Sudden behaviorial changes in your child can be deeply concerning—and rightfully so. While it’s normal for children and teens to display behavioral changes in response to typical life stressors—such as school challenges, peer conflicts, or sibling issues—sudden, unexplained changes may signal something more significant.
In cases where behavioral changes appear abruptly or even overnight, it’s important to consider medical conditions like PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome) and PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections).
These disorders are associated with a sudden onset of neuropsychiatric symptoms, often triggered by infections, and can profoundly affect a child’s emotional and physical well-being (Swedo et al., 1998).
Most of the families I work with have never heard of PANS/PANDAS until they do an exhaustive internet search or they are lucky enough to have a provider or friend tell them about it.
Recognizing these changes early and seeking appropriate medical and psychological evaluation is critical to ensuring your child receives the care and support they need.
Common Potential Causes of Behavioral Changes In Children and Teens
When your child's behavior changes unexpectedly, it can be concerning and confusing. Understanding the potential causes is the first step in addressing the issue. Many more common factors can lead to sudden behavioral changes in children, such as:
Bullying
Bullying is a significant stressor that can cause dramatic changes in a child's behavior. Social interaction struggles, frequent temper tantrums, and negative behaviors can stem from being bullied at school or online. Parents should look for warning signs such as a sudden drop in grades, frequent tantrums, and mood swings.
Grief and Loss
Experiencing the loss of a loved one, whether it's a best friend, pet, or family member, can lead to behavioral problems. Young kids might have difficulty expressing emotions, leading to atypical behavior or withdrawal from social activities.
Stressors at Home
Family dynamics significantly impact a child's behavior. Power struggles between parents, sibling issues, substance abuse, or physical abuse can create an unstable environment, resulting in out-of-control behavior or aggressive behaviors.
School Issues
Academic pressures, attention, learning and language skills challenges, or peer difficulties can also contribute to behavioral issues. Middle and high school years are particularly critical, and children might exhibit negative attitudes or challenging behaviors as they navigate these pressures.
Physical or Emotional Trauma
Physical or emotional trauma can leave deep scars, manifesting as negative attention-seeking or oppositional defiant disorder. Early detection and intervention are crucial to addressing these mental health issues.
Sudden Changes in Behavior Associated with PANS and PANDAS
PANS and PANDAS are conditions characterized by the sudden onset of psychiatric symptoms following infections. PANDAS is explicitly associated with strep throat, while PANS can be triggered by various diseases. These syndromes involve a misdirected immune response that affects the brain.
The hallmark of PANS and PANDAS is the rapid onset of severe neuropsychiatric symptoms. These include:
- Psychiatric Symptoms
- Obsessive-compulsive behaviors (OCD): New or significantly worsened compulsions and obsessions.
- Tics: Sudden, repetitive motor movements or vocalizations.
- Mood instability: Severe irritability, rage episodes, or emotional dysregulation.
- Separation anxiety: Intense fear of being away from parents or caregivers.
- Hallucinations: In rare cases, children may report seeing or hearing things that aren't there (Brackney & Winters, 2022).
- Depression and suicidal ideation: Sudden onset or worsening of depressive symptoms.
- Behavioral Changes
- Aggression or oppositional defiance.
- Regression in developmental milestones (e.g., reverting to baby talk or needing help with basic tasks).
- Hyperactivity and inattention, mimicking ADHD.
- Physical Symptoms
- Motor and vocal tics.
- Sleep disturbances, including insomnia or nightmares.
- Enuresis (bedwetting) or urinary frequency.
- Sudden clumsiness or handwriting deterioration.
Diagnosis
Diagnosing PANS and PANDAS requires a multidisciplinary approach, as symptoms often overlap with other neurological and psychiatric conditions.
- Medical and Family History
- Detailed documentation of the child’s health, focusing on the sudden onset or escalation of symptoms.
- Screening for recent infections (e.g., strep throat, sinusitis).
- Laboratory Tests
- Blood and throat culture tests for infections like group A streptococcus.
- Tests for immune markers or other infections (e.g., Lyme disease, Epstein-Barr virus).
- Neuropsychiatric Evaluation
- Comprehensive assessment of emotional, cognitive, and behavioral symptoms.
- Collaboration with specialists, such as pediatric neurologists, psychiatrists, and immunologists.
- Imaging or Specialized Tests (in some cases)
- Brain imaging to rule out other causes of neurological changes.
- QEEG for neuroinflammation
- Lumbar punctures or advanced immune profiling (for complex cases).
Neuroinflammation Assessment: QEEG
Quantitative Electroencephalography (QEEG) is a powerful tool for assessing neuroinflammation and abnormal brain activity patterns associated with PANS and PANDAS. This non-invasive technique involves placing sensors on the scalp to measure electrical activity in the brain, which is then analyzed using sophisticated algorithms to identify deviations from typical patterns.
QEEG can detect brain areas affected by inflammation and dysfunction, providing a visual map of brain activity. This detailed information helps clinicians understand the specific neurological impacts of PANS and PANDAS, which can be critical for accurate diagnosis and tailored treatment plans.
One study investigated the potential of Quantitative electroencephalography (QEEG) as a diagnostic tool for differentiating Parkinson's Disease with dementia from Parkingson’s Disease without dementia. They examined 125 individuals with healthy controls, analyzing QEEG indices alongside markers of inflammation and lipid metabolism.
Findings showed higher delta frequency in the frontal region among Parkinson’s Disease with dementia patients compared to those without dementia and controls. Correlations were found between QEEG indices and inflammatory and metabolic markers, suggesting potential for evaluating Parkingson’s Disease with dementia (Liu et al., 2022).
Managing Sudden Behavioral Changes in PANS and PANDAS
When you notice sudden changes in behavior, parents should first consult a child's healthcare provider and rule out the common reasons for behavioral changes listed above.
Early diagnosis and early intervention are crucial to managing behavioral problems effectively. Adopting a positive parenting program can help manage challenging behaviors. Some strategies include:
- Positive reinforcement to encourage good behavior.
- Establishing clear rules and consequences.
- Using the time-out method for negative behaviors.
- Promoting positive behaviors through consistent praise and rewards.
- Maintain an open communication with your child.
- Encouraging social interaction and activities they enjoy.
- Provide consistent routines to create a sense of security.
- Regular monitoring and adjusting as needed.
Understanding and addressing sudden changes in behavior is vital for their emotional development and well-being. Whether these changes are due to PANS, PANDAS, or other stressors, professional help and supportive parenting can make a significant difference. Stay informed and proactive to easily navigate these challenges and support your children in developing positive behaviors and coping mechanisms.
Empower your child and help them achieve a calm brain without relying on medication. Download the Natural PANS/PANDAS Calm Brain Kit.
What could cause sudden behavioral changes in my child?
Sudden behavioral changes in children can result from various factors such as bullying, grief and loss, stressors at home, school issues, or physical and emotional trauma.
How can I identify if my child is experiencing bullying?
Look for signs such as a sudden drop in grades, frequent temper tantrums, mood swings, and withdrawal from social interaction. These are common indicators that your child may be facing bullying.
How does PANDAS affect my child's behavior?
PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections. It can cause sudden onset of obsessive-compulsive disorder (OCD), tics, anxiety, and other psychiatric symptoms in children.
How is PANS different from PANDAS?
While both conditions cause sudden psychiatric changes in children, PANDAS is associated explicitly with streptococcal infections, whereas PANS can be triggered by various diseases.
What role does QEEG play in diagnosing behavioral issues in children?
Quantitative Electroencephalography (QEEG) assesses neuroinflammation and abnormal brain activity patterns, helping to identify and understand the neurological impacts of conditions like PANS and PANDAS.
What are the common signs of emotional trauma in younger children?
Emotional trauma in younger children can manifest as atypical behavior, frequent temper tantrums, aggression, withdrawal from social interaction, and changes in eating or sleeping patterns.
How can stressors at home affect my child's behavior?
Stressors such as power struggles between parents, substance abuse, or physical abuse can create an unstable environment, leading to negative behaviors and out-of-control behavior in children.
When should I seek professional help for my child's behavioral problems?
Seek professional help when you notice significant changes in your child's behavior, such as persistent mood swings, aggressive behaviors, withdrawal from social interaction, or if you suspect conditions like PANS or PANDAS.
What are effective strategies for managing sudden behavioral changes in children?
Effective strategies include positive reinforcement, establishing clear rules and consequences, using the time-out method, and promoting positive behaviors through consistent praise and rewards.
How can I support my child if they have been diagnosed with PANS or PANDAS?
Support your child by seeking early intervention and professional help, creating a stable and supportive environment, and considering diagnostic tools like QEEG to guide treatment strategies.
Citations
ReferencesBrackney, T., & Winters, B. (2022). PANDAS: How to Recognize and Intervene. Student Works. https://scholarsarchive.byu.edu/studentpub/346/
Liu, H., Deng, B., Zhou, H., Wu, Z., Chen, Y., Weng, G., Zhu, S., Xu, J., Wang, H., Zhou, Z., Tan, E.-K., & Wang, Q. (2022). QEEG indices are associated with inflammatory and metabolic risk factors in Parkinson’s disease dementia: An observational study. EClinicalMedicine, 52, 101615. https://doi.org/10.1016/j.eclinm.2022.101615
Dr. Roseann is a mental health expert in PANS/PANDAS who frequently is in the media:
- Parenting beyond the headlines Podcast Talking About PANS, PANDAS and Autoimmune Encephalitis
- Parenting Prism Podcast Understanding Lyme Disease
- The Mack Talks Podcast Topic: Fighting the Stigma on Mental Health & Lyme Disease with Dr. Roseann
Always remember… “Calm Brain, Happy Family™”
Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.”
She coined the terms, “Re-entry panic syndrome” and “eco-anxiety” and is a frequent contributor to media on mental health.
Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches.
She is the author of three bestselling books, It’s Gonna Be OK!: Proven Ways to Improve Your Child's Mental Health, The Teletherapy Toolkit, and Brain Under Attack. Dr. Roseann is known for offering a message of hope through science-endorsed methods that promote a calm brain.
Her trademarked BrainBehaviorResetⓇ Program and It’s Gonna be OK!Ⓡ Podcast has been a cornerstone for thousands of parents facing mental health, behavioral or neurodevelopmental challenges.
She is the founder and director of The Global Institute of Children’s Mental Health, Neurotastic™Brain Formulas and Dr. Roseann Capanna-Hodge, LLC. Dr. Roseann is a Board Certified Neurofeedback (BCN) Practitioner, a Board Member of the Northeast Region Biofeedback Society (NRBS), Certified Integrative Mental Health Professional (CIMHP) and an Amen Clinic Certified Brain Health Coach. She is also a member of The International Lyme Disease and Associated Disease Society (ILADS), The American Psychological Association (APA), Anxiety and Depression Association of America (ADAA) National Association of School Psychologists (NASP), International OCD Foundation (IOCDF).
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