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The Current State of Pediatric Functional Neurological Disorder Treatment in the United States
Meagan Watson1, Jason Kreuzman2, Karen Zeribi3
1Department of Neurology, University of Colorado, Aurora, Colorado.
Insights
Pediatric functional neurological disorder (FND) treatment is available nationwide, but care varies significantly. Research is needed to standardize effective, accessible FND care for children and adolescents.
Area of Science:
- Neurology
- Child Psychiatry
- Pediatric Healthcare
Background:
- Pediatric functional neurological disorders (FNDs) are prevalent yet under-researched.
- Existing FND treatment programs lack comprehensive data.
- This study addresses the need for understanding pediatric FND care in the US.
Purpose of the Study:
- To define the current landscape of pediatric FND treatment in the United States.
- To identify available treatment programs, care team composition, and treatment modalities.
- To assess aftercare management strategies for pediatric FND.
Main Methods:
- A survey was conducted by the Functional Neurological Disorder Society (FNDS) Pediatric Special Interest Group (SIG).
- Information was gathered from 39 care team members across 24 healthcare centers in 16 states.
- Data on treatment settings, patient demographics, and therapeutic approaches were collected.
Main Results:
- 31 unique pediatric FND treatment settings were identified, primarily outpatient (62%).
- Psychologists were the most common specialists (52%), with most centers treating ages 6-21 and all FND symptoms.
- Cognitive behavioral therapy (77%) and personalized approaches (58%) were common, alongside strong school (97%) and caregiver (94%) involvement.
Conclusions:
- Pediatric FND treatment is accessible across the US, but significant variability exists in care delivery.
- Differences in care team composition, treatment strategies, and aftercare management were observed.
- Further research is essential to develop standardized, effective, and sustainable treatments to enhance access to care for pediatric FND patients.
Background:
Pediatric functional neurological disorders (FNDs) are common but grossly under-researched. This survey study aims to define the current landscape of pediatric FND treatment in the United States, identifying treatment programs, care team composition, treatment approaches, and aftercare management.
Methods:
The Functional Neurological Disorder Society (FNDS) Pediatric Special Interest Group (SIG), a diverse set of clinician and caregiver stakeholders, collected information on available treatment programs in the United States via survey. Current programs were identified through the FNDS Pediatric SIG and FND Hope's provider registry.
Results:
Thirty-nine care team members from 24 health care centers yielded 31 unique FND treatment settings. Centers existed in 16 states, concentrated in the Midwest and Southern regions. Outpatient settings (62%) were more prevalent than inpatient. A psychologist (PhD/PsyD) was the most common clinician (52%) with dedicated time to treat FNDs. Most settings accepted ages six to 21 (55%) and treated all FND symptoms (77%). A spectrum of treatment approaches was endorsed with the most common being cognitive behavioral therapy (77%) and personalized approaches (58%). A biopsychosocial approach was evident, with most settings reporting active involvement with school (97%) and caregivers (94%). Most settings (74%) encouraged treatment re-engagement when needed with no strict time limits. All respondents provided aftercare recommendations or referrals.
Conclusions:
Pediatric FND treatment is available across the United States, but there is high variability in care team membership, treatment approach, and aftercare management. Future research is necessary to develop effective and sustainable treatment to improve access for this population.
