PANS Impacts Multiple Areas of Learning

PANS is characterized by a cluster of symptoms occurring concurrently.

PANS symptoms impact multiple areas of learning, specifically academic, cognitive, behavioral, and physical. PANS is essentially a spectrum disorder; some PANS students will be affected more severely than others and some will have a small concentration of symptoms while others will exhibit many symptoms across all domains.

“Our special education processes, often, rely on the assumption that students will make progress throughout the year. In contrast, students with PANDAS or PANS may demonstrate rapid shifts in their social, emotional or academic functioning as their systems react to, then recover from, illness. Teachers may, understandably, be baffled that the student who was passing math last week is now failing the class and acting out daily. Frequently, students with PANDAS or PANS experience such heightened anxiety that it is difficult to attend school at all, and their immune systems may not be able to tolerate exposure to peers during the height of cold and flu season.”

Little Known Disorder Underscores Education Needs Patricia Rice Doran (Baltimore Sun-2014)

Academic/Cognitive Symptoms

  • Loss of math skills
  • Decline in handwriting skills (dysgraphia)
  • Reduced concentration
  • Perfectionism
  • Work refusal
  • Reduced memory: working memory and holding information
  • Avoidance of high sensory settings
  • Decline in creativity
  • Inability to make decisions
  • Reduced ability to focus
  • Poor organizational skills
  • Time management problems
  • Difficulty in planning & prioritizing
  • Visual and spatial processing difficulties
  • Processing delays

Physical Symptoms

  • Restricted food intake: fear of contamination, choking, sensory
  • Tics: Vocal and/or motor
  • Urinary frequency and involuntary urination
  • Unusual gait
  • Balance issues
  • Hair pulling and skin picking
  • Balance issues
  • Dilated pupils
  • Stomach pain
  • Fatigue and looking tired
  • Hallucinations
  • Selective mutism
  • Frequently sick
  • Low tone
  • Chapped Hands or Lips/Mouth

Behavioral Symptoms

  • Obsessive thoughts: rigidity, perfections, inappropriate
  • Compulsive actions
  • Anxiety: separation, school refusal, general
  • Depression & emotional lability
  • Aggression: oppositional behavior, rages
  • Behavior regression: immaturity, baby talk
  • ADHD: poor impulse control, fidgeting, outbursts
  • Sensory issues: defense and seeking.

Remember the Student’s Perspective
One of the pitfalls of writing a list of accommodations for a student is that the student’s perspective is often forgotten. Imagine being a student who enjoyed going to school as much as the next student, understood the curriculum, had friends, feels healthy, and had a full life outside of school too. Then imagine losing all of it in a blink of an eye. It is terrifying, disturbing and disorienting. Schools must support the student’s emotional well being as well as academics. Make school a safe place for these children. Understand the student’s limited capacity and that any participation and effort should be encouraged and applauded.