It is arguably the central problem in the field, and it deserves a more useful answer than "keep looking." The National Institute of Mental Health describes the hallmark as the suddenness: a child who was fine last month is now unrecognizable. What Families Typically try First, and Why it StallsThe usual sequence is a local pediatrician, then perhaps a psychiatrist or neurologist. Families in the Midwest and beyond can access this through a PANDAS specialist who offers exactly this kind of records review and doctor-to-doctor consultation, with in-person treatment where the physician is licensed. Write down the timeline, gather the records, and get the case in front of someone who has seen this before.