Looking beyond the symptoms to the immune, inflammatory and neurological factors behind sudden behavioural changes.
PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections) can be distressing conditions for both children and parents, often appearing suddenly and dramatically.
Many families seek naturopathic support when their child experiences an abrupt onset of anxiety, OCD behaviours, emotional outbursts, tics, mood changes, behavioural regression or other symptoms that seem to develop “overnight”.
Parents often describe feeling shocked by the sudden change in their child’s personality, behaviour or emotional wellbeing, particularly when symptoms appear following an infection or illness.
PANS and PANDAS are complex conditions that affect the brain, nervous system and immune system, and many families are looking for support in understanding how these symptoms may be affecting their child’s overall wellbeing.
• Sudden onset OCD behaviours
• Anxiety or separation anxiety
• Motor or vocal tics
• Emotional outbursts
• Aggression or irritability
• Mood swings
• Behavioural regression
• Sleep disturbances
• School refusal
• Difficulty concentrating
• Sensory sensitivities
• Frequent urination
• Restrictive eating or food fears
• Decline in handwriting or school performance
• Symptoms that worsen following illness or infection
The Children’s Naturopath provides support for children experiencing PANS (Paediatric Acute-onset Neuropsychiatric Syndrome) and PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections).
Many families seek naturopathic support when their child experiences a sudden onset of anxiety, OCD behaviours, tics, emotional outbursts, behavioural changes, sleep disturbances or symptoms that appear to develop seemingly overnight.
PANS, PANDAS & child wellbeing
PANS and PANDAS can affect many areas of a child’s daily life, including emotional wellbeing, learning, behaviour, sleep and family relationships.
The sudden nature of symptom onset can be particularly challenging for both children and parents.
OCD, anxiety & behavioural changes
Children with PANS or PANDAS commonly experience OCD behaviours, anxiety, emotional dysregulation, mood changes or behavioural regression.
These symptoms can fluctuate over time and may have a significant impact on everyday functioning.
Sleep, learning & daily functioning
Sleep disturbances, poor concentration, school refusal and changes in academic performance are commonly reported by families affected by PANS and PANDAS.
Supporting overall wellbeing can be an important part of helping children navigate these challenges.
Infection history & immune health
PANS and PANDAS are often associated with infections and changes in immune function.
Many families seek a better understanding of how illness history, symptom patterns and overall health may be connected to their child’s presentation.
At The Children's Naturopath, we see children whose parents describe a sudden and dramatic change in behaviour following an illness or infection.
In clinic, we pay particular attention to children who develop obsessive behaviours, severe anxiety, emotional outbursts or food refusal seemingly overnight.
One of the most important questions we ask is whether the child's symptoms began following an infection, and whether they become worse during subsequent illnesses.
PANS and PANDAS are diagnosed and managed by doctors. There is no laboratory test that confirms either, prevalence is unknown, and treatment evidence remains limited — so a child with a sudden change like this needs medical assessment first. Our role is nutritional and general health support alongside that care.
A particularly concerning pattern is a child who was previously happy, independent and managing everyday activities but suddenly becomes extremely anxious, distressed or unable to cope with familiar situations.
Parents may describe:
A child who suddenly refuses to separate from their parents.
New obsessive thoughts or repetitive behaviours.
Extreme emotional outbursts, anger or aggression.
Sudden food refusal or fear surrounding eating.
Sleep disturbances and increased night-time anxiety.
New tics, repetitive movements or unusual behaviours.
For parents, the speed of these changes can be particularly distressing.
Rather than looking at each symptom separately, we investigate the sequence of events leading up to the behavioural changes.
PANS and PANDAS are associated with an abrupt onset of neuropsychiatric symptoms. PANDAS is specifically associated with streptococcal infections, while PANS may involve other suspected infectious or inflammatory triggers.
In clinic, we explore whether a child experienced a respiratory infection, sore throat, fever or other illness before symptoms appeared.
We are also interested in whether symptoms fluctuate over time. For example, parents may notice their child's anxiety or obsessive behaviours improve for several weeks, only to become more intense during another illness.
Understanding these patterns is an important part of building a clearer picture of the child's health history.
PANS and PANDAS have been investigated in relation to immune and inflammatory processes that may affect brain function and behaviour. This is why a child's infection history and changes in physical health are particularly relevant.
We look at the broader picture, including recurrent infections, recovery between illnesses, sleep, appetite and nutritional intake.
We are particularly interested in whether the child has experienced repeated infections or ongoing physical symptoms alongside their behavioural changes.
Children experiencing PANS or PANDAS may develop significant changes in appetite or food preferences, particularly when obsessive thoughts or anxiety begin affecting eating.
We pay attention to whether a child's nutritional intake has become restricted and whether they are obtaining adequate nutrients to support normal brain and nervous system function.
Iron, zinc, magnesium and vitamin D all have important roles in children's health, including neurological and immune function. Understanding a child's diet and nutritional status can help identify areas where additional nutritional support may be appropriate.
One of the most useful things parents can do is keep a record of their child's symptoms and any illnesses that occur. We encourage families to note:
When behavioural symptoms first appeared.
Any illness or infection preceding the changes.
Whether symptoms improve or worsen over time.
Changes in OCD behaviours, anxiety, tics or emotional outbursts.
Sleep patterns, appetite and food intake.
Whether another infection coincides with a worsening of symptoms.
This information helps us understand the child's individual symptom patterns and identify areas of their general health that may benefit from additional support. Our focus is on the connection between a child's physical health, nutritional needs and behavioural wellbeing, while providing practical support for the family.
National Institute of Mental Health — PANS and PANDAS: Questions and Answers
Sudden-onset symptoms, infection associations and clinical criteria. NIMH states that no lab test can confirm PANS or PANDAS, that prevalence is unknown, and that evidence for long-term antibiotic use is insufficient.
The paper that defined the PANS criteria, in Pediatrics & Therapeutics.
Many families come to us after experiencing a sudden and unexpected change in their child’s behaviour, emotions or daily functioning.
Parents are often looking for practical guidance and a better understanding of the factors affecting their child’s wellbeing.
During the initial consultation, we take the time to understand your child’s health history, infection history, diet, digestion, sleep, behaviour, emotional wellbeing and overall health.
Parents often leave their consultation with:
Verified Google reviews for The Children’s Naturopath.
The Children’s Naturopath provides consultations for children experiencing PANS, PANDAS, OCD behaviours, anxiety, tics, emotional regulation challenges and sudden behavioural changes. Consultations are available Australia-wide via phone or telehealth, as well as in-person at our Melbourne clinic.
