Diagnosis and Assessment

Accurate diagnosis is the foundation of appropriate treatment. Pediatric ME/CFS diagnosis requires modifications to adult criteria to account for developmental context.

1 Pediatric Diagnostic Criteria Modifications

2 Distinguishing ME/CFS from Differential Diagnoses

WarningPractical Warning: The Danger of Misdiagnosis as School Avoidance

Misdiagnosing ME/CFS as school avoidance is not merely inconvenient—it is potentially dangerous. Children labeled as school-avoidant are often subjected to forced school attendance, psychological interventions aimed at overcoming “avoidance,” and graded exposure programs that push increasing activity. For children with actual ME/CFS, these interventions cause harm: physical deterioration, progression to severe disease, and psychological trauma from being disbelieved. Always take reported symptoms seriously and look for objective evidence of ME/CFS before concluding that symptoms are psychologically mediated.

2.1 School Avoidance/School Refusal

2.2 Post-Infectious Mononucleosis

2.4 POTS and Orthostatic Intolerance

2.5 Depression and Anxiety

WarningPractical Warning: The Danger of Misdiagnosis as School Avoidance

Misdiagnosing ME/CFS as school avoidance is not merely inconvenient—it is potentially dangerous. Children labeled as school-avoidant are often subjected to forced school attendance, psychological interventions aimed at overcoming “avoidance,” and graded exposure programs that push increasing activity. For children with actual ME/CFS, these interventions cause harm: physical deterioration, progression to severe disease, and psychological trauma from being disbelieved. Always take reported symptoms seriously and look for objective evidence of ME/CFS before concluding that symptoms are psychologically mediated.