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Supporting Children and Adolescents with Functional Neurological Disorder in the School Setting

Kelsey Borner, PhD; Rebecca Laptook, PhD

Rhode Island Medical Journal (2024)

  • Pediatric, School
  • Clinical Study, Professional Insight, Research Translation

Key Takeaways

  • School attendance is therapeutic. Regular presence at school helps prevent the avoidance cycle that can worsen FND symptoms.
  • Planful reintegration works best. A pre-planned schedule that gradually increases time in class supports a smoother return after absences.
  • Clear communication reduces crises. Educating staff that FND episodes are real but rarely medical emergencies prevents unnecessary 911 calls or early dismissals.
  • Balanced accommodations matter. Academic, physical, and coping supports should help the student engage—not create new barriers or over-protective habits.
  • Formal 504 plans can safeguard progress. When needed, Section 504 accommodations provide accountability if a school is unfamiliar with FND.

Overview

This article explains why staying engaged in school is a core part of FND care and offers practical guidance for families, clinicians, and educators. It reviews how FND symptoms—like gait changes, functional seizures, or fatigue—can disrupt academics, social life, and attendance, then outlines steps to keep children learning and connected.

Discussion

How the guidance was built

  • Draws on clinical experience from the Hasbro Children’s Partial Hospital Program and published FND literature.
  • Focuses on youth who have missed school or need extra support to remain in class.

Recommended actions

  • Start with education: A guidance-counselor–led team meeting shares FND basics, explains why symptoms look dramatic but are rarely dangerous, and sets a “stay in school” expectation.
  • Create a reintegration schedule: For prolonged absences, begin with brief visits (e.g., parking-lot drop-ins, meeting a favorite teacher) and build to full days over weeks.
  • Use three accommodation buckets:
    • Academic – trimmed workload, extended deadlines, psychoeducational testing if learning issues are suspected.
    • Physical – hallway passes, extra time between classes, “wall-surfing” instead of wheelchairs when safe.
    • Coping – stress balls, brief check-ins with support staff, limited self-selected breaks (e.g., three passes per day).
  • Monitor and fade supports: As symptoms improve, gradually remove accommodations to build resilience.
  • Leverage formal plans when needed: A Section 504 plan or IEP ensures legal backing if the school struggles to comply.
  • Limitations & future needs
    • Guidance is based on expert consensus rather than controlled trials; more systematic research on school-based FND interventions would strengthen recommendations.

Next Steps

  • Draft a short, honest explanation of FND to share with classmates (“My brain and body signals get mixed up, so sometimes my legs don’t work right.”).
  • Ask your healthcare team to email the guidance counselor with an overview of FND and suggested accommodations.
  • Build a step-by-step return-to-school schedule—start small, add classes as confidence grows.
  • Pack a coping toolkit: stress ball, earbuds with a calm playlist, and a laminated “symptom reset” card.
  • Review the plan monthly with teachers and caregivers; celebrate progress and trim supports you no longer need.

Reference

Borner K, Laptook R. Supporting children and adolescents with Functional Neurological Disorder in the school setting. Rhode Island Medical Journal. 2024;107(11):29-33.

http://rimed.org/rimedicaljournal/2024/11/2024-11-29-fnd-borner.pdf

This summary is provided for informational purposes only and does not constitute medical, financial, or legal advice. It is not intended to replace professional consultation or treatment. Always consult qualified healthcare providers regarding your specific circumstances, symptoms, or questions.

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