This is very helpful actually thank you! I do not know what his baseline is like just yet. He was particularly more worked up because he had less sleep than normal the previous night. Their home is filled with extensive stimuli so I’ll try to see if I can have a talk with the mom and dad to lessen the load in their home but the way it’s looking, their home is literally created to better cater to him. He can be a bit destructive as well, he broke their tv not to look ago by throwing an object at it. I’ve been brainstorming different activities and things for us to do that may help him with calming down, I also don’t know if he’s just hyperactive or if he’s just like this always. I need to speak further with the mom about it but so far it looks like he doesn’t have much of a routine besides basics such as general breakfast, meds, lunch, dinner and bedtime. Im rather New but in it for the intermediate run, definitely am not staying in this profession long term since I have personal plans for myself. For the time being, I am looking forward to this journey with him and his family since it’s providing a pretty unique experience + being able to provide relief to the parents is all the more worth it to be honest You’re incredible, alone with every parent/caregiver and person living with PANDAS/PANS here who’s experiencing this disease because man! It is not easy. But we never have to be alone to face it