There are numerous professionals with expertise in treating selective mutism.    Addressing the selective mutism might help your teen and you to feel more confident when she transitions to adult care.  In addition, talk to your pediatric rheumatology team, and together you can develop a plan specific for your teen that will take into [...]

In some rheumatic diseases, such as systemic lupus or vasculitis, involvement of the brain is well known, although does not affect all patients. Some children with periodic fever disorders may have inflammation affecting the brain as well.   Many other rheumatic diseases, such as arthritis, are not known to directly affect the brain with [...]

This is one of those specific rheumatic diseases where more study is needed regarding the psychological impact of JDM.  I am aware of a couple of studies that look at quality of life in youth with juvenile dermatomyositis that show lower quality of life than peers. 

SRIs (serotonin-reuptake inhibitors) have been shown to offer benefit to some individuals for anxiety and depression.   Medications might be something to consider for those with moderate to severe symptoms and when there is substantial functional impact from the symptoms.  As for children/youth with rheumatic disease, you will need to talk with your prescribing [...]

Yes, there are many things that can be done to reduce anxiety about receiving needles.  For some parents, this means coming up with a coping plan- things like using distraction, giving the child a sense of control by offering options (e.g., where the injection goes, look away, using numbing cream, identifying distractions to use).  [...]