WHAT THE EXPERTS SAY.... THE LITTLE KNOWN MEDICAL CONDITION THAT


COULD TRIGGER A MENTAL HEALTH CRISIS Comment by education journalist SAL MCKEOWN


P


eople often ask why we are seeing such a massive increase in children with poor mental health, serious anxiety and OCD. There are no simple answers but we are now finding that some children develop these conditions, almost overnight, shortly after having an infection. Harry gave his family no cause for concern until he was eight. He developed a rash all


over his body and his behaviour and speech regressed so he sounded more like a toddler. He struggled with basic motor skills and had to use a wheelchair. His parents took him to several different specialists to little effect, until they met Dr Tim Ubhi. He is a specialist in brain dysregulation, working with children who have PANS and PANDAS. PANS stands for Paediatric Acute-onset Neuropsychiatric Syndrome and PANDAS is Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections. While most children recover quickly from childhood illnesses and bacterial infections with no ill effects, a tiny minority suddenly develop a distinctive range of symptoms, more commonly associated with neurodivergent conditions. After starting a course of antibiotics, Harry started to get better. He has greatly improved and his speech has returned to what might be expected of a boy of his age. You can see videos of Harry at different stages at: e-hospital.co.uk/resources/pandas/case-studies-dr-tim-ubhi/.


Sudden onset


PANS PANDAS UK is a charity that supports patients and families and raises awareness with politicians, health, education and social care professionals. This informative site shows that children can exhibit a broad range of symptoms: • Extreme obsessive-compulsive behaviours: sudden, severe rituals or intrusive thoughts


• Motor and vocal tics: involuntary movements or sounds, including eye rolling


• Severe generalised and separation anxiety: wanting to be with a parent


• Behavioural regression: acting like a much younger child or even a toddler


• Emotional regulation issues: feelings of desperation, intense mood swings


• Restricted food intake: sudden aversion to textures and foods they previously enjoyed


• Insomnia and disturbed sleep patterns • Urinary problems, including unexpected bed wetting • Development of learning difficulties: issues with memory and sometimes with handwriting, so it could seem as if they have suddenly developed dyslexia


One key factor that distinguishes PANS and PANDAS from neurodiverse conditions is the suddenness and intensity of the changes in behaviour. There are several case studies on the PANS PANDAS UK site, including the story of Annie. She currently spends much of her time, “crouched on the floor, refusing to be touched or dressed. She experiences constant physical and verbal tics and uses compulsive repetitive behaviours and rituals to cope with extreme anxiety.” When children receive the right treatment, often a mixture of antibiotics and talking therapies, recovery can be equally dramatic, as


December 2025


the story of Christopher illustrates. In January 2019, he was ill with what doctors thought was a virus. But his family soon started to see alarming changes in his behaviour. “It quickly became apparent that something awful was happening to our son. Within the space of 2 weeks, he developed a body tic, verbal tics, memory issues, anxiety, OCD. Our son was changing right before our eyes, and we did not know what to do to save him.”


They searched the internet looking for clues and found that PANS and PANDAS can cause, ‘inflammation in the brain resulting in neuro- psychiatric symptoms such as OCD, tics, eating disorders and anxiety along with many more’. Christopher ticked all the boxes. They saw a GP who had trained in paediatrics. He gave them a prescription for antibiotics and forms for blood tests. His parents reported: ‘Within 3 days of Nurofen and antibiotics Christopher’s speech started returning to normal, his behaviour became more rational, the anxiety was better, and his body tic was not as frequent.’


Issues for schools


PANS/PANDAS poses a dilemma for schools. Tina Coope, Education Lead at PANS PANDAS UK, has worked both in mainstream and special education and has lived experience as a parent of a child with this condition. She warns that: “acute, biologically driven symptoms are frequently misread as emotional or behavioural issues, and the underlying medical causes may themselves be misattributed to trauma or adversity. Striking an informed balance is essential, one that neither pathologises distress unnecessarily, nor dismisses genuine medical conditions as purely psychosocial.”


Quite rightly, we have moved away from attaching medical labels to children’s behaviour and have developed more holistic approaches which consider the school environment, the child’s past history, family dynamics and possible trauma. However, teachers should record dramatic changes in a pupil’s behaviour, check their attendance and see if they have had a recent illness.


The public is gradually becoming more aware of these conditions. An All-Party Parliamentary Group (APPG) is using its political influence to improve diagnosis and treatment in the UK. National clinical guidelines are on the horizon and local authorities are soon to provide updates to schools. PANS PANDAS UK has produced training for teachers and educational psychologists and EPs are starting to gather case studies and contributing to interdisciplinary research. Hopefully, by increasing awareness and collaboration between health and education sectors, we can ensure children experiencing the dramatic onset of PANS/PANDAS receive timely and effective treatment.


www.education-today.co.uk 33


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44