E2 ModerateModerate confidencePEM unclearCross-SectionalPeer-reviewedMachine draft
Chronic fatigue syndrome in children aged 11 years old and younger.
Davies, S, Crawley, E · Archives of disease in childhood · 2008 · DOI
Quick Summary
This study looked at young children under age 12 with ME/CFS at a specialist clinic in Bath, UK. The researchers found that even very young children (including one as young as 2 years old) can have ME/CFS and experience severe disability, with symptoms almost identical to those seen in teenagers. Children in this age group attended school only about 40% of the time on average and reported high levels of fatigue and pain.
Why It Matters
This study demonstrates that ME/CFS affects children in primary school with substantial severity and that diagnostic criteria developed for adults remain applicable to very young patients. Recognition of ME/CFS in this age group is critical for early identification and appropriate management, as severe functional impairment (40% school attendance) can occur even in young children.
Observed Findings
- Thirty-two children under age 12 were diagnosed with CFS/ME; the youngest was 2 years old and four were under 5 years old.
- Children under 12 had mean school attendance of just over 40% (approximately 2 days per week).
- Mean Chalder fatigue score in children under 12 was 8.29 (maximum 11), indicating severe fatigue.
- Mean pain visual analogue score was 39.7 on a 0-100 scale.
- Twenty-four of 26 children under 12 with complete symptom lists (92%) met stricter adult CDC diagnostic criteria.
Inferred Conclusions
- ME/CFS can affect young children including those under 5 years old, and clinical presentation is remarkably similar to that in older children and adolescents.
- The disability associated with ME/CFS in young children is substantial, with profound impacts on school attendance and daily functioning.
- Adult diagnostic criteria are appropriate for identifying ME/CFS in children under 12 years old.
Remaining Questions
- What is the natural history and long-term prognosis of ME/CFS in children diagnosed before age 12?
- Are there differences in symptom presentation, disease severity, or treatment response between children under 5, children aged 5-11, and older children?
What This Study Does Not Prove
This study does not establish why ME/CFS develops in young children or whether symptom patterns in children under 12 differ from those in younger age groups due to biological differences or reporting bias. The cross-sectional design cannot determine disease progression, outcomes, or whether early intervention alters the natural history of illness.
Tags
Symptom:PainFatigue
Phenotype:SeverePediatric
Method Flag:PEM Not DefinedNo ControlsExploratory Only
Metadata
- DOI
- 10.1136/adc.2007.126649
- PMID
- 18192312
- Review status
- Machine draft
- Evidence level
- Single-study or moderate support from human research
- Last updated
- 8 April 2026
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
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