Contact your provider as early as possible — do not wait to see if it resolves. During a flare, reduce demands on your child. This is not the time to hold firm on homework or social obligations that require executive function the child temporarily does not have access to. One of the hardest things to do, but one of the most important, is not accommodating OCD rituals — answering repeated reassurance questions or rearranging the environment to avoid triggers tends to expand the OCD over time. A therapist trained in CBT/ERP for PANS and PANDAS can help you understand what to do instead. Protect yourself too. Caregiver burnout in these families is real. If you have any access to support — another parent who understands, a therapist of your own, a few hours of help — use it without guilt.