Treatment for PANS/PANDAS

At home, Paige Brick (9) creates a fortress out of blankets and pillows. Once an active, outgoing child, her mother says PANS/PANDAS has left her more withdrawn, making indoor play a central part of her days.
(Brayan Gutierrez for Bridge Michigan)

The Brick family keeps a shared board of daily reminders in their home. Paige’s mother says household routines have become crucial as her daughter copes with neurological decline from PANS/PANDAS.
(Brayan Gutierrez for Bridge Michigan)

Nursing student Sianna Hill (right) helps Paige Brick (9) with her morning routine. Erin Brick, Paige’s mother, says Hill’s twice-weekly visits often involve encouraging Paige to finish tasks and complete her personal board of daily reminders, a tool made necessary by executive function loss from PANS/PANDAS.
(Brayan Gutierrez for Bridge Michigan)

Sianna Hill, a nursing student, spends two mornings each week with Paige (9), helping her start the day and prepare for therapy sessions. Her mother, Erin Brick (42), says the support gives structure to mornings that would otherwise feel overwhelming. (Brayan Gutierrez for Bridge Michigan)

Paige Brick (9) engages in a therapy activity led by clinician Grace MacFarland, LLMSW, MPH, from the mental health arm of My Relationships Project. Grace incorporates play-based techniques designed to support Paige’s social and emotional development amid ongoing challenges with PANS/PANDAS. (Brayan Gutierrez for Bridge Michigan)

Erin Brick (42), mother of Paige (9), recalls the confusion that followed her daughter’s sudden decline. She says months passed before doctors diagnosed PANS/PANDAS, leaving the family struggling to understand Paige’s rapid changes.
(Brayan Gutierrez for Bridge Michigan)

Paige Brick (9) plays on her tablet while the time is tracked. Her mother, Erin Brick (42), says activities like gaming must be timed to help her daughter transition to the next task on her board, a structure made necessary by PANS/PANDAS. (Brayan Gutierrez for Bridge Michigan)

At breakfast, Paige Brick (9) keeps her board close. “It’s the first thing she sees in the morning,” said her mother, Erin Brick (42), who uses it to guide her daughter through routines made harder by PANS/PANDAS. (Brayan Gutierrez for Bridge Michigan)

Pages from Paige Brick’s (9) artbook, created between 2020 and 2022, show her work before and after developing PANS/PANDAS following a strep infection in 2022. Her mother, Erin Brick, says the shift is visible: “Her drawings grew simpler, just like her schoolwork, once the symptoms began.”
(Brayan Gutierrez for Bridge Michigan)

Paige Brick (9), left, rests next to her mother, Erin Brick (42). Brick says daily life is unpredictable: some days Paige can join therapy or engage at home, and other days exhaustion takes over. (Brayan Gutierrez for Bridge Michigan)