Understanding PANS and PANDAS: A Guide for Educational Psychologists
Introduction
PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) are complex, post-infectious medical conditions that can profoundly affect a child’s or young person’s emotional, cognitive, and behavioural functioning.
Children and young people with PANS or PANDAS may experience a sudden and dramatic shift from thriving in school to struggling with a wide range of challenges. These can include the onset of obsessive thoughts and compulsive behaviours, tics, heightened anxiety, emotional regression, irritability, eating disturbances, and sleep difficulties. In some cases, severe and unexpected special educational needs may emerge.
Families often face extremely difficult experiences as they navigate the impact of these symptoms. A significant disconnect exists between the severity of what children and young people are going through and the limited recognition, inconsistent diagnosis, and lack of coordinated support available. Outdated perceptions and unclear clinical pathways further compound these challenges.
As awareness grows, Educational Psychologists (EPs) are increasingly encountering pupils with a diagnosis or suspected diagnosis of PANS or PANDAS. However, responses across educational and clinical settings remain variable and fragmented.
At Psychology Direct, we’re committed to supporting Educational Psychologists with the knowledge and resources they need to understand the full spectrum of needs affecting children and young people. That commitment includes raising awareness of conditions that remain under-recognised within educational settings. We’re pleased to share this guest blog from PANS PANDAS UK. This article aims to deepen professional understanding and inform educational practice by exploring the nature of PANS and PANDAS, and the implications for supporting affected children and young people within school settings.
What you might see in the classroom
Children and young people with PANS or PANDAS may experience sudden and dramatic changes in behaviour, cognition, and emotional regulation. These symptoms can fluctuate and may resemble traits commonly associated with neurodivergent profiles such as autism, or ADHD. However, PANS and PANDAS are distinct medical conditions that require specific clinical interventions, in addition to educational support.
Importantly, neurodivergent pupils can also develop PANS or PANDAS. This intersection adds complexity to assessment and support, as it can be challenging to distinguish between a child or young person’s established neurodevelopmental profile and new, acute medical symptoms. Without careful consideration, some children and young people may be misidentified or their evolving needs misunderstood, potentially delaying access to appropriate diagnosis and support.
More generally, the impact of PANS and PANDAS on special educational needs and disabilities (SEND) can be far-reaching. These conditions may trigger the sudden emergence of complex needs in pupils who previously required no additional support. The acute and often unpredictable nature of symptoms can fall outside established SEND profiles, making it essential for professionals to remain alert and advocate for flexible, responsive provision that adapts swiftly to changing presentations.
Meet Rosie
Rosie first experienced symptoms of PANS PANDAS at 14, with OCD thoughts and tics, and was diagnosed at 17 after glandular fever was found to be the trigger. School life became more challenging as fatigue, cognitive difficulties, and limited awareness from teachers and peers often left her feeling misunderstood, though her determination meant she maintained strong grades and attendance.
With flexible support at sixth form and a receptive University, Rosie was able to thrive academically and personally. She has just graduated with a BA (Hons) in Early Years Education, is currently training to be a Forest School Lead, and has been an integral member of the Education, Social Care and Health group, (ESCHG) a national multi-disciplinary and lived-experience team creating guidance for Local Authorities in England.
Rosie’s journey highlights the crucial role of awareness, empathy, and flexibility in education, and serves as an inspiring reminder of the power of tailored support in enabling children and young people with PANS PANDAS to reach their full potential
‘My journey through education is something I am very proud of. I have never let my condition get the better of me and I have always been determined to do the best I can. I have now completed a foundation degree in Early Education BA where I hope to work with children from the ages of 0-8. Also, although it took me a while, I was really proud when I passed my driving test!’
You can read the full story of Rosie here
Shared with the kind permission of Rosie and her family
The Role of Educational Psychologists
EPs play a pivotal role in identifying and supporting pupils with PANS and PANDAS. Given the episodic and unpredictable nature of these conditions, trauma-informed and flexible approaches are essential. EPs can:
- Recognise red flags and advise on medical referrals
- Support schools in understanding symptom variability (e.g., handwriting regression, executive functioning difficulties, sensory sensitivities)
- Promote inclusive strategies that accommodate fluctuating needs
- Facilitate multidisciplinary team (MDT) collaboration across health and education
Key Takeaways for Educational Psychologists
To support effective practice, EPs are encouraged to:
- Recognise the Medical Nature
Understand that PANS and PANDAS are post-infectious conditions with fluctuating emotional and cognitive impacts. - Adopt Trauma-Informed, Flexible Approaches
Tailor support to reflect symptom variability, including regression and sensory sensitivities. - Identify Red Flags and Support Referrals
Guide families and schools toward appropriate medical assessment and intervention. - Work Within an MDT Framework
Promote collaboration across health and education for coordinated care. - Build Sector Capacity
Lead training, contribute to research, and develop guidance to improve understanding and provision.
The Role of the PANS PANDAS UK Steering Group
As national attention around PANS and PANDAS has grown, the need for coordinated clinical care has become increasingly clear. In response, the PANS PANDAS Steering Group (PPSG), a multidisciplinary coalition of medical professionals was established to address the urgent need for coordinated national action and to drive consistency across services. The Steering Group now guides key developments, including:
- Research priorities and incidence tracking
- Development of Local Authority guidance (expected in 2026)
- A forthcoming clinical service specification
- Clinical guidelines endorsed by the Royal College of Paediatrics and Child Health (RCPCH), expected in 2026
In the interim, the PPSG strongly recommends a Multidisciplinary Team (MDT) approach to the assessment and treatment of children and young people presenting with acute-onset neuropsychiatric symptoms. This collaborative model ensures that complex cases are reviewed across specialties and that care is not delayed due to the absence of a formal MDT service.
To support clinicians, the PPSG signposts two sets of international peer-reviewed clinical guidelines, The Journal of Child and Adolescent Psychopharmacology (JCAP) 2017 Guidelines and The Nordic Guidelines (2021)
Together, these initiatives aim to create a coherent, evidence-based framework for diagnosis and support across the UK, helping to bridge the gap between clinical understanding and educational practice. Alongside these national clinical developments, further work has focused on supporting Local Authorities to navigate this evolving area and clarify their responsibilities in practice.
The Local Authority
In January 2025, recognising that many Local Authorities were navigating a rapidly evolving landscape around these medical conditions, the charity PANS PANDAS UK, issued a Local Authority Update. This was developed as an interim measure to support professionals.
The update was shared with all Local Authorities in England and aimed to:
- Clarify that PANS and PANDAS are recognised medical conditions
- Encourage professionals in education, health, and social care to access training and utilise available resources
- Highlight legal responsibilities
- Reference recent legal developments, including a High Court Judicial Review, including a diagnosis of PANS.
The update acknowledged the complex and evolving nature of the conditions and the systems surrounding them and sought to provide clarity and direction while formal clinical and educational guidance is still in development.
About PANS PANDAS UK
PANS PANDAS UK is a nationally recognised charity dedicated to improving recognition, diagnosis, and support for children and young people affected by these conditions. Established in 2018 by a group of dedicated parents/caregivers, the charity now plays a strategic role in shaping national policy and practice across health, education, and government. Its work includes:
- Facilitating and supporting the work of the PANS PANDAS Steering Group (PPSG)
- Delivering professional training
- Engaging with Parliament through the PANS PANDAS All-Party Parliamentary Group (APPG)
- Promoting the voice of lived experience through initiatives such as the Youth Advisory Board
The charity’s cross-sector approach ensures that the voices of affected families and young people remain central to planning and support.
Further Learning
We’re proud to partner with PANS PANDAS UK to raise awareness among Educational Psychologists and to provide practical resources that strengthen practice. To further raise awareness, PANS PANDAS UK will be participating in an upcoming podcast. Supporting all children and young people, particularly those with complex and under-recognised needs, is at the heart of what we do. Thank you to PANS PANDAS UK for helping us strengthen that support.
Resources
Free CPD accredited online training for teachers and educational psychologists- https://panspandasuk.org/training/
PANS PANDAS UK –Further Education Resources
Ask the Educational psychologist- A series of recorded education Q and A tailored for parents/caregivers- with many thanks to the educational psychologist Dr Joanne Riordan- https://panspandasuk.org/ask-the-educational-psychologist/
Engagement with The Department for Health and Social Care (DHSC) and the Department for Education (DfE)- https://panspandasuk.org/support-resources/pans-pandas-all-party-parliamentary-group/
MIMS CPD accredited online 0.5hr Learning Module for all health professionals
https://panspandasuk.org/wp-content/uploads/2024/11/Training-Modules-in-Health-and-Education-Transforming-Support-for-PANS-and-PANDAS-Flyer-A5.pdf
