Connecting With Your PANS/PANDAS Child When Talking Isn't Working
One of the hardest parts of parenting a child or teen with PANS/PANDAS isn't just watching them struggle.
It's feeling like you've lost your connection with them.
You ask how they're doing, and they shrug.
You ask about school, medications, or symptoms, and they become irritated or shut down.
You try to help, but every conversation seems to end in frustration—for both of you.
If you've experienced this, you're not alone.
Many parents tell me they miss talking with their child. They worry that they've done something wrong or wonder whether their child simply doesn't want to connect anymore.
But often, that's not what's happening at all.
If You Only Have a Minute, Read This
✓ PANS/PANDAS can make communication much more difficult for children, teens, and families.
✓ When the nervous system is overwhelmed, talking may simply feel like too much.
✓ Connection doesn't always happen through conversation.
✓ Sometimes changing how we communicate can help rebuild trust and emotional safety.
Why Connection Can Break Down
Children and teens living with PANS/PANDAS spend an enormous amount of time talking about things they never wanted to become experts in.
Symptoms.
Appointments.
Medications.
School accommodations.
Treatments.
Questions about how they're feeling.
These conversations come from loving, concerned parents.
But after months—or sometimes years—they can begin to feel overwhelming for a child whose nervous system is already working overtime.
Many young people begin to anticipate that conversations with their parents will revolve around PANS. Even simple questions like, "How are you feeling?" can start to feel emotionally loaded.
This doesn't mean they don't love their parents.
And it doesn't mean they don't need support.
Often, it simply means their nervous system needs communication to feel different.
When Talking Isn't the Best Way to Connect
One thing I've noticed in my work with families is that many children and teens communicate more openly when the pressure to respond immediately is removed.
Writing can do that.
Unlike a conversation, a note doesn't require eye contact, immediate answers, or finding the right words in the moment.
It creates space.
And sometimes, that space is exactly what's needed.
A Small Change That Opened a Door
I remember working with one family whose parents desperately wanted to reconnect with their teenage daughter.
Every conversation about PANS seemed to end the same way—with frustration, silence, or someone walking away upset.
We talked about trying something different.
Instead of asking more questions, the parents began leaving short notes for their daughter.
Nothing elaborate.
Just simple messages like:
"I'm proud of how hard you're trying."
"I'm thinking about you today."
"I know this has been really hard, and I'm here whenever you're ready."
At first, there was no response.
But after a while, their daughter began writing back.
Not with long conversations.
Not with dramatic breakthroughs.
Just small pieces of herself that she hadn't been able to say face-to-face.
Those brief notes became the beginning of a new way of communicating.
They didn't solve everything.
But they helped rebuild connection.
Why This Works
When children feel emotionally safe, they're often better able to share what's happening inside.
Writing gives them time.
It reduces pressure.
It allows them to organize their thoughts before responding.
For some children and teens, that's exactly what's needed.
Of course, writing notes isn't the answer for every family.
Some children might prefer texting.
Others may connect while taking a walk, driving in the car, drawing together, or simply sitting quietly side by side.
The goal isn't the notes.
The goal is finding a way to communicate that feels safe enough for connection to grow again.
A Few Things You Might Say
If you'd like to try writing a note, keep it simple.
"I'm thinking about you."
"I'm proud of how hard you're trying."
"I know today was difficult."
"I'm here whenever you want to talk."
Notice what's missing.
No advice.
No problem-solving.
No questions that require an answer.
Just connection.
Sometimes the Relationship Needs Less Pressure—Not More
When talking isn't working, it's natural to want to try harder.
To ask more questions.
To look for better words.
But sometimes what helps most isn't saying more.
It's creating enough emotional safety that your child can begin moving toward you again in their own time.
Those small moments of connection often become the foundation for bigger conversations later.
Need Support?
Parenting a child or teen with PANS/PANDAS can place tremendous strain on even the strongest relationships. If you're feeling disconnected from your child or wondering how to rebuild trust and communication, you're not alone.
I work with PANS/PANDAS families throughout New York State, helping them understand their child's nervous system, strengthen connection, and navigate this journey with compassion and confidence.
If you'd like to learn more, you can schedule a free 15-minute consultation by clicking the button below.
Julie Cox, LCSW is a fully licensed therapist with 25 years of experience supporting children, teens, parents, and adults in New York and Delaware.
She specializes in working with families navigating PANDAS and PANS, offering child and parent-centered support based on co-regulation, nervous system education, and evidence-based approaches that help reduce anxiety, OCD symptoms, and demand-avoidance behaviors.
She helps parents feel more empowered and supported while caring for children experiencing neuroinflammatory symptoms.