Treatment approaches for functional neurological disorders in children
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Abstract Purpose of Review Functional neurological disorder (FND) is a multi-network brain disorder that encompasses a broad range of neurological symptoms. FND is common in pediatric practice. It places substantial strains on children, families, and health care systems. Treatment begins at assessment, which requires the following: themedicaltask of making the diagnosis, theinterpersonaltask of engaging the child and family so that they feel heard and respected, thecommunicationtask of communicating and explaining the diagnosis, and thelogisticaltask of organizing treatment. Recent Findings Over the past decade, three treatment approaches—Retraining and Control Therapy (ReACT), other cognitive-behavioral therapies, and multidisciplinary rehabilitation—have been evaluated in the USA, Canada, and Australia. Of children treated in such programs, 63 − 95% showed full resolution of FND symptoms. The common thread across the programs is their biopsychosocial approach—consideration of biological, psychological, relational, and school-related factors that contribute to the child’s clinical presentation. Summary Current research strongly supports a biopsychosocial approach to pediatric FND and provides a foundation for a stepped approach to treatment. Stepped care is initially tailored to the needs of the individual child (and family) based on the pattern and severity of FND presentation. The level of care and type of intervention may then be adjusted to consider the child’s response, over time, to treatment or treatment combinations. Future research is needed to confirm effective treatment targets, to inform the development of stepped care, and to improve methodologies that can assess the efficacy of stepped-care interventions.
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FTLBs are suggested to have unique psychological and pathophysiological underpinnings and are best conceptualized using a biopsychosocial model.
“they are suggested to have unique psychological and pathophysiological underpinnings (15) and are best conceptualized using a biopsychosocial model (16, 17).”
From Integrated cognitive behavioral intervention for functional tics (I-CBiT): case reports and treatment formulation (2023) · cites this paper as [17]
Evidence-based approaches to working with FND include both individual and systemic interventions.
“Evidence-based approaches to working with FND include both individual and systemic interventions (17).”
From Integrated cognitive behavioral intervention for functional tics (I-CBiT): case reports and treatment formulation (2023) · cites this paper as [17]
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- Authors
- Vassilopoulos, A., Mohammad, S., Dure, L., Kozlowska, K., & Fobian, A. D.
- Affiliations
- Yale University (US)
- The University of Sydney (AU)
- University of Alabama at Birmingham (US)
- Children's Hospital at Westmead (AU)
- Corresponding author
- Kozlowska, Kasia
- Venue
- Current Treatment Options in Neurology
- Published
- 2022-02
- Volume
- 24
- Issue
- 2
- Pages
- 77-97
- ISSN
- 1092-8480 (ISSN-L)
- 1534-3138
- PMC
- PMC8958484
- OpenAlex
- W4220762285
- Cited by
- 70
- References
- 68
- Citations by year
- 2026: 13 · 2025: 18 · 2024: 17 · 2023: 12 · 2022: 10
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Current Treatment Options in Neurology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- University of Sydney
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Keywords
- conversion disorder, React, cognitive behavioral therapy, multidisciplinary rehabilitation, biopsychosocial model, stepped care, family involvement, treatment efficacy
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