Functional Neurological Symptom Disorder (FNSD)

What do schools need to know about FNSD?

FNSD happens to people who have past or current stressors.  Symptoms begin when the mind and body do not communicate well about how to cope.  They also happen when students avoid coping with these stressors or stressful events. 

Stressors can be related to school, friendships, family life, sports, or other important areas in a person’s life. Feelings of stress are not always easily noticed when they start. 

The symptoms of FNSD can affect how the body moves and feels. Symptoms are not due to a medical or brain problem.

Symptoms may include: 

• weakness or paralysis (unable to move a body part).
• changes in vision.
• Tremors. 
• trouble swallowing.
• arms or legs shaking.
• a short time when they are not responsive (this could be conscious or unconscious).

How can schools help students with FNSD?

• Teachers and counselors are needed to help students with FNSD.   
• School work should be done.  The student may need a Section 504 plan or individual health plan (IHP) to help with this. Your student’s health care team can help with making the plan.

What is best for the student?

It is important that all staff and teachers use the plan daily. A Section 504 or individual health plan (IHP) can help with this. It is helpful to allow your student to help create the school plans. 

The plan would include: 

• when to communicate with the family.
• what information to share with the family. 
• permission for the school and your student's health care team to communicate as needed. 
• a school plan should be used to help and support these students.   

What is the return to school plan? 

A return to school plan lists ways to help and support students with FNSD.

• Plan a slow and steady return to school for your student. This is needed when they missed important or too much learning. Start your student with half days when they first return to school. Slowly work up to full days.
  
  
• Ask your student to complete work to show they learned the missed content.  Give smaller amounts of homework for items missed while they were in the hospital or at visits. 
  
  
• Find a staff member at school who will work with your student and caregivers to create a plan.  This could be a nurse, case worker, social worker or counselor. The plan should address behaviors and symptoms.  It should include:  
  • a list of things that trigger symptoms. 
  • warning signs to watch for at the start of symptoms. 
  • what to do to stop symptoms from getting worse.  This could include relaxation, breathing, or a quiet room. 
  • ways to avoid major disruptions to your student's routine.
  • ways to avoid increased attention from peers when symptoms occur. 
  • how to handle symptoms in a calm, planned, and neutral tone.
  • not calling EMS or 911 when an episode takes place. EMS should only be used if it is a potentially life-threatening injury. The episodes themselves are not a medical emergency.
  • what to do to manage symptoms when they occur.  This could include a place for your student to go for short breaks.  This will help them gain control of symptoms.  The student should return to the class as soon as possible. 
  • using rewards for healthy behavior. 
    
    
• Schedule regular sessions with the school counselor to help with coping with the illness. 
  
  
• Provide access to the school nurse for any prescribed medicines.