What Is PANS or PANDAS?

PANS and PANDAS describe sudden onset or sudden worsening of anxiety, OCD, eating difficulties, or behavioral changes in children, often triggered by an immune or inflammatory response.

PANDAS occurs when symptoms are associated with a recent strep infection.

PANS includes cases triggered by other infections, immune responses, or metabolic stressors.

Symptoms often appear rapidly—sometimes overnight—and may include:

• Sudden-onset OCD or intrusive thoughts

• Separation anxiety or generalized anxiety

• Sudden fears, phobias, or panic

• Regression in skills (speech, handwriting, toileting, independence)

• Irritability, emotional outbursts, mood swings

• Sensory issues or motor tics

• Severe food restriction or fear of choking/vomiting

• Sleep disturbance

• Trouble with attention, focus, or school performance

What the Research Says About PANS & PANDAS

PANS/PANDAS is a real clinical presentations recognized by many clinicians, with ongoing research improving clarity. The evidence suggests:

Sudden-onset OCD and anxiety are hallmark symptoms.

Research shows that children with PANS/PANDAS often experience abrupt development of OCD symptoms, anxiety, or food restriction (Swedo et al., 2012).

Neuroinflammatory responses may play a role.

Studies suggest that immune activation may affect brain circuits related to anxiety, mood, and motor control (Chang et al., 2015).

CBT and Exposure and Response Prevention (ERP) are effective treatments for OCD symptoms—even in PANS/PANDAS presentations.

The American Academy of Pediatrics and International OCD Foundation both reinforce that CBT/ERP is a key part of treatment, even when symptoms have a medical trigger.

Stabilization and reduction of avoidance improves functioning and long-term outcomes.

Behavioral and psychological interventions help restore functioning and reduce disability even when symptoms fluctuate (Murphy & PANS Research Consortium, 2017).

Families benefit from coordinated care.

Studies stress the importance of collaboration between mental health clinicians, pediatricians, and—when appropriate—specialists such as immunologists or infectious disease providers.

How We Support Kids With PANS or PANDAS

We focus on stabilizing daily functioning, decreasing anxiety, and reducing OCD-related impairment—even while medical evaluation or treatment is ongoing.

Our approach includes:

CBT & Exposure Response Prevention (ERP)

Even when symptoms have an immune or infectious trigger, behavioral symptoms respond well to ERP, especially compulsions, avoidance, food fears, and intrusive thoughts.

Kids learn to:

• Tolerate distress safely

• Reduce avoidance

• Challenge OCD-like patterns

• Build back independence and flexibility

ACT (Acceptance & Commitment Therapy)

ACT helps kids and teens:

• Understand their emotions without panic

• Build willingness to face difficult moments

• Focus on values—like family, school, friendships, and creativity

• Strengthen resilience during flare-ups

Support for Anxiety, School Avoidance & Emotional Regulation

We help kids:

• Manage panic and overwhelm

• Re-engage in school with step-by-step plans

• Build body-awareness and calming strategies

• Reconnect socially and rebuild confidence

Parent Guidance & Family Support

We coach parents in:

• Reducing accommodation

• Supporting exposures at home

• Responding to emotional dysregulation

• Setting compassionate boundaries

• Creating predictable routines that stabilize symptoms

Collaboration With Pediatric & Medical Providers

With parent consent, we coordinate with:

• Pediatricians

• Psychiatrists & Psychiatric Nurse Practitioner

• Infectious disease specialists

• Immunologist or Rheumatologist

• Neurologist

• Dietitian

• Occupational Therapist (OT)

• School support teams

This ensures your child receives comprehensive care that is aligned and supportive.

Stabilizing School, Home, and Daily Life

PANS/PANDAS can touch every area of life. We help you create a plan that is:

Predictable

Reliable routines reduce anxiety and help kids regain stability.

Gentle but Structured

We introduce the right amount of challenge—never overwhelming, always supported.

Family-Centered

Parents receive concrete tools and scripts that reduce chaos and build confidence.

Rooted in Functioning

Whether symptoms fluctuate or stabilize, we focus on helping kids participate in daily life again..

Why Start Now?

PANS or PANDAS symptoms can feel sudden and overwhelming—but early support truly makes a difference. Research consistently shows that children who receive coordinated care early in the process have shorter flare-ups, less long-term disability, and stronger recovery.

“Early intervention leads to improved outcomes, reducing or eliminating impact before neurological changes occur.”

Source: PANDAS Physicians Network — Research Priorities & Roadmap 

“Findings highlight the benefit of early multidisciplinary evaluation and treatment.”

Source: Children’s National Hospital (2025) 

“Prompt behavioral, psychological, and medical interventions are believed to reduce disability and improve long-term outcomes.”

Source: PANS Research Consortium Treatment Guidelines (Murphy et al., 2017) 

“Targeted treatment was significantly associated with faster symptom improvement… earlier treatment predicted shorter flare duration.”

Source: Gromark et al., Frontiers in Neurology (2021) 

The sooner we support your child’s nervous system, emotions, and functioning, the more quickly they tend to stabilize—even when symptoms fluctuate.

A Steady Path Forward With PANS or PANDAS

When your child’s world changes overnight, you shouldn’t have to figure out the next steps alone. At Raising Brave Kids, we walk beside families with structure, clarity, and compassion—helping your child rebuild confidence and regain steadiness one small step at a time.

We offer child and teen therapy in-person at our Portland, Oregon office and online for families across Oregon and California. Whether you’re looking for specialized child therapy or practical parent support our team is here to help.

Contact us today or schedule a free 15 min consultation

Sources

• PANDAS Physicians Network (PPN). Research Priorities & Roadmap to a Cure. (2021).
  https://pandasnetwork.org/research-priorities-pandas-pans-roadmap-to-a-cure/
  
  Murphy, T. K., et al. PANS/PANDAS Research Consortium: Clinical Evaluation and Treatment Guidelines. Journal of Child and Adolescent Psychopharmacology (2017).
  https://pmc.ncbi.nlm.nih.gov/articles/PMC5740997/
  
  Gromark, C., et al. “A Two-to-Five Year Follow-Up of a Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) Cohort.” Frontiers in Neurology (2021).
  https://pmc.ncbi.nlm.nih.gov/articles/PMC7870456/
  
  Swedo, S. E., et al. “Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Clinical Description of a New Disorder.” Journal of Child and Adolescent Psychopharmacology (2012).
  https://pubmed.ncbi.nlm.nih.gov/22356870/
  
  Children’s National Hospital. “Therapy Approach Shows Promise for PANS/PANDAS.” (2025).
  https://innovationdistrict.childrensnational.org/therapy-approach-shows-promise-for-pans-pandas/
  
  Chang, K., Frankovich, J., & Cooperstock, M. “Clinical Evaluation of Youth with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS): Recommendations from the 2013 PANS Consensus Conference.” Journal of Child and Adolescent Psychopharmacology.
  (Root paper summarizing neuroinflammatory links.)
  
  American Academy of Pediatrics (AAP). Clinical guidance on OCD assessment and treatment relevance for acute-onset presentations (referenced in PANS/PANDAS guidelines).
  
  International OCD Foundation (IOCDF). PANS/PANDAS resources and treatment recommendations.
  https://iocdf.org/pandas/