Different stories.
The same knot.
Anxiety. Gut trouble. Exhaustion. Rage. Every family arrives with a different tangle of symptoms. It’s almost never just one thing. We look for the thread that starts it.
Call (845) 592-0727.
10
Root causes
67
Questions in our intake
5
Steps
Maybe one of these is yours.
Seven ways families arrive here. If one of them is yours, you’re in the right place.
Your child was well, and then wasn’t, and nobody can tell you what changed.
The tests keep coming back normal.
School has turned into a negotiation you lose most mornings.
Sleep stopped working, and everything got worse from there.
You’ve seen five specialists and been handed five pieces of an answer.
You’ve started to wonder whether people think you’re imagining it.
Or maybe it’s you, a teen or a young adult. Foggy at school or at work. Worn out. Told it’s just stress.
You’ve been right.
Five steps. The same method, every family.
Consult
You tell the whole story once. We read what you send before the visit.
Map
A 67-question intake shows which of the ten root causes weigh the most.
Confirm
Testing checks the strongest suspicions, so the plan rests on evidence.
Treat in cycles
Cycles of about six weeks. We check what changed before every next step.
Reassess
What moved, what didn’t, what’s next. Then we go deeper.
We look for why — across ten root causes.
It’s rarely one broken part. It’s root causes pulling on each other. We map all ten, then start with the heaviest.
What happens in each cycle
Diagnose
Map all ten, then test the strongest suspicions.
Sequence
Start with the heaviest. Then the next.
Act
Cycles of about six weeks. Re-check. Adjust.
Infection
Tick-borne and viral. The immune system stuck on.
Nutrition
The building blocks running low.
Gut
The gut sets the tone for everything.
Environmental
Mold and other exposures the body can’t clear.
Medication
Meds that help here, cost you there.
Lifestyle
Sleep, movement, food.
Mind & Mood
Stress that lives in the body.
Genetics
What you were born with.
Hormones
The signals behind energy and repair.
Substance
What gets in the way of sleep and recovery.
Sized by how often each tends to be part of the picture in our practice — a map to start from, not a diagnosis.
What families bring to us.
These are the illnesses we see most. Each one is a place to start, not the whole story. We still map all ten root causes for every family.
Lyme disease and tick-borne infectionsPlus the infections that often come with it, like Bartonella and Babesia.
Many families never saw a tick bite. In kids, it can show up as mood swings, poor sleep, joint pain, or a school year falling apart. We look at the whole picture, not just one test result.
PANS and PANDASThe child who changes overnight.
A sudden change in a child: new fears, rituals, tics or rage, often after an infection. Dr. Somer looks for what set it off, and works alongside your child’s other care.
Immune-related brain inflammationWhen anxiety, OCD, or mood changes have an immune piece.
Sometimes what looks like a mental health problem has an immune piece underneath. We look for that piece, and work alongside the care your family already has.
Mold and environmental exposuresMycotoxins, heavy metals, and other things the body can’t clear.
A home, a school, or an old exposure can keep the immune system on edge. Your practitioner decides whether testing makes sense.
Mast cell activationReactions that come and go.
Flushing, hives, stomach trouble, or reactions to foods and smells. It is often one part of a bigger picture, so we look at what is driving it.
Gut problems, including SIBOSmall intestinal bacterial overgrowth, and a gut that won’t settle.
The gut sets the tone for everything. Bloating, belly pain and food reactions are often tied to the other root causes. So we treat them together.
Symptoms that never went away after an infectionFatigue, brain fog, or pain that started with an illness.
Some families can point to the week it started: a virus, a strep throat, a tick bite. Then it never fully cleared. We look for why.
This list isn’t complete, and it isn’t a diagnosis. After your first visit, your practitioner tells you what fits your family. Not sure we can help? Call (845) 592-0727.
Meet Dr. DelSignore
Somer DelSignore, DNP, PNP-BC
Board-certified pediatric nurse practitioner · MAPS Fellow 2025 · ILADS member
Dr. Somer is a champion of root-cause medicine. She cares for children, teens and young adults with long-lasting illness that touches many parts of the body. These are families who have already seen the specialists. They left with only pieces of an answer. Tick-borne illness. PANS and PANDAS. The child who changes overnight.
She built R.E.S.E.T. so all ten root causes are looked at early, before a plan is built. She prescribes, she orders labs, and she walks the recovery with the whole family.
More about Dr. DelSignore
Voted a Hudson Valley Parent
Favorite Doc
This takes time. We say so up front.
Bodies don’t heal on a schedule that suits anybody. We would rather tell you that at the start than let you find out at month three.
So we work in cycles of about six weeks: test, treat the heaviest thing, re-test, adjust. There’s something to do in between.
And we’re not the right fit for everyone. If there’s a faster answer somewhere else, we’ll tell you where to look.
We keep the practice small on purpose.
Careful work takes time, and time is the one thing that can’t be stretched. That means we are often full, and sometimes we have to say not yet.
If that happens, it isn’t a judgment about your child. It’s how we keep enough time for each family already in our care.
Real progress, not a quick fix.
A path, not a turnstile.
One conversation, and an honest answer.
Mon · Tue · Thu 10–5
Friday by appointment
Closed Wednesday and weekends
If you email, send just your name and the best number to reach you. Please no health details.
In an emergency, call 911. For thoughts of self-harm, call or text 988.