — a rare, progressive brain artery disorder — received special education services at Woodside High School under the category of Other Health Impaired. She had been prescribed Keppra, an anti-seizure medication, for nearly four years. On November 9, 2016, the morning after the presidential election, she became angry at a classmate (referred to as Jane Doe) over what she believed was a racist social media post. Beginning before 9:00 a.m., the student spent more than three hours planning a confrontation: she inquired about Jane Doe's identity, visited the lunch area twice, gathered a group of friends to watch, sought the crowd's approval, calmly removed and handed off her glasses, and then attacked Jane Doe — punching, kicking, kneeing, and stomping on her. The incident was recorded on multiple cell phones. Jane Doe suffered a bloody nose, bruises, signs of a concussion, and had a section of hair pulled out.

Sequoia suspended the student and held a manifestation determination on November 18, 2016. Over the mother's objection, the team concluded the assault was not a manifestation of the student's disability. The student was moved to an alternative educational setting and expulsion proceedings were initiated. The mother filed for an expedited due process hearing, arguing that Keppra's known behavioral side effects — including aggression — caused or substantially contributed to the attack, and that the district committed multiple procedural violations during the manifestation determination process.

What the ALJ Found

The ALJ ruled entirely in favor of the district. Here is what the evidence showed:

The assault was planned, not impulsive. Keppra-related interpersonal violence — on the rare occasions it occurs — is always impulsive. The student's conduct was deliberate and premeditated over more than three hours, with clear conscious motives rooted in political and racial anger. This was fundamentally inconsistent with how Keppra affects behavior.
The student had taken Keppra for four years without any similar incidents. Her school records consistently described her as friendly, well-mannered, and positive toward peers. The absence of prior assaultive behavior while on Keppra strongly undermined the claim that Keppra caused this event.
The neurologist's opinion at hearing was not credible. The student's treating neurologist, Dr. Elbers, offered three different opinions over time — the first being that there was only a "slim chance" the disability and conduct were related, offered before litigation. Her later opinions (issued during expulsion and due process proceedings) grew progressively stronger and were found to have been shaped by private, previously undisclosed information fed to her by the mother and student's attorney. The ALJ gave little weight to these litigation-driven revisions.
Dr. Elbers herself admitted Keppra-related violence is always impulsive. Her own testimony that interpersonal violence from Keppra is rare and always impulsive undermined the student's argument, since nothing about this assault was impulsive.
There was one procedural defect, but it was harmless. The district obtained a medical opinion from Dr. Elbers before the manifestation determination but kept her identity anonymous at her own request to protect the doctor-patient relationship. The ALJ found this was technically a violation of the IDEA's requirement that all relevant information be shared with the full team — but ruled it harmless, because knowing Dr. Elbers was the source would have strengthened, not weakened, the district's position.
All other alleged procedural violations were rejected. The district did consider medication side effects, did obtain a medical opinion (from Dr. Elbers herself), did provide adequate prior written notice on a fully completed form, and did not ignore the advocates' input — it simply disagreed with a non-expert's cursory Google search. The ALJ also rejected a late-raised predetermination claim as both unsupported and improperly raised.

What Was Ordered

The November 18, 2016 manifestation determination — finding that the student's assault was not a manifestation of her disability — was affirmed.
All relief sought by the student was denied.
The district was declared the prevailing party on all issues.

Why This Matters for Parents

Document behavioral side effects in real time, not retroactively. The mother knew about aggressive incidents at home for years but never reported them to the doctor, the IEP team, or anyone else. When these incidents were disclosed only after the expulsion process began, the ALJ found them unreliable. If you believe your child's medication is affecting their behavior, report it to both their doctor and the IEP team in writing as it happens — contemporaneous documentation is far more credible than after-the-fact accounts.
A doctor's opinion formed during litigation carries less weight. Dr. Elbers's opinion evolved dramatically over three versions, with each revision coinciding with a new legal proceeding. The ALJ gave the most weight to her first, pre-litigation opinion. If you intend to rely on a medical expert, seek their written opinion early and independently — before attorneys are involved — to preserve its credibility.
Premeditation is a critical factor in manifestation determinations. Courts and hearing officers look closely at whether the conduct was impulsive or planned. If the evidence shows your child thought about and organized the conduct over time, it is much harder to connect it to a disability — even one with behavioral components. Understanding this distinction helps parents frame their arguments more effectively.
Anonymizing a medical source at an IEP or MDR meeting can backfire procedurally. The district withheld Dr. Elbers's identity to protect the doctor-patient relationship. While the ALJ called this a violation (though harmless here), it created confusion and distrust. Parents should know they have the right to know the sources of information relied upon at any IEP or manifestation determination meeting — and should ask directly.
A Google search by a non-expert will not carry the day. The student's advocate cited an informal Google search to claim Keppra commonly causes violence. The ALJ gave it zero weight. If medication side effects are central to your argument, you need a qualified medical or pharmacological expert — not internet research — to support your position.

What Happened

What the ALJ Found

The ALJ ruled entirely in favor of the district. Here is what the evidence showed:

The assault was planned, not impulsive. Keppra-related interpersonal violence — on the rare occasions it occurs — is always impulsive. The student's conduct was deliberate and premeditated over more than three hours, with clear conscious motives rooted in political and racial anger. This was fundamentally inconsistent with how Keppra affects behavior.
The student had taken Keppra for four years without any similar incidents. Her school records consistently described her as friendly, well-mannered, and positive toward peers. The absence of prior assaultive behavior while on Keppra strongly undermined the claim that Keppra caused this event.
The neurologist's opinion at hearing was not credible. The student's treating neurologist, Dr. Elbers, offered three different opinions over time — the first being that there was only a "slim chance" the disability and conduct were related, offered before litigation. Her later opinions (issued during expulsion and due process proceedings) grew progressively stronger and were found to have been shaped by private, previously undisclosed information fed to her by the mother and student's attorney. The ALJ gave little weight to these litigation-driven revisions.
Dr. Elbers herself admitted Keppra-related violence is always impulsive. Her own testimony that interpersonal violence from Keppra is rare and always impulsive undermined the student's argument, since nothing about this assault was impulsive.
There was one procedural defect, but it was harmless. The district obtained a medical opinion from Dr. Elbers before the manifestation determination but kept her identity anonymous at her own request to protect the doctor-patient relationship. The ALJ found this was technically a violation of the IDEA's requirement that all relevant information be shared with the full team — but ruled it harmless, because knowing Dr. Elbers was the source would have strengthened, not weakened, the district's position.
All other alleged procedural violations were rejected. The district did consider medication side effects, did obtain a medical opinion (from Dr. Elbers herself), did provide adequate prior written notice on a fully completed form, and did not ignore the advocates' input — it simply disagreed with a non-expert's cursory Google search. The ALJ also rejected a late-raised predetermination claim as both unsupported and improperly raised.

What Was Ordered

The November 18, 2016 manifestation determination — finding that the student's assault was not a manifestation of her disability — was affirmed.
All relief sought by the student was denied.
The district was declared the prevailing party on all issues.

Why This Matters for Parents

Document behavioral side effects in real time, not retroactively. The mother knew about aggressive incidents at home for years but never reported them to the doctor, the IEP team, or anyone else. When these incidents were disclosed only after the expulsion process began, the ALJ found them unreliable. If you believe your child's medication is affecting their behavior, report it to both their doctor and the IEP team in writing as it happens — contemporaneous documentation is far more credible than after-the-fact accounts.
A doctor's opinion formed during litigation carries less weight. Dr. Elbers's opinion evolved dramatically over three versions, with each revision coinciding with a new legal proceeding. The ALJ gave the most weight to her first, pre-litigation opinion. If you intend to rely on a medical expert, seek their written opinion early and independently — before attorneys are involved — to preserve its credibility.
Premeditation is a critical factor in manifestation determinations. Courts and hearing officers look closely at whether the conduct was impulsive or planned. If the evidence shows your child thought about and organized the conduct over time, it is much harder to connect it to a disability — even one with behavioral components. Understanding this distinction helps parents frame their arguments more effectively.
Anonymizing a medical source at an IEP or MDR meeting can backfire procedurally. The district withheld Dr. Elbers's identity to protect the doctor-patient relationship. While the ALJ called this a violation (though harmless here), it created confusion and distrust. Parents should know they have the right to know the sources of information relied upon at any IEP or manifestation determination meeting — and should ask directly.
A Google search by a non-expert will not carry the day. The student's advocate cited an informal Google search to claim Keppra commonly causes violence. The ALJ gave it zero weight. If medication side effects are central to your argument, you need a qualified medical or pharmacological expert — not internet research — to support your position.