Dig Deeper – Children and Lyme disease

Educational Impact of Lyme Disease

Abstract:

School psychology publications contain few articles on the impact of Lyme disease on the capacity of school-aged children to function successfully within an educational program. This oversight is of considerable concern, as the school psychologist can be a front-line consultant for assistance with a child or adolescent presenting with sequelae of vague behavioral, cognitive, learning and/or psychological problems. The focus of this article is to highlight the importance of the school psychologist to recognize impaired school performance due to undiagnosed Lyme disease, act as the child’s advocate within the medical and school community, and assist in the design of a supportive educational environment for the ill child.

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Babesiosis an Underdiagnosed Disease of Children

Abstract:

Babesiosis is a malaria-like illness caused by the intraerythrocytic parasite Babesia microti and is transmitted by the same tick that transmits Borrelia burgdorferi, the causative agent of Lyme disease. Babesiosis is well recognized in adult residents of southern New England and New York but has been described in only five children. To determine whether children are infected with B microti less often than are adults, a prospective serosurvey was carried out on Block Island, RI, where babesiosis is endemic. Randomly recruited subjects completed a questionnaire and provided a blood sample. Antibodies against B microti and B burgdorferi were measured using a standard indirect immunofluorescence assay and enzyme-linked immunosorbent assay, respectively. Of 574 subjects, 9% tested positive for B microti, including 12% of the 52 children (7 months through 16 years) and 8% of the 522 adults (not significant, P < .6). Although babesiosis had not been diagnosed in any of the Babesia-seropositive subjects, 25% of the children and 20% of the adults reported symptoms compatible with this infection during the previous year. Of the 6 children and 45 adults seropositive for B burgdorferi, 17% and 14%, respectively, were also seropositive for B microti. It is concluded that children are infected with B microti no less frequently than are adults and that this infection is under-diagnosed in all age groups. Physicians who practice where Lyme disease is endemic should become familiar with the clinical presentation and diagnosis of babesiosis, both in adults and children.

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Study of Cognitive Deficits in Children with Chronic Lyme Disease

Abstract:

Although neurologic Lyme disease is known to cause cognitive dysfunction in adults, little is known about its long-term sequelae in children. Twenty children with a history of new-onset cognitive complaints after Lyme disease were compared with 20 matched healthy control subjects. Each child was assessed with measures of cognition and psychopathology. Children with Lyme disease had significantly more cognitive and psychiatric disturbances. Cognitive deficits were still found after controlling for anxiety, depression, and fatigue. Lyme disease in children may be accompanied by long-term neuropsychiatric disturbances, resulting in psychosocial and academic impairments. Areas for further study are discussed.

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Pediatric Lyme Disease – a School Issue and Tips for School Nurses

Abstract:

Lyme disease is the fastest growing vector-transmitted disease in the United States and school-age children are at high risk of infection. If these children are to receive appropriate and prompt medical intervention, school nurses must have a basic understanding of Lyme disease symptoms and diagnosis and be able to recognize and articulate the impaired behavior and school performance frequently caused by this illness.

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Effects of Lyme Disease on Students and School Policy

Abstract:

While it comes as no surprise that the numbers of classified students are increasing, it may surprise some to know that Lyme disease may be causing many of the learning problems experienced by students in Lyme-endemic areas. New Jersey ranks fourth in the nation in Lyme cases.

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Kids and Lyme Disease and How It Affects Learning

Abstract:

There is an urgent need for Lyme disease education and awareness in the schools throughout the United States. In addition to the “ABC’s of Lyme,” and the new “Time for Lyme” video, Lyme professionals – physicians, psychotherapists, neuropsychologists, need to be seeking opportunities to provide in-service training to schools, so that teachers and other school professionals understand and appreciate the difficulties that face kids with Lyme every day. We need to call on the schools to help these children, and education is the key.

The following is a presentation I gave to the Northern Dutchess County (NY) Support Group in November 2002. Perhaps it will provide ideas for other presentations to Lyme groups and schools around the country. Every child with Lyme disease should feel understood and supported, and be successful in school. Lyme disease may be a handicap that some children have, but it should not be an insurmountable obstacle.

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How Lyme Disease Mimics Attention Deficit Disorder

Abstract:

Dr. Charles Ray Jones, the world’s leading pediatric specialist on Lyme disease calls it “the second great imitator.” (Syphilis is the first.) Since it can affect the entire body in a myriad of ways, it often mimics Attention Deficit Disorder (ADD), rheumatoid arthritis, autism, depression, chronic fatigue, multiple sclerosis and more. If this disease is not diagnosed properly it can become chronic and cause neuralgic, psychiatric, cardiac  and arthritic problems. Left untreated, it can lead to heart block, seizure disorder and brain destruction. Although in rare cases, people have died from it, most live a life of constant suffering.

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The Role of Neuropsychological Testing in Children with Lyme disease

Abstract:

The cognitive problems associated with Lyme disease and other tick-borne illnesses include difficulty with: 1) attention and concentration, 2) speed and efficiency of processing information, 3) learning and memory, 4) auditory processing and language expression, 5) planning and organization and 6) multitasking. These cognitive symptoms have a significant impact on learning and school performance.

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Underdiagnosis of Neuropsychiatric Lyme Disease in Children and Adults

Abstract:

Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi. Reported throughout the United States, the greatest incidence of Lyme disease occurs in certain areas, such as the Northeast, the upper Midwest, and the Pacific Coastal states. It has been dubbed “The Great Imitator” because, like another spirochetal illness neruosyphilis, – the original Great Imitator, Lyme disease has a vast array of multisystem manifestations, including neuropsychiatric ones. Failure to recognize Lyme disease early in its course can result in the development of a chronic illness that is only temporarily or partially responsive to antibiotic therapy. The goal of this article is to present the typical and atypical manifestations of Lyme disease in children and adults in order to help the clinician more rapidly unmask the correct diagnosis behind the puzzling presentations of some patients.

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Cognition and School Problems in Adolescents with Posttreatment Lyme Disease

Abstract:

Although adults with late stage posttreatment Lyme disease often experience difficulties in memory, little is known about the relationship between cognition and Lyme disease in children and adolescents. Twenty-five adolescents with late stage posttreatment Lyme disease (symptoms >6 months) and 25 participants without Lyme disease (matched on gender, IQ, age, socioeconomic status) were assessed for neuropsychological functioning, depression, school functioning, and predisease academic achievement. The Lyme group had significant deficits in cognition (short-term visual memory, short-term and delayed verbal memory, all forms of recognition memory), as well as worse  attendance, grades, and subjective reports of memory problems, without differing in predisease achievement or depression. Deficits in visual memory exceeded deficits in verbal memory—a striking difference from what is reported in adults. These results reveal that adolescents with a history of treated Lyme disease are at risk for long-term problems in cognition and school functioning.

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Lyme Disease in kids – Parenting Dilemmas

Abstract:

I’m writing this as an introduction to the topic of “Parenting Dilemmas,” and hope to address this topic further in future issues of the Lyme Times. This is the first time I’ve specifically focused on “parenting dilemmas” and I encourage readers to contribute by writing letters to the Editor of the Lyme Times. I’d also like to see other psychotherapists participate in this discussion, so that a body of knowledge becomes available on how to help parents deal with the non-medical side of Lyme disease in children and adolescents.

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Reflections on Lyme Disease in the Family

Abstract:

Ideally, the family is a safe, protective, nurturing unit in which a child develops and grows. The early years are demanding for parents, who, in addition to bonding with their child, must make daily decisions that are vital to their child’s life and growth. In contrast, the adolescent years are emotionally challenging, as parents struggle to remain connected, supporting their child’s bid for independence, while protecting them from making sometimes disastrous choices, as the child struggles to develop her own ideas and direction.

Let’s add Lyme disease to this picture. Parents of children with Lyme disease carry an enormous burden, far greater than those outside the Lyme community are likely to understand. They worry about accuracy of diagnosis, selecting the right doctor and treatment approach, paying for treatment that is very costly, and the complexities of identifying and advocating for educational supports that may be necessary for a child to make it through school.

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Personality Effects on Children – Case Study

Abstract:

Opening the door of my office one day in May 2001, I stepped back in surprise. The teenager standing there wore a brilliant orange, neck-to-foot jumpsuit. There were shackles with chains between her wrists and she was hobbled by more chains between her ankles. Surrounding her were two rather determined-looking women, looking at me doubtfully. I had known that 17- year-old Vicki was coming from a juvenile detention unit, but I hadn’t expected matrons, manacles, and chains.

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Antibiotic Enhances Third Grade Student Performance

Abstract:

“I am writing this letter in regards to what I have observed regarding your patient’s academic performance while on his antibiotics compared to his performance without antibiotics. We are now in our third month of school and I have had a solid opportunity to observe the Bruce’s abilities on a daily basis. I have maintained a continual communication with his parents and together we have been able to monitor, both, his  social and academic behavior, in relation to his treatment for Lyme disease.”

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Bartonella – Neurocognitive Case Studies

Abstract:

We detected infection with a Bartonella species (B. henselae or B.  vinsonii subsp. berkhoffii) in blood samples from six immunocompetent patients who presented with a chronic neurological or neurocognitive  syndrome including seizures, ataxia, memory loss, and/or tremors. Each of these patients had substantial animal contact or recent arthropod exposure as a potential risk factor for Bartonella infection. Additional studies should be performed to clarify the potential role of Bartonella spp. as a cause of chronic neurological and neurocognitive dysfunction.

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Lyme Disease – Identifying it in the Schools

Abstract:

How might a child or adolescent with undiagnosed Lyme Disease present to: Teacher, School Nurse, Guidance Counselor

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Pediatric Lyme disease and Associated Tick-borne Infections:
Causes and Physical and Neuropsychological Effects in Children

Abstract:

Whenever a change in a child’s behavior, mood, or overall functioning occurs, including a suspected attention deficit/hyperactivity disorder, Lyme disease (LD) or tick-borne infections (TBI) should be considered quickly as delays in diagnosis frequently lead to debilitating chronic illness and cognitive impairments. Parents and educators need to be aware of the possibility of LD and TBIs as they may be first to recognize the possible underlying infections origin of aberrant student behavior. Lyme disease and TBIs have become a permanent part of America’s public health landscape, affecting most perilously its young, their families, and school community. Many children seriously affected by these infections have alterations in personality, cognitive functioning, and behavior.

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Lyme Disease and Tick-Borne Infections:
Causes and Physical and Neuropsychological Effects in Children

Abstract:

Education publications contain few articles on the impact of Lyme disease and associated tick-borne infections on the capacity of school-aged children to function successfully within an educational program. This oversight is of considerable concern, as educators are front-line service providers for children and adolescents presenting with symptoms of behavioral, cognitive, learning, and/or psychological problems. Educators can play a significant role in recognizing impaired school performance due to Lyme disease or other tick-borne infections and advocate for the child within the medical/school community.

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