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Understanding school attendance for children with PANS and PANDAS

Date Published: 07/01/2026

Many children and young people face significant challenges in attending school, sometimes for long periods. The reasons behind these attendance difficulties can be complex.

For those with PANS or PANDAS, physical symptoms during flares and psychological factors can also become intertwined and easily misunderstood.

Families of children with PANS or PANDAS often report that their child or young person is supported as if they have Emotionally Based School Avoidance (EBSA), when the primary reason for absence is a flare-up of a medical condition. This misunderstanding can add stress and delay appropriate support. Over time, the experience of PANS or PANDAS can, in some cases, lead to EBSA.

About the Toolkit

Our new toolkit aims to help. It is designed to untangle these complex factors and provide practical guidance for professionals working with children who have PANS or PANDAS and school attendance difficulties.

The toolkit includes:

  • A series of short videos by EBSA consultant Vicky Batlle, exploring how PANS and PANDAS intersect with EBSA and how schools and families can provide effective support.
  • A written guide explaining the relationship between PANS or PANDAS and EBSA, with strategies for schools and families.

What is EBSA

Emotionally Based School Avoidance (EBSA) describes situations where a child or young person experiences severe emotional distress about attending school. This can lead to prolonged absence and is often linked to anxiety or other psychological factors.

An Evolving Area

This is an evolving area, and we hope this guide will give both professionals and families the confidence to navigate the attendance journey for children and young people with PANS or PANDAS.

Please share this toolkit with any professionals who may find it helpful.

Toolkit produced with many thanks to:
Vicky Batlle, EBSA Consultant
Members of the Skylakes Educational Psychology Team
Francesca and Pearl for consent to use their case study

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Glossary

  • ADHD
    Attention Deficit Hyperactivity Disorder
  • AE
    Auto-immune Encephalitis
  • ARFID
    Avoidant Restrictive Food Intake Disorder
  • ASD
    Autism Spectrum Disorder
  • CAMHS
    Child and Adolescent Mental Health Service
  • CBT
    Cognitive Behavioural Therapy
  • Dysgraphia
    difficulty writing by hand
  • EHCP
    Education, Health and Care Plan
  • Emotional Lability
    Rapid, and dramatic changes in mood (for example uncontrollable laughter to crying)
  • Enuresis
    wetting
  • GAS
    Group A Streptococcal infection
  • NHSE
    NHS England
  • NICE
    National Institute for Health and Care Excellence
  • OCD
    Obsessive Compulsive Disorder
  • PP
    PANS PANDAS
  • PPUK
    PANS PANDAS UK
  • PPN
    PANS Physicians Network
  • PPSG
    PANS PANDAS Steering Group
  • SENCo
    Special Educational Needs Coordinator
  • SIGN
    Scottish Intercollegiate Guidelines Network to the glossary
  • Tic
    Sudden repetitive movement (motor tic) or sound (vocal tic) which is difficult or impossible to control