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  • PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are a broad spectrum of acute onset neuropsychiatric conditions that may include OCD, tics, severe eating restrictions, cognitive, behavioral and neurological symptoms.
  • Triggers may include strep throat, influenza, hand foot and mouth disease, chicken pox, pneumonia, allergens, anxiety, trauma or other environmental factors.
  • In simple terms, instead of becoming ill with a sore throat, sore ears, temperature, etc…, the immune system attacks a small area of the brain called the Basal Ganglia which controls voluntary motor movements, procedural learning, habits and emotion.
  • Some children suffer debilitating flares while others function enough to continue to go to school.
  • PANS/PANDAS symptoms may relapse and remit. During subsequent flares, symptoms can worsen and new symptoms may manifest. Children are often misdiagnosed with psychiatric problems, ASD or ADHD.
  • Source: PANS/PANDAS UK School Information Sheet

Supporting students with PANS/PANDAS

Symptom Reasonable Adjustment
Anxiety: Difficulty separating from main carer which may result in poor attendance Flexibility, shorter days, earlier or later starts
Underachievement: Deterioration in school performance. E.g. Cognitive changes, memory issues, dysgraphia, Maths deterioration, difficulties in Art and loss of motor skills. Refusal to do homework Extra time and support, laptop use if appropriate and homework accommodations
Sensory Abnormalities: Inability to wear certain items of clothing/footwear, increased sensitivity to light and sound Accommodate the child’s heightened sensory issues enabling them to attend school and provide a ‘safe’ place to go if overwhelmed
Perceptual & Physical issues: Tics and bodily movements affecting fine and gross motor skills Provide understanding and acceptance
Incontinence or urinary frequency New onset enuresis for a child who was toilet trained or a constant need to leave the classroom to use the bathroom. Accommodate with discretion the child’s need to have frequent visits to the bathroom.
Restricted food or water intake: Inability to eat normally or restrictive diet Allow child to have access to water and snacks if required
Social Issues with peers: Victim of bullying Education of peers, awareness and support
OCD: Need to carry out compulsions Awareness and support

Further Reading