Dysautonomia (Autonomic Dysfunction)
Helping Kids Live Active, Healthy Lives
Frequent dizziness, flushing, fast heartbeat upon standing, or near-fainting in a child can be signs of autonomic nervous system dysfunction. Also called “dysautonomia†and “postural orthostatic tachycardia syndrome (POTS),†autonomic dysfunction can also cause symptoms including weakness, headaches, vomiting, bowel changes, difficulty concentrating, increased sweating, sensitivity to heat or cold and more. These can happen alone or together and affect a child’s daily activities.
The autonomic nervous system controls involuntary body function such as heart rate, blood pressure, temperature and digestion. A problem in the autonomic nervous system is like a software problem in a computer. The "hardware" of the body (the bones, muscles, organs) is healthy. But the "software" (the nerve signals controlling dizziness and pain) is not working like it should.
Nemours Children’s dysautonomia team is part of our award-winning care at heart centers in Delaware and Florida. We partner closely with experts in the autonomic nervous system including psychologists, cardiac exercise physicians, rehabilitation therapists, and others to care for your child.
We work together to restore your child’s quality of life and get them back to the fun of being a kid.
What to Expect
Comprehensive Heart Evaluation
The first step in understanding your child's condition is to ensure that their heart is functioning and working as it should.Â
We tailor testing to your child’s specific symptoms. Our cardiology team may perform a variety of tests such as:
- Vital sign measurements like heart rate, blood pressure, temperature, oxygen levels, breathing rate and others
- Active standing test to assess heart rate, blood pressure and symptoms during position changesÂ
- Electrocardiogram (ECG) to measure heart rhythm
- Echocardiogram, or ultrasound of the heart, that use soundwaves to look at the heart’s function and structure
- Exercise stress tests to see how the heart responds during physical activity
- Other tests as needed, such as tilt-table tests, 24-hour ECG heart monitoring (Holter monitor), QSWEAT (to assess autonomic nerve function), and referral to other specialists
We may use different therapies, including:
Physical Activity
Physical activity is vital to autonomic dysfunction treatment success. However, children often reduce activity because of their symptoms. It’s important to slowly and safely introduce exercise to help your child get back to doing what they love. We may recommend:
- Exercise programs developed just for your child and their individual needs, such as our Autonomic Dysfunction Exercise Program
- Rehabilitation therapies, like physical and/or occupational therapy to build endurance, balance and strength
- Integrative therapies like yoga to gently stretch out tight muscles and strengthen weak muscles
Cognitive Behavioral Therapy
Our child psychology experts use cognitive behavioral therapy (CBT) to change thinking patterns (cognition) and behaviors (lifestyle habits and physical activity).
Thoughts, beliefs, memories, attention and emotions — as well as environmental, social, cultural and family factors — can play roles in pain and symptoms. CBT helps teach thoughts, skills and behaviors that may reduce the impact symptoms have on your child’s everyday life.
Lifestyle Changes
Lifestyle changes refer to things we can do in our daily life to improve symptoms. For dysautonomia, we may suggest:
- Making nutrition changes, like increasing fluid and salt intake, improving diet or eating more throughout the day
- Enhancing wellness with integrative therapies like healing touch, guided imagery and massage
- Encouraging other healthy habits like improving sleep, taking breaks, managing stress and more
Referral to Other Nemours Specialists
Patients with POTS or other forms of cardiovascular autonomic dysfunction may have symptoms that need  further evaluation and care. Depending on their symptoms, we may refer your child to specialists in pain management, dysmotility gastroenterology, autonomic urology, neurology and others.
Two Leading Pediatric Heart Centers
Our heart centers offer highly advanced, integrated care just for kids and young adults with congenital heart disease. Learn about our focused programs, innovative research and exceptional outcomes. Â
Dysautonomia, or POTS, has many symptoms. Learn more about this disorder from the experts at Nemours KidsHealth®.
Exercise is one of the most effective treatments for autonomic dysfunction. Learn more about getting your child active.
Managing stress is important, even for kids. Find relaxation techniques that work.
Your child may need an echocardiogram to help assess their heart. See what to expect.Â
- Learn POTS
- Exercise
- Managing Stress
- Echocardiogram
Related Specialties & Programs
Advanced Screening, Treatment and Lifestyle Support
Our team knows how dysautonomia can affect a child. We listen and provide integrated treatments that support your child, physically, emotionally and socially.Â
![](/services/dysautonomia/_jcr_content/root/container/container/regionalizedcontaine_1515688686/regionalizeditem/differentiator_image/columnsplitter/col1/image.coreimg.jpeg/1694459720095/differentiator-mom-teen-age-girl.jpeg)
Dysautonomia is hard to diagnose. We help you find answers and build a treatment program that fits in your family’s life.
°Â±ð’v±ð cared for kids with POTS for many years. Families throughout the Southeast come here for our expertise.Â
Our team provides seamless care with different specialists your child may need, like gastroenterology, urology and neurology.
We're researching autonomic dysfunction and sharing our knowlege so that kids everywhere can benefit.
Advanced Screening, Treatment and Lifestyle Support
Our team knows how dysautonomia can affect a child. We listen and provide integrated treatments that support your child, physically, emotionally and socially.Â
![](/services/dysautonomia/_jcr_content/root/container/container/regionalizedcontaine_1515688686/regionalizeditem_1758651956/differentiator_image/columnsplitter/col1/image.coreimg.jpeg/1694459733690/differentiator-mom-teen-age-girl.jpeg)
Dysautonomia is hard to diagnose. We help you find answers and build a treatment program that fits in your family’s life.
We team with our Integrated Pain and Wellness Program that offers both medical and holistic therapies, like massage, yoga and healing touch, just for kids.Â
Our team provides seamless care with different specialists and programs your child may need.
°Â±ð’r±ð experts in pediatric heart health. If there is a problem with your child’s heart, we work to diagnose it quickly and start treatment right away.
Meet the Team
Nemours dysautonomia teams are experienced and focused on your child's healthiest future. Meet them now.Â
-
Sean Daniel Connolly, DO
Cardiology Associate Program Director, Pediatric Cardiology FellowshipPrimary Office
Wilmington, DE -
Joel D. Temple, MD
Cardiology Director, Electrophysiology; Associate Chief, CardiologyPrimary Office
Wilmington, DE
-
Bahram Kakavand, MD
Cardiology Director, Cardiopulmonary Exercise Lab-OrlandoPrimary Office
Orlando, FL
![Smiling mom and smiling preschooler look at laptop Close-up of smiling mom and smiling preschooler looking at laptop](/content/experience-fragments/nemours/us/en/site/video-specialty-appointments/master/_jcr_content/root/two_panel_block_left/col1/image.coreimg.jpeg/1686927050154/block-mother-son-laptop-j7254.jpeg)
Convenient Follow-Up Appointments by Video
We offer follow-up appointments through scheduled, live video visits. You can avoid waiting rooms and save travel time. Ask your doctor if this is an option for your family.