Date Presented 04/04/2025
Examining the impact of pediatric acute-onset neuropsychiatric syndrome (PANS) exacerbation on occupational performance, we found typical performance at remission but significant declines at exacerbation. Thus, targeted OT interventions are needed.
Primary Author and Speaker: Michelle J. Newby
Contributing Authors: Shelly Lane, Janice Tona, Kirsti Haracz
PURPOSE: Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) is characterised by exacerbation and remission phases. Children with PANS experience occupational performance challenges across various domains, but differences between phases and the relationship between exacerbation and occupational performance remains unclear. We examined occupational performance at both phases as a foundation for designing targeted interventions.
DESIGN: Non-randomised, two-period bidirectional case-crossover design with data collected during PANS exacerbation (T-E) and remission (T-R) phases.
METHOD: Parents of children aged 4.6 to 13.1 years diagnosed with PANS were recruited globally from Australia, the USA, England, Ireland, Scotland, Canada, and New Zealand. They completed online surveys and monthly updates. Parents reported on occupational performance at T-E and T-R using the Vineland Adaptive Behaviour Scale (VABS) A linear mixed model was used to assess differences in VABS standardised scores.
RESULTS: VABS data was provided by n = 21 parents at T-E and n = 15 at T-R. We found significantly lower scores in the Adaptive Behaviour Composite (p = 0.015) and Socialisation domain (p = 0.012) at T-E compared to T-R, indicating a decline in occupational performance and social skills. At T-R parents reported typical performance across all VABS domains.
CONCLUSION: Children with PANS experience a marked decline in occupational performance and socialisation at T-E, which return to typical levels at T-R. Findings underscore the necessity for targeted occupational therapy interventions to support children with PANS during exacerbations.
IMPACT STATEMENT: This research highlights the importance of targeted interventions for children during PANS exacerbations, potentially influencing therapy approaches and improving outcomes for affected children.
References
Calaprice, D., Tona, J., Parker-Athill, E. C., & Murphy, T. K. (2017). A survey of pediatric acute-onset neuropsychiatric syndrome characteristics and course. Journal of Child and Adolescent Psychopharmacology, 27(7), 607–618. https://doi.org/10.1089/cap.2016.0105
Swedo, S., Leckman, J., & Rose, N. (2012). From Research Subgroup to Clinical Syndrome: Modifying the PANDAS Criteria to Describe PANS (Pediatric Acute-onset Neuropsychiatric Syndrome). Pediatrics & Therapeutics, 2(113). https://doi.org/https://doi.org/10.4172/2161-0665.1000113
Tona. J.T., Bhattacharjya. S, Calaprice. D. (2017). Impact of PANS and PANDAS Exacerbations on Occupational Performance: A Mixed-Methods Study. American Journal of Occupational Therapy, 71. https://doi.org/doi:10.5014/ajot.2017.022285
