Date Presented 04/05/2025
Investigating the impact of pediatric acute-onset neuropsychiatric disorders associated with streptococcus (PANS) exacerbations on sensory reactivity, we observed significant variation between exacerbation and remission phases, with a notable decline during exacerbations. Therefore, targeted OT interventions are needed.
Primary Author and Speaker: Michelle J. Newby
Contributing Authors: Kirsti Haracz, Shelly Lane, Janice Tona
PURPOSE: Research indicates that children with Paediatric Acute-onset Neuropsychiatric Syndrome (PANS) experience sensory processing differences impacting occupational performance. We aimed to investigate sensory reactivity differences during and between PANS exacerbations using the Sensory Processing Measure Home Form (SPM).
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 sensory reactivity at T-E and T-R using the SPM. A linear mixed model was used to assess differences in SPM standardised scores.
RESULTS: The study included 82 participants, with 80 providing initial data and 27 at follow-up. Results showed statistically significant declines in performance across the SPM domains of Hearing (4.1 T-Score difference; p = .018), Social Participation (9.8 T-Score difference; p = <.001), Planning and Ideas (4.3 T-Score difference; p = <.046), and Total Sensory Systems (2.6 T-Score difference; p = <.016) during exacerbation compared to remission. Atypical sensory processing was also observed in Vision (60.8 T-Score), Hearing (60.6 T-Score), Touch (63.6 T-Score), Balance and Motion (60.0 T-Score), and Total Sensory Systems (62.8 T-Score) during remission.
CONCLUSION: Children with PANS experience significant sensory reactivity differences, with declines observed during exacerbations. Occupational therapists should conduct sensory assessments to create effective, tailored intervention plans.
IMPACT STATEMENT: This study highlights the importance of sensory assessments and tailored interventions for children with PANS, 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
