tbursts,
(In general, kids and adolescents do not have a high degree of frustration tolerance. We all know that. Lyme disease severely challenges the child's already-limited resources)
What, then, might the child do to COMPENSATE for what is going on?
(these are what I call the "self-selected solutions")
All that I have discussed so far is distressful
for the child. She may try to cope with all of this by
doing any of the following:
• As school performance falls, and they're less involved with activities,
Lyme patients might shift to a lower-functioning peer group, cut classes, and, in the extreme, they might drop out of school (if over 16), to avoid the frustration of dealing with academic demands
• For the kids with GI problems, they might severely limit
their food intake, or begin gorging and purging
• For energy, or to self-treat the attentional problems,
• To calm them down, or to keep them from thinking about all that
is going on, alcohol, marijuana or other drugs might be chosen
I have seen all of the above in adolescents with chronic Lyme in my practice.
Any of the functional impairments can lead to any of the results, and to any or all of the self-selected solutions.
Functional impairments in school are often very significant, and call on the educators to develop
creative plans to help the student with Lyme succeed. Without the support of the school, the best
efforts of the parents might not be enough to keep a kid on track, in school, and successful!!
What THERAPEUTIC SOLUTIONS might we offer, to help deal with the FUNCTIONAL
Please note that these solutions do NOT directly connect with any particular item in the previous
There are different categories of therapeutic solutions, but for now, I'd like to focus on what the
school can do. They can make the difference between success and failure for a child with
We see several listed on this slide. I'll mention others later. They DO WORK, and most of them
are not very costly for the district or the state:
I'll just mention briefly another important area where there can be therapeutic solutions, the home front:
Always keep in mind that when your child has chronic Lyme, he needs to be both SUPPORTED and ENCOURAGED. It's important that you base your expectations of him on how he is able to function, on a day to day basis, but you don't want him to feel like, or function like, an invalid. Have expectations of him, but keep them in line with where he is in his medical treatment, as well as whether he's having a good day or a bad day. Some families need help dealing with children with Lyme, particularly if it effects their brain, and their school functioning. That is where psychotherapy and family therapy can be helpful. Therapy can serve an important role for kids and families with chronic Lyme, but it's important to find a therapist who is at least Lyme-open, if not Lyme-literate. The kid and the parents should be involved, in a combination of individual and family therapy. The therapy should be concrete, focusing on the problems.
Now lets look more specifically at school. As I mentioned earlier, cognitive problems are common with kids with Lyme disease, as are attentional problems. Kids with chronic Lyme might find it hard to retain new information. Lyme also can effect receptive and expressive language, visual-spatial processing, abstract reasoning, processing speed. Just as Lyme disease can effect any part of the body, it can effect any cognitive process. These kids may appear to be distracted easily, have poor concentration, appear scattered, have just about any symptom of attention deficit disorder. Or if the child had ADD before
she got Lyme, her ADD symptoms are often exaggerated by the illness. These symptoms might be intermittent and transitory, given the nature of Lyme disease, making it even more difficult to develop an education plan. When I speak to teachers' groups, I tell them that when they have a child with chronic neurological Lyme in their class, the child may appear learning disabled one day, seem normal the next. She may act like she's got ADD on an