Guided imagery for kids with chronic illness or sensory sensitivities

Guided imagery can be especially powerful for children who feel overwhelmed by medical procedures, pain, or emotional stress. It gives them a sense of agency and comfort, even when their bodies feel out of control.

Guided imagery can be a beautiful, empowering tool for children—especially those navigating pain, anxiety, or sensory overwhelm. Here’s a gentle overview tailored for kids and the adults who support them:

Guided Imagery for Kids: A Gentle Introduction

What is it?

Guided imagery is like storytelling for the body and mind. Children are invited to imagine calming scenes—like floating on a cloud, walking through a magical forest, or cuddling with a friendly animal—to help their bodies relax and their minds feel safe.

Why is it helpful?

• Pain relief: Helps kids shift focus away from discomfort (e.g., muscle aches, headaches, or growing pains)

• Emotional regulation: Eases anxiety, sadness, or overstimulation

• Confidence building: Encourages self-esteem through affirming imagery and phrases

• Sleep support: Creates a soothing bedtime routine that helps kids wind down

How can kids practice it?

• Audio recordings: Gentle voice-led meditations with music

• Parent-led scripts: Read aloud calming stories or visualizations

• Self-guided imagination: Encourage kids to “build” their own safe place in their mind

You can explore nearly 50 free child-friendly scripts on Green Child Magazine—including favorites like The Sleepy Seahorse, Peaceful Butterfly, and The Thankful Turtle.

Sample Script Snippet

“You’re walking through a quiet forest. The leaves whisper gently as you pass. A wise turtle greets you and offers a glowing stone that makes your body feel warm and strong…”

 

A Chinese Girl with NMOSD and Sjögren’s: case report

Case Report: A Chinese Girl with NMOSD and Sjögren’s Disease

This case involves a 14-year-old Chinese girl diagnosed with two rare autoimmune diseases: neuromyelitis optica spectrum disorder (NMOSD) and primary Sjögren’s. NMOSD is a condition where the immune system attacks the central nervous system, particularly the optic nerves and spinal cord, causing symptoms like vision loss and pain. Sjögren’s is another autoimmune disorder that typically affects moisture-producing glands, like those for saliva and tears, but can also impact other organs.

What Happened?

- At age 11, the girl experienced sudden headaches, painful eye movements, and vision loss in her right eye. Tests showed she had NMOSD, confirmed by the presence of specific antibodies (AQP4-IgG) and MRI findings showing inflammation in her optic nerve.

- She was treated with strong anti-inflammatory drugs (methylprednisolone) and immune system support (immunoglobulin), which helped restore her vision. She was then put on long-term medications (prednisone and mycophenolate mofetil) to prevent further attacks.

- Later, tests showed she had elevated liver enzymes (ALT and AST), which led to further investigation. A biopsy of her salivary gland revealed signs of Sjögren’s, confirmed by specific antibodies (anti-Ro/SSA and anti-La/SSB). She met the official criteria for primary Sjogren's diagnosis.

- Because her liver enzymes remained high, her medication was switched from mycophenolate mofetil to tacrolimus, which normalized her liver function. She has not had any NMOSD relapses since the initial episode.

Why Is This Important?

- NMOSD and primary Sjögren’s are rare in children, and having both together is even rarer. This case shows the importance of checking for other autoimmune diseases in kids with NMOSD, as they can have additional conditions like Sjögren’s that need specific treatment.

- Regular testing for antibodies (like ANA or others) can help doctors catch these conditions early, improving treatment and quality of life. If someone with Sjögren’sdevelops neurological symptoms, testing for NMOSD is critical to avoid missing the diagnosis.

SOURCE: A Chinese girl with neuromyelitis optica spectrum disorder coexisting with primary Sjogren’s syndrome: a case report and literature review.

What is Pediatric Autoimmune Disease?

Pediatric autoimmune diseases are conditions where a child’s immune system mistakenly attacks their own body’s healthy cells, tissues, or organs — thinking they’re harmful invaders.

These diseases can affect many parts of the body, including the joints, skin, brain, gut, and vital organs. Symptoms vary widely depending on which area is affected.

Common Pediatric Autoimmune Diseases

1. Juvenile Idiopathic Arthritis (JIA)
   Inflammation in the joints causing pain, stiffness, and swelling.

2. Type 1 Diabetes
   The immune system attacks insulin-producing cells in the pancreas.

3. Pediatric Lupus (SLE)
   Affects skin, joints, kidneys, and other organs.

4. PANS/PANDAS (Pediatric Acute-onset Neuropsychiatric Syndrome)
   Sudden OCD or tics after an infection (often strep).

5. Celiac Disease
   The immune system reacts to gluten, damaging the intestines.

6. Autoimmune Hepatitis, Thyroiditis, Vitiligo
   Other less common autoimmune types affecting liver, hormones, or skin pigmentation.

Warning Signs to Watch For

• Ongoing fevers with no infection

• Joint pain, swelling, or stiffness

• Extreme fatigue or weakness

• Sudden behavioral changes or tics (as in PANS/PANDAS)

• Skin rashes, mouth sores, or sun sensitivity

• Stomach pain, diarrhea, or weight loss

What Causes It?

There’s no single cause, but common factors include:

• Genetics (family history of autoimmune conditions)

• Environmental triggers (infections, stress, diet)

• Overactive or misdirected immune response

Diagnosis and Treatment

Diagnosis can be complex and may involve:

• Blood tests (e.g. ANA, inflammation markers)

• Imaging (e.g. X-rays or MRIs for joint issues)

• Specialist assessments (pediatric rheumatologists, endocrinologists, neurologists)

Treatment goals:

• Control immune activity

• Reduce inflammation

• Manage symptoms (pain, fatigue, organ damage)

• Maintain normal growth and development

Common treatments:

• Anti-inflammatory drugs

• Immunosuppressants

• Biologic therapies

• Diet and lifestyle changes

• Mental health support

Living with a Pediatric Autoimmune Disease

• Early diagnosis = better outcomes

• Many children go into remission or live full lives with good care

• Support is key: physical, emotional, educational

• Advocacy and awareness help reduce stigma and improve research

🔗 Support Resources

• Arthritis Foundation – Kids Get Arthritis Too

• Lupus Foundation of America

• JDRF – Type 1 Diabetes

• PANDAS Network

• Local pediatric hospitals and chronic illness support groups

Measures to identify unmet medical needs of children and adults with autoimmune and autoinflammatory diseases

 

Patients with autoimmune and autoinflammatory diseases face tough challenges in terms of their physical, mental, and social health, and they have many medical needs that are not being fully addressed. To help these patients, it's important to clearly understand what these unmet needs are. One way to gather this information is through Patient-Reported Outcomes (PROs), which are reports from patients about their own health issues. These reports are very useful in understanding what patients truly need.

This article looks at established ways to measure PROs to determine which are best for identifying the unmet needs of patients with autoimmune and autoinflammatory diseases. Experts from the Ministry of Health, Labor, and Welfare met to discuss these measures and also considered the possibility of using technology to collect PRO data electronically.

The experts suggested 28 potential measures, both specific to certain diseases and general ones. They emphasized the importance of making sure the measures are clearly understood in different languages and noted that the results from adults and children should not be mixed. They also discussed the challenges of moving from paper-based PRO measures to digital ones, mainly because of concerns about accuracy and a lack of technical and financial resources.

For non-disease-specific PRO measures, the experts recommended KINDL® and EQ-5D-Y for children, and SF-36v2® and EQ-5D™ for adults.

Here’s a quick breakdown of what these terms refer to:

1. KINDL®: This is a questionnaire specifically designed to measure the quality of life in children. It looks at various aspects of a child's well-being, like their physical health, emotional state, and social life.

2. EQ-5D-Y: This is a version of the EQ-5D, which is used to assess the general health of children. The "Y" stands for "Youth," so it's tailored for younger patients. It focuses on five areas: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.

3. SF-36v2®: This is a survey used to measure health-related quality of life in adults. It covers a wide range of health aspects like physical functioning, pain, mental health, and social well-being. The "v2" indicates it's the second version, with updates for better accuracy and clarity.

4. EQ-5D™: This is a general health measure used for both adults and children. Like the EQ-5D-Y, it looks at five key areas (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) but is meant for a broader age group.

These tools help doctors and researchers understand how diseases and treatments affect a person's day-to-day life and well-being.

READ ORIGINAL JOURNAL REPORT: Consideration of useful patient-reported outcome measures to identify unmet medical needs of children and adults with autoimmune and autoinflammatory diseases published in Modern Rheumatology April 2025.

Lupus in children

Lupus in children, also known as pediatric lupus, is a rare but serious autoimmune disease where the immune system attacks healthy tissues and organs in the body. Normally, the immune system defends us against harmful things like viruses and bacteria, but in lupus, it mistakenly targets parts of the body like the skin, joints, kidneys, heart, and other organs.

Types of Lupus in Children

The most common type of lupus in children is Systemic Lupus Erythematosus (SLE). This form affects multiple parts of the body and can cause a variety of symptoms.

Symptoms of Lupus in Children

Lupus symptoms can vary a lot, and some kids may have mild symptoms while others experience more severe issues. Common symptoms include:

• Skin rashes, often a butterfly-shaped rash across the cheeks and nose

• Joint pain or swelling, which might affect knees, wrists, and hands

• Fatigue, feeling tired all the time

• Fever without a clear cause

• Sensitivity to sunlight (the skin can get worse with sun exposure)

• Hair loss or thinning hair

• Swelling in the legs or around the eyes

• Mouth sores or ulcers

Diagnosis

Diagnosing lupus in children can be tough since the symptoms can look like other conditions. Doctors typically use a combination of:

• Blood tests to check for specific antibodies associated with lupus

• Physical exams to assess signs like rashes or joint swelling

• Urine tests to check kidney function, as lupus can affect the kidneys

Treatment

While there’s no cure for lupus, the goal is to manage symptoms and prevent flare-ups. Treatment often includes:

• Medications like anti-inflammatory drugs, corticosteroids, or immunosuppressive drugs to reduce the immune system’s attack on the body.

• Regular check-ups to monitor how the disease is progressing, especially kidney function and organ health.

• Lifestyle changes, such as using sunscreen to protect from sun sensitivity, maintaining a healthy diet, and getting enough rest.

Impact on Children

Living with lupus can be tough for kids. They may need to take regular medications, and they might miss school or other activities due to feeling unwell. The condition can also affect their social life and emotional health, so strong support from family, friends, and healthcare providers is important. Talking with a counselor or support groups can help kids cope with the emotional challenges of living with a chronic illness.

Outlook

With early diagnosis and proper treatment, many children with lupus can live active lives. Some may have long periods where their symptoms are under control, while others might experience flare-ups that require additional treatment. The key is to catch it early and manage the disease effectively.

Conclusion

Lupus in children is a serious condition, but with the right treatment, children can lead fulfilling lives. Awareness, early diagnosis, and good medical care are crucial for managing the disease and helping kids stay as healthy as possible.

Support for Children and Teens with Lupus in Australia

1. Chronic Illness Peer Support (ChIPS) – Royal Children's Hospital Melbourne
ChIPS is a peer support program for young people aged 12 and over living with chronic illnesses, including lupus. It provides a safe space for teens to connect, share experiences, and support each other. ​Royal Children's Hospital

2. Musculoskeletal Health Australia (MHA)
MHA offers peer support groups for various musculoskeletal conditions, including lupus. They have groups tailored to specific conditions and age groups, such as "Teen Talk" for adolescents. ​Musculoskeletal Health Australia (MHA)

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Support for Families and Caregivers

1. Lupus Association of NSW
This organization provides support groups across New South Wales for individuals with lupus and their families. They also offer resources for those interested in starting their own local support groups. ​Lupus Association of NSW Inc.

2. Lupus Victoria
Lupus Victoria facilitates support groups that offer a safe and empathetic space for individuals with lupus, their families, and caregivers. These groups provide a platform for sharing experiences and coping strategies. ​Lupus Victoria

3. Arthritis Queensland

While primarily focused on arthritis, this organization offers online support groups and a peer-mentor telephone service called 'Arthritis Assist,' which can be beneficial for families dealing with lupus. ​Arthritis Queensland

These organizations can provide valuable support and resources for children with lupus and their families.

🌍 Global Support Resources

1. Lupus Foundation of America (LFA)

• Offers a dedicated section for children and teens, providing educational materials and resources.​

• Hosts virtual support groups, including:​LUPUS LA -

  • Asian Lupus Support Group: A national, virtual group for those in the Asian community living with lupus and their loved ones.​Lupus Foundation of America

  • Spanish-language Lupus Support Group: A virtual group for Spanish-speaking members of the lupus community and their loved ones.​

• Provides LupusConnect, an online community where people with lupus and their loved ones can connect.​

• Find more information at lupus.org.​

2. Lupus LA

• Hosts a Teen Support Group for ages 14–18, meeting virtually.​

• Offers bilingual support groups in partnership with Looms4Lupus, accommodating both English and Spanish speakers.​LUPUS LA -

• For more details, visit lupusla.org.​LUPUS LA -

3. Hospital for Special Surgery (HSS) – Charla de Lupus

• Provides peer support groups where teens with lupus offer support and education to each other.​Hospital for Special Surgery+1sflupussupport.org+1

• Parents or caregivers participate in separate sessions to share experiences and support.​Hospital for Special Surgery

• Learn more at hss.edu.​Hospital for Special Surgery+1sflupussupport.org+1

4. Lupus Kids

• An education and outreach program offering resources and a message of hope for children with rheumatic illnesses and their families.​Lupus Kids

• Provides activities, health information, and a community for kids to ask questions and meet others.​Lupus Kids

• Visit lupuskids.org for more information.​Lupus Kids

5. The Hibbs Lupus Trust (UK)

• Offers support and information to anyone affected by lupus, including children and teens.​

• Provides a telephone support helpline, online forum, and face-to-face support meetings.​Wikipedia

• Find out more at hibbslupustrust.org.​

Support groups for children with Lupus and their families

Support groups can be really helpful for children with lupus and their families. These groups provide a space to share experiences, learn from others, and feel less alone. For children with lupus, support groups can also help them connect with others who understand what they're going through, while also providing emotional support and coping strategies. Here are some options for support groups and resources:

1. Lupus Foundation of America (LFA)

• The Lupus Foundation of America offers a variety of resources for both adults and children with lupus, including support groups and online communities. They often have local chapters where families can connect with others.

• Website: www.lupus.org

• LFA has Children and Teens info here.

• LFA also offers LupusConnect, an online community where patients and caregivers can connect.

2. Lupus Support Groups on Facebook

• Facebook has many private support groups for people with lupus, including those specifically for children or families of children with lupus. These groups allow parents and children to share experiences, ask questions, and offer support to each other.

• You can search for groups like "Lupus in Children" or "Pediatric Lupus Support" on Facebook to find active communities.

3. The American College of Rheumatology (ACR)

• ACR offers information about pediatric lupus and can direct families to support resources and specialists.

• Website: www.rheumatology.org

4. Children’s Hospitals and Pediatric Rheumatology Centers

• Many children's hospitals or clinics that specialize in rheumatology will offer support groups or can direct families to local support options. For example, hospitals like Boston Children’s Hospital and Children’s Hospital of Philadelphia often have lupus-specific programs or support groups for young patients and their families.

5. Lupus UK

• Although based in the UK, Lupus UK provides online support and resources for people with lupus worldwide, including for children and their families. They often have online forums and other virtual support options.

• Website: www.lupusuk.org.uk

6. Online Forums and Communities

• Websites like PatientsLikeMe and HealthUnlocked have communities where people living with lupus can connect, share experiences, and offer advice. Some forums are specifically for younger people or parents of kids with lupus.

7. Support from Rheumatologists and Social Workers

• Many pediatric rheumatologists and social workers can help connect families with local support groups or peer mentors who have experience with pediatric lupus. It's always a good idea to ask your child's doctor about available local or virtual support options.

Benefits of Support Groups:

• Emotional support: Connecting with others who truly understand the challenges of living with lupus can provide comfort.

• Practical advice: Parents and children can share tips on managing symptoms, navigating school, or handling treatment.

• Peer connections: Children can build friendships with others who are going through similar experiences.

• Awareness and advocacy: Support groups can help families stay informed about new treatments, research, and advocacy opportunities for lupus.

Finding the right support group can make a big difference in coping with the emotional and practical challenges of lupus. If you're unsure where to start, talk to your child's doctor—they may have additional recommendations or connections to local groups.

Could it be PANS/PANDAS?

We're hearing the stories of children affected.

We're hearing the stories of children across the country, whose personalities have completely changed - with the cause a rare brain condition...  PANS/PANDAS.

PANS/PANDAS symptoms from PANS PANDAS UK

They are both autoimmune conditions that usually develop suddenly following an illness, like Scarlett Fever for example.

Antibodies created to fight the infection go on to mistakenly attack the brain, leading to symptoms like massive changes in behaviour, including severe OCD.

Harry, whose name we've changed, was a happy nine-year-old boy in Lichfield, getting involved in sports and doing well at school, when he caught Scarlett Fever at the end of 2019.

A couple of months later, he started to develop severe OCD, and started to refuse to eat and drink. He also started writing in his diary that he wanted to die.

Dad Richard - whose named we've also changed, along with his mum initially took him to see his GP, but after his condition got worse, was taken to hospital for two weeks.

"He just seems less happy, less willing to communicate, and his sleeping pattern is all over the place. He's not been able to have a proper sleep for a very long time.

"Everything changed pretty much overnight".

Read the full story at RAYO

SYMPTOMS 

PANS and PANDAS are thought to be autoimmune disorders that occur when the body's immune system mistakenly attacks the brain, leading to inflammation and a wide range of neuropsychiatric symptoms. These symptoms can include sudden onset of obsessive-compulsive disorder (OCD), tics, restricted food intake, developmental regression, anxiety, depression, irritability, and even hallucinations and delusions.

One of the most distinctive features of PANS and PANDAS is that symptoms tend to come on suddenly, often following an infection, such as streptococcal infections, influenza, or chickenpox. Children who previously were healthy and developmentally on track may suddenly start exhibiting signs of OCD or other neuropsychiatric symptoms. ~ 

2024 Royal College of Nursing

More information and support

• in the UK 
• in the US a Pandas Physicians Network.
• in Australia a parents group
• in Europe a Facebook group

If you know of any other organisations or support groups for PANS and PANDAS please let us know in the comments to be included here.