504 Plan Basics for PANS PANDAS

504 Plan Basics aspire pans pandas

Read Getting Started with 504 & IEP Plans first.

Many PANS PANDAS kids will qualify for a 504 plan. A 504 plan will provide accommodations for the educational program within the regular classroom. A 504 plan is a set of accommodations within the classroom environment to help your child with a disability, PANS PANDAS, access the regular curriculum by removing learning barriers that significantly limit daily activities. Accommodations do not alter the content or expectations of the established curriculum or who provides the education. Instead, accommodations change how the student learns and completes the curriculum by providing support. On occasion, 504 plans may provide limited services like occupational or speech therapy, but often, those services fall under an IEP plan with specific goals. 

Qualifying Impairments for a 504 plan

To qualify for a 504 plan, the student must have a physical or mental impairment that affects or limits any of their abilities (listed below in italics). Note: below the qualifying impairments, we provide examples of they may apply to PANS PANDAS but it is not all-inclusive.  It may be helpful to review PANS PANDAS Symptoms and how PANS impacts multiple areas of learning.

  • Walk, Breathe, Eat, or Sleep
    • Walk: Tics & adventitious movements may affect walking.
    • Eat: Severely restricted food intake is a major PANS symptom.
    • Sleep: PANS may affect sleep due to night terrors, lack of REM sleep, separation anxiety, or long bedtime rituals due to OCD.
  • Communicate, See, Hear, or Speak
    • Speak: a small percentage of PANS patients have selective mutism. Tics may prevent a student’s ability to speak in typical patterns.
  • Read, Concentrate, Think or Learn
    • Concentrate: Many patients with PANS have significant brain fog. ADHD-like symptoms are common.
    • Think: Symptoms of OCD, a major PANS criteria, can significantly impact a student’s ability to think rationally and clearly
    • Learn: Processing may be delayed. Executive functioning skills can be impacted. Developmental regression is a symptom.
  • Stand, Bend, Lift, or Work
    • Work: Tics can impair the ability to perform basic learning skills. Dysgraphia can hinder a student’s ability to write.


Accommodations must give the student meaningful equal opportunities, consider their functional limitations, and offer different ways to show what they know. For example, a student who uses a wheelchair but does not need academic support would have a 504 plan. Or in the case of a PANS PANDAS student, handwriting changes may warrant needing to type their responses or speak them into a recording device, but the curriculum and the content of the work are graded the same. For more examples, see Accommodations for Symptoms and Accommodations Across All Grade Levels & All Levels of Need.

Typical accommodations provide changes to

  • Instruction – i.e., Additional check-ins to assess understanding
  • Presentation of Curriculum– i.e., Class notes – Outlines – Long assignments further divided into manageable parts
  • Environment – i.e., Anytime pass to visit a designated safe space and person as needed to calm OCD, anxiety, aggression – Private testing space – Movement breaks – Excused absences, early dismissal, late arrival

A 504 Plan May Include

  • Accommodations– Supports to help the student access the curriculum and learn, i.e., extended time on tests and projects, shortened assignments, anytime pass, breaks, attendance adjustments (https://aspire.care/schools-educators/pans-significantly-impacts-attendance/)
  • Assistive Technology – Provide tools that help students work around barriers to learning, i.e., calculators, fidget tools, lined paper, recording devices, math manipulatives, graphic organizers
  • School Services – Assist the student access general education, i.e., occupational therapy, transportation services, tutoring

Assessing for a 504 plan

Parents, guardians, doctors, therapists, or teachers can request that the school assess the student for a 504 plan. The academic advisor, guidance counselor, or principal sets a meeting with the 504 planning team. The team often consists of parents, principal/vice-principal, teachers, and possibly social a worker, guidance counselor, nurse, or psychologist. The team reviews medical and academic records and interviews the parents and the student to determine eligibility. If there are disagreements about eligibility or the plan, parents can write appeals to the district or U.S. Office for Civil Rights (OCR).

Once a 504 plan is determined, individual teachers are responsible for its implementation. However, a guidance counselor or other staff may help manage its implementation. Planning teams should review the 504 plan annually or more often as needed. Frequent reviews may be necessary for students with PANS PANDAS whose symptoms can relapse with exposure to a new trigger or remit once treatment has taken effect. The termination of 504 plans happens when the student is no longer affected by the impairing disability, accommodations are not needed to support deficits, and the student can learn in general education with no support. 

See Sample Letters to Request Assessment for a 504

Special Education Articles

Learn more about PANS PANDAS in the school setting. PANS PANDAS is a medical condition in which symptoms affect a student’s ability to attend school and learn.


Written in conjunction with ASPIRE Education Committee and Shara Virlan.

Sharla has 14 years of classroom education. She also has a child with PANDAS. She runs the PANS PANDAS Education Facebook page.

  • S Elementary Ed. with a minor in Early Childhood ED.
  • Masters in Educational Leadership
  • License in Reading Instruction
  • 14 years of teaching experience (Grades K-3)
  • 1 year of Literacy Coaching

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