LIVE from ILADS: Tick Boot Camp sits down with Dr. Somer DelSignore, DNP, BC-PNP, founder of Hudson Valley Integrative Health in Beacon, New York, for a wide-ranging conversation about pediatric Lyme disease, congenital tick-borne infections, autism spectrum symptoms, PANS/PANDAS, autoimmune encephalopathy, developmental delays, behavioral changes, and the importance of investigating potential biological contributors to neuroimmune dysfunction.
Dr. DelSignore practices integrative pediatrics with a focus on children experiencing complex chronic illness and neuroimmune symptoms. Rather than stopping at a behavioral or developmental diagnosis, she describes a root-cause approach that asks a deeper question:
What biological processes could be contributing to this child’s symptoms?
The conversation explores some challenging and evolving areas of medicine, including possible relationships among infections, inflammation, immune dysfunction, neurological development, and behavioral symptoms. Dr. DelSignore shares observations from her clinical practice and argues for more comprehensive biomedical evaluation of children with complex or atypical presentations.
This interview was recorded live at the ILADS conference, so you may hear some of the energy and background activity of the event throughout the conversation.
Looking Beyond a Pediatric Diagnosis
Dr. DelSignore describes treating children who don’t always fit neatly into one diagnostic category.
Some arrive with:
- Autism spectrum diagnoses or symptoms
- Developmental delays
- Behavioral changes
- Cognitive difficulties
- Motor delays
- Speech and language delays
- PANS/PANDAS
- Autoimmune or neuroimmune symptoms
- Suspected congenital Lyme disease
- Other tick-borne infections
A pattern she says sometimes catches parents’ attention is an unexpected improvement when a child receives treatment for an unrelated infection.
Parents may report that their child temporarily gains language, motor, behavioral, or other skills while taking an antibiotic, only to regress after treatment ends.
For Dr. DelSignore, observations like these are clues that warrant further investigation rather than immediate conclusions.
Root-Cause Medicine for Children
Dr. DelSignore describes her work as a form of detective work.
A diagnosis describes what clinicians are observing, but she wants to investigate why those symptoms are occurring.
When a child presents with neurological, developmental, behavioral, or immune dysfunction, she evaluates possible contributors and works backward from the symptoms.
That may involve extensive history-taking, laboratory evaluation, the child’s medical history, environmental factors, immune function, infections, inflammation, genetics, and sometimes the parents’ medical histories.
Once potential contributors are identified, her goal is not only to address them but also to support the immune and neurological systems as the child progresses.
Learn more about Dr. Somer DelSignore and Hudson Valley Integrative Health.
Congenital Lyme & Tick-Borne Infections
One of the most important subjects in this conversation is congenital or maternal-fetal transmission of tick-borne infections.
Dr. DelSignore discusses evaluating both children and their parents when the child’s presentation suggests that infection or immune dysfunction could have begun during pregnancy or early development.
She specifically discusses Borrelia, Bartonella, and Babesia — the pathogens Tick Boot Camp often refers to as the Three B’s — in the context of her clinical work.
Dr. DelSignore also discusses another possibility: even when direct transmission isn’t established in an individual case, maternal infection and inflammation during pregnancy could potentially influence fetal immune or neurological development.
These are complex and evolving areas of research, and determining what occurred in an individual child requires careful clinical evaluation rather than assuming that every developmental or neuroimmune condition has an infectious cause.
Why Family History Matters
With very young patients, Dr. DelSignore says the parents’ history can become especially important.
She asks mothers questions such as:
- Were you exposed to ticks?
- Did you experience unexplained symptoms before or during pregnancy?
- Did you have unusual illnesses earlier in life?
- Did you struggle with immune dysfunction?
- Do you have autoimmune conditions?
- Were there infections or inflammatory problems during pregnancy?
For an infant who cannot describe symptoms, family history may provide clues that aren’t available from the child alone.
Dr. DelSignore combines that history with clinical presentation and diagnostic testing when deciding what warrants further investigation.
What Might Lyme Disease Look Like in a Young Child?
Young children present a unique diagnostic challenge.
They cannot necessarily explain that they are exhausted, experiencing pain, having temperature changes, or feeling neurologically different.
Dr. DelSignore describes seeing infants with findings such as hypotonia — unusually low muscle tone — along with feeding and sleeping difficulties that extend beyond what would ordinarily be expected.
As children grow, additional clues may emerge.
Clinicians and parents can begin evaluating whether a child is:
- Sitting appropriately
- Crawling
- Developing speech
- Gaining words
- Building sentences
- Developing motor skills
- Interacting socially
- Meeting expected developmental milestones
Dr. DelSignore emphasizes that none of these signs by themselves diagnose Lyme disease or another tick-borne infection.
Instead, they may be reasons to investigate further when considered alongside medical history, exposures, physical findings, and other symptoms.
Behavioral Symptoms in Toddlers & Children
In toddlers and older children with tick-borne illness, Dr. DelSignore says the presentation can become heavily neurological or behavioral.
She discusses symptoms including:
- Irritability
- Impulsivity
- Poor sleep
- Delayed speech
- Social difficulties
- Auditory sensitivity
- Visual sensitivity
- Anxiety
- Depression
- OCD-like behaviors
- Rage
- Fatigue
- Sweating
- Temperature dysregulation
The difficulty is obvious: many of these symptoms overlap with other pediatric neurological, developmental, psychiatric, and medical conditions.
A nonverbal child also may not be able to report fatigue, pain, headaches, sensory changes, or other physical symptoms.
That overlap is one reason Dr. DelSignore argues against trying to identify tick-borne illness from behavior alone.
Autism, Lyme Disease & an Important Distinction
A substantial portion of this conversation explores autism and possible biological contributors to autism-spectrum presentations.
This requires an important distinction.
Autism is not synonymous with Lyme disease, and an autism diagnosis by itself does not establish the presence of a tick-borne infection.
Dr. DelSignore’s position is that some children diagnosed with autism or presenting with autism-like symptoms may also have infections, inflammation, autoimmune processes, or other biomedical issues that deserve investigation.
She describes autism as a syndrome diagnosed from patterns of behavior and development rather than through a single definitive laboratory test. From her root-cause perspective, she therefore asks what potentially modifiable biological factors might coexist with or contribute to an individual child’s presentation.
This distinction is especially important because the scientific questions surrounding infection, immune activation, neurodevelopment, and autism remain complex and actively studied.
Can Treating an Infection Change Developmental Symptoms?
Dr. DelSignore shares clinical experiences in which she says children experienced substantial developmental and behavioral improvement after underlying infections and immune dysfunction were addressed.
She discusses one case involving a nonverbal child with significant autism-spectrum symptoms whom she says tested positive for Borrelia, Bartonella, and Babesia in the context of suspected maternal transmission.
Following treatment, she reports that the child progressed dramatically and was functioning much more typically by school age.
This is a clinical case described by Dr. DelSignore, not evidence that tick-borne infections explain autism broadly or that antimicrobial treatment is an established autism treatment.
What it illustrates is the central argument she makes throughout this episode:
When a child’s presentation is unusual or complex, clinicians should remain curious about potentially treatable medical contributors.
The Neuroimmune Connection
Dr. DelSignore encourages clinicians to think about some pediatric presentations through a neuroimmune lens.
The nervous system and immune system don’t operate independently.
Infection can trigger immune activity and inflammation, and immune dysfunction can have neurological consequences.
Dr. DelSignore discusses evaluating children for both infections and evidence of autoimmune activity when clinically appropriate.
Rather than attempting to draw a clean line between a behavioral diagnosis and an infectious diagnosis, she looks at the entire clinical picture and asks what combination of processes could be affecting that individual child.
PANS/PANDAS & Autoimmune Encephalopathy
This same framework is relevant to Dr. DelSignore’s work with PANS, PANDAS, and autoimmune encephalopathy.
Children with these conditions can experience dramatic neuropsychiatric or behavioral changes associated with immune activation.
Dr. DelSignore’s clinical focus includes identifying possible infectious and inflammatory triggers and then addressing both the trigger and the downstream immune or neurological dysfunction.
Her work therefore overlaps infectious disease, immunology, neurology, psychiatry, and developmental pediatrics rather than remaining confined to a single specialty.
ILADS identifies Dr. DelSignore’s areas of focus as neuroimmunology, autism spectrum disorder, PANS/PANDAS, and chronic/congenital Lyme disease.
Why Comprehensive Evaluation Matters
One of Dr. DelSignore’s strongest messages is that children with complex developmental or behavioral presentations deserve a thorough medical evaluation.
She says older children often reach her practice after seeing numerous providers while their symptoms have been characterized primarily as behavioral or psychiatric.
By the time they arrive, some families have spent years searching for explanations.
Dr. DelSignore advocates looking more broadly at potential contributors, including infection, immune dysfunction, inflammation, environmental exposures, genetics, nutrition, and other biological factors when clinically indicated.
The goal isn’t to assume every child has Lyme disease.
It’s to ask enough questions before deciding that nothing else is contributing to the child’s symptoms.
Psychiatric Symptoms Can Have Medical Contributors
The conversation also examines the relationship between physical health and psychiatric symptoms.
Dr. DelSignore describes situations in which she believes infection-driven immune activation and neuroinflammation may contribute to anxiety, depression, irritability, OCD-like behaviors, rage, and other neuropsychiatric symptoms.
She argues for investigating potential biological contributors rather than automatically treating every behavioral presentation as an isolated psychiatric problem.
At the same time, the conversation acknowledges that psychiatric medications can be appropriate and important for some patients.
The larger message is individualized care: evaluate the whole child and determine what combination of supports that particular patient needs.
No Single Cause of Autism
Near the end of the interview, the conversation turns to claims about acetaminophen/Tylenol use during pregnancy and autism.
Dr. DelSignore rejects the idea that there is a simple, single explanation for autism.
She describes autism as potentially involving many interacting factors and argues that research findings about individual exposures need to be interpreted in context rather than reduced to a headline claiming one substance "causes autism."
Her broader point aligns with the philosophy she describes throughout the interview:
There is no simple answer for a complex biological system.
Instead, she looks for what she describes as a "stacking" of contributing factors that may differ substantially from one child to another.
Can Women with Lyme Disease Have Children?
The interview closes on a question that creates tremendous fear for many young women diagnosed with Lyme disease:
Can I safely have a child?
Tick Boot Camp raises the importance of helping women understand congenital Lyme disease, pregnancy, treatment before conception, care during pregnancy, and what parents and clinicians should consider after birth.
Dr. DelSignore agrees that these questions deserve much deeper discussion.
The existence of congenital transmission concerns should not be interpreted as meaning that someone with Lyme disease cannot have a healthy pregnancy or healthy child.
Instead, it reinforces the value of working with knowledgeable healthcare professionals to develop an individualized plan before and during pregnancy.
For a deeper Tick Boot Camp conversation with Dr. DelSignore, listen to Pediatric Lyme, Autism Regression, PANS/PANDAS & Root-Cause Healing.
About Dr. Somer DelSignore
Dr. Somer DelSignore, DNP, BC-PNP is a board-certified pediatric provider and founder of Hudson Valley Integrative Health in Beacon, New York.
Her clinical work focuses on complex chronic illness in children, including neuroimmunology, PANS/PANDAS, autoimmune encephalopathy, autism-spectrum presentations, Lyme disease, and congenital tick-borne illness.
She completed graduate and doctoral education at the University of Pennsylvania and SUNY Upstate Medical University and has pursued advanced mentorship and training in integrative medicine, Lyme disease, PANS, and autism. She developed the R.E.S.E.T. Protocol, a root-cause framework for addressing immune dysfunction.
Dr. DelSignore is also a member of the ILADS Pediatric Committee.
Key Topics in This Episode
Pediatric Lyme disease, congenital Lyme disease, Dr. Somer DelSignore, autism and Lyme disease, autism spectrum disorder, PANS, PANDAS, autoimmune encephalopathy, neuroimmune dysfunction, neuroinflammation, Borrelia, Bartonella, Babesia, Three B’s, developmental delays, speech delay, hypotonia, behavioral symptoms, pediatric tick-borne disease, maternal-fetal transmission, congenital tick-borne infections, root-cause medicine, integrative pediatrics, biomedical evaluation, immune dysfunction, psychiatric symptoms, pregnancy and Lyme disease, and pediatric Lyme testing.
About This LIVE from ILADS Interview
This conversation was recorded in person at the 2025 International Lyme and Associated Diseases Society Annual Scientific Conference, From Terrain to Treatment: Advances in Vector-Borne Illness, held October 9–12, 2025, in San Antonio, Texas.
Because these interviews were recorded live at the conference, they have a different feel from Tick Boot Camp’s traditional long-form virtual and studio conversations — shorter, focused, and surrounded by the activity of one of the world’s major gatherings of Lyme and tick-borne disease clinicians, researchers, advocates, and innovators.
Dr. DelSignore was also a speaker at the conference, where ILADS highlighted her work in integrative pediatrics and personalized treatment for children.
Explore all Tick Boot Camp LIVE from ILADS interviews.
More from Tick Boot Camp
Watch or listen to Tick Boot Camp’s long-form interview with Dr. Somer DelSignore for a deeper exploration of pediatric Lyme disease, congenital infection, autism regression, PANS/PANDAS, and root-cause healing.
Hear more conversations with Lyme disease doctors and healthcare professionals, or explore the Tick Boot Camp Podcast for hundreds of patient stories and interviews with doctors, researchers, advocates, and other voices throughout the Lyme disease community.
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