Provision of health and education services in school children with chronic fatigue syndrome

Abstract

ABSTRACTBackground Chronic fatigue syndrome (CFS) in childhood may have a profound effect on a child's life in terms of schooling, social activity and family interaction. Many reports have been based on specialist clinics with little information about CFS in children in the general population and the health and education services provided.Objectives To review cases of CFS in school age children (5–18 years) within the East Suffolk area and determine the health and education services provided.Methods Cases were identified by consultation with the three local health trusts and the education department. Provision of services was determined by review of hospital and school health records. School attendance was determined by postal questionnaire to the school in each case.Results A total of 32 cases were identified, with diagnosis at a peak age of 15 years and 5.8 months as the mean duration of symptoms prior to diagnosis. Some 28 cases were referred by their GP to an acute paediatrician. Only one case was referred to the school medical service. The majority (28/32) received a rehabilitation programme provided by either a child psychiatrist or physiotherapist. Only half the cases were attending school more than half‐time and 10 were not attending school at all and were receiving home tuition. Two of these had never received local paediatric review to confirm the diagnosis or plan management. Follow‐up was highly variable and rarely involved school medical services.Implications A significant number of children with CFS were identified in this semirural school‐age population. Poor involvement of community child services reduced the opportunity for liaison between health and education and made identification of cases difficult. Paediatric review should be mandatory before home tuition is instituted, appropriate referral to psychiatric services encouraged and regular school follow‐up organized to review progress. Close liaison between all health and education services is imperative in planning the provision of services and providing a coherent programme of rehabilitation.