PANS and PANDAS: What Practitioners Miss, and How to Recognise It

PANS and PANDAS are missed in clinical practice because their presentation borrows almost entirely from conditions practitioners already know: ADHD, autism, OCD and anxiety. A child arrives with sudden-onset obsessions, emotional dysregulation, tics or food restriction, and the picture maps neatly onto a familiar diagnosis, so the underlying neuroinflammatory event goes unnamed. Recognition is the first clinical skill, and it is the one most often skipped. The Moore Method, developed by naturopath Keonie Moore across more than 10 years of clinical work with children presenting with PANS and PANDAS, treats recognition as a discipline in its own right: read the pattern, identify the drivers, then sequence the response.

Key takeaways

• PANS and PANDAS are missed because their symptoms overlap with ADHD, autism, OCD and anxiety, and the sudden onset is the signal that gets overlooked.
• Surface symptoms are downstream of neuroinflammation; recognising the drivers behind them is where better outcomes begin.
• The Moore Method gives practitioners a structured way to interpret functional testing and sequence treatment toward causes, not symptoms.
• Building this capability is a defined skill set, taught through the academy's clinical excellence standard and the Moore Method Practitioner Certification.

Why these conditions hide in plain sight

PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (its streptococcal-associated subset) announce themselves through behaviour, not pathology a parent can point to. The child becomes anxious, ritualistic, rigid around food, or develops tics. Every one of those features lives comfortably inside an existing label. Anxiety explains the fear. OCD explains the rituals. ADHD explains the dysregulation. Autism explains the rigidity. Each individual symptom has a ready home, so the cluster never gets read as a cluster.

The detail that separates these conditions from their look-alikes is onset. ADHD, autism and most anxiety presentations build over time and have a developmental history behind them. PANS and PANDAS arrive abruptly, often after an infection, frequently with a change a parent can date to a particular week. That sudden, dramatic shift is the recognition cue, and it is precisely what gets lost when a practitioner assesses the symptom in front of them rather than the trajectory that produced it.

This is the gap the Moore Method Practitioner Certification is built to close. It trains practitioners to hold the whole pattern in view: the timing, the immune trigger, and the constellation of behaviours together, rather than matching the loudest symptom to the nearest diagnosis. Recognition is not a single test result. It is a way of reading the case.

The symptom is not the problem

The reason symptom-matching fails these children is that the symptoms are downstream. Obsessions, tics and dysregulation are expressions of neuroinflammation, and neuroinflammation has drivers. Treating the obsession without addressing what is inflaming the brain manages the surface while the underlying process continues. This is the principle at the centre of the academy's standard of clinical excellence: the practitioner's job is to find what is driving the picture, not to suppress the picture.

The Moore Method names the key drivers of neuroinflammation and teaches practitioners to work backward from presentation to cause. Several systems sit at the heart of this:

• Barrier function. The integrity of the gut barrier and the blood-brain barrier determines what reaches the brain. When these barriers are compromised, the brain is exposed to influences it should be protected from.
• The gut-brain-immune connection. The microbiome shapes immune behaviour, and immune behaviour shapes the brain. These are not separate stories; they are one system, and the child's behaviour is its output.
• Mitochondrial function. Energy production underpins neurological resilience. A brain under inflammatory load with compromised mitochondrial capacity behaves very differently from one that is well resourced.

When a practitioner can see these drivers, the abrupt-onset child stops looking like a behavioural mystery and starts looking like a case with a mechanism. That shift, from symptom to mechanism, is the whole point.

Reading complexity instead of reducing it

The instinct under clinical pressure is to simplify: pick the diagnosis, pick the protocol, move on. PANS and PANDAS punish that instinct, because two children with the same surface presentation can have entirely different drivers underneath. The advanced clinical work covers subtypes for exactly this reason, including histamine-driven and mould-driven PANS, where the presentation may look similar but the mechanism, and therefore the response, is not.

This is where functional testing earns its place. The Moore Method teaches practitioners to interpret nutrigenomics and Organic Acids Testing not as a box-ticking exercise but as evidence that points toward the actual driver in this particular child. A result is only as useful as the practitioner's ability to read it in context, and reading it well is what allows treatment to be sequenced rather than thrown at the problem all at once. Sequencing matters because the order in which you address barrier function, immune load and energy production changes the result.

Progress then has to be measured, not assumed. Using OCD and tic scales to track change over time turns a subjective impression into something observable, so the practitioner knows whether the sequence is working and can adjust with evidence rather than hope. This is the difference between managing a child and moving a child forward.

Recognition is a trainable skill

None of this is innate. The reason PANS and PANDAS are missed so often is not a lack of care; it is a lack of a framework for reading the pattern and the drivers behind it. Keonie Moore built that framework the hard way, through more than a decade of clinical work and recognition that includes the NHAA Award for Notable Contributions to Naturopathy in Australia and invitations to speak internationally at the IHC Symposium. The Moore Method exists so other practitioners do not have to assemble it case by case from scratch.

If you are seeing children whose anxiety, OCD or behavioural presentations do not quite resolve under the obvious diagnosis, the question worth asking is whether you are looking at the symptom or the driver. That question is the start of better outcomes, and it is the question the academy is built to help you answer. To talk through whether this training fits your practice, get in touch.

The bottom line

PANS and PANDAS are not rare; they are rarely recognised. They hide behind ADHD, autism, OCD and anxiety because their symptoms are shared and their abrupt onset is overlooked. The practitioners who get these children right are the ones who read the pattern, identify the drivers of neuroinflammation, and sequence treatment toward the cause. That is a skill, it is trainable, and the Moore Method is how you build it.