Text Box 3: Educational Interventions That Can Be Implemented Across Clinical Fields to Increase Understanding of FND and Respect for Patients (Child and Adult) Who Suffer from This Complex Disorder

Educational Modality	Intervention Description
Health care training program curricula (e.g., nursing, paramedics, medicine, psychology, physical therapy, occupational therapy, speech therapy)	Lectures on functional somatic symptoms—including FND—need to be included in all curricula to signal that functional presentations are common within the health care system and represent a substantial proportion of practitioner workload.
Postgraduate student rotations (e.g., nursing, paramedics, medicine, psychology, physical therapy, occupational therapy, speech therapy)	Inclusion of functional disorders—including FND—in clinical discussions pertaining to assessment, differential diagnosis, and treatment of patients. Provision of educational materials when patients with functional disorders present (e.g., Functional Somatic Symptoms in Children and Adolescents [23], when working in the pediatric setting).
Hospital-based continuing education programs	Grand rounds and inbuilt continuing educational programs (in the emergency department, neurology, pain team, consultation-liaison team, physiotherapy, occupational therapy, speech therapy, and wards that manage patients with FND) all present ongoing educational activities.
Conference-level education	The Functional Neurological Disorder Society (FNDS, https://www.fndsociety.org) has set up bi-yearly conferences to promote education. Neurology, neuroscience, psychiatry, psychology, occupational therapy, speech therapy, nursing, and paramedic conferences provide other venues for conference-level education. Conference-level education should also include all medical subspecialties. For example, gastroenterologists, respiratory physicians, and otolaryngologists all see patients with functional communication, swallowing, cough, and related disorders.
Peer-reviewed literature	A concerted effort has been made to publish clinical neurology handbooks [36], consensus criteria, expert opinion articles, updates on etiology, assessment, and treatment of FND subtypes [23], [37], [38], [39], [40], and articles describing the clinical assessment process [41], [42].
Use of video teaching resources within all levels of education	Video teaching resources can be helpful in teaching about patterns of presentation, the neurology examination, and interviewing skills.
Supervision of clinicians/provision of second opinions	Supervision of clinicians, discussion of cases, and provision of second-opinion consultations for difficult cases via a variety of modalities (face to face or via telephone, telehealth, site visits, or ambulant teams).
Miscellaneous resources that clinicians from all fields can use for patients	FND website written for patients by neurologist Jon Stone: https://www.neurosymptoms.org Educational resources available via the Functional Neurological Disorder Society (FNDS): https://www.fndsociety.org American Epilepsy Society Task Force Handout on PNES for Mental Health Professionals: http://www.aesnet.org/docs/default-source/pdfs-clinical/5-pnes-for-mental-health-profs-final.pdf?sfvrsn=d8f1bbf5_2 A comic book—“Not There: A Story of Functional Neurological Disorders”—written for young adults [51].
Resources pertaining to costs of FND for use in education and lobbying of administrators, government bodies, and insurance companies	FND as a common disorder (approximately 16% of neurology outpatient visits and up to 23% of patients in epilepsy clinics) [43], [44]. FND and other presentations with functional somatic symptoms are both common and costly [45], [46], [47]. Investment in recently developed treatment interventions (including those for functional seizures) is worthwhile because the interventions have good outcomes [48], [49], [50]. Insurance providers do cover health care costs associated with FND [52].