Jason, Leonard, Porter, Nicole, Shelleby, Elizabeth et al. · Child psychiatry and human development · 2009 · DOI
This study tested a new way to diagnose ME/CFS in children and teenagers, comparing those with the illness to those without it. The researchers found that the new diagnostic criteria could successfully identify who has ME/CFS and could also distinguish between children with more severe symptoms versus those with moderate symptoms. The study looked at six main symptom areas: fatigue, post-exertional malaise (getting worse after activity), sleep problems, pain, thinking/memory difficulties, and autonomic/immune system problems.
This research establishes that pediatric ME/CFS can be reliably diagnosed using structured criteria that differentiate illness severity levels. This matters for children and adolescents because consistent, evidence-based diagnostic criteria improve access to appropriate medical care, reduce diagnostic delays, and help clinicians recognize when symptoms warrant different management approaches based on disease severity.
This study does not prove that the severity categories (Moderate vs. Severe) remain stable over time or predict treatment outcomes. It does not establish causation for any symptom manifestations, and the small, specialist-referred sample may not represent all pediatric ME/CFS patients, limiting generalizability to broader populations.
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 →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Jason, Leonard, Porter, Nicole, Shelleby, Elizabeth, Till, Lindsay, Bell, David S, Lapp, Charles W, et al. (2009). Severe versus Moderate criteria for the new pediatric case definition for ME/CFS.. Child psychiatry and human development. https://doi.org/10.1007/s10578-009-0147-8
BibTeX
@article{mecfsatlas-jason-2009-severe-versus,
author = {Jason, Leonard and Porter, Nicole and Shelleby, Elizabeth and Till, Lindsay and Bell, David S and Lapp, Charles W and Rowe, Kathy and De Meirleir, Kenny},
title = {Severe versus Moderate criteria for the new pediatric case definition for ME/CFS.},
journal = {Child psychiatry and human development},
year = {2009},
doi = {10.1007/s10578-009-0147-8},
note = {PubMed: 19513826},
url = {https://www.mecfsatlas.com/evidence/jason-2009-severe-versus},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-26. https://www.mecfsatlas.com/evidence/jason-2009-severe-versus
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