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  • Results of visit with pediatrician...

    So, my little guy has been jumping and running compulsively across the living room and back for over a year now. Some vocalizing, with grunts and excited sounds so I started researching Tourettes which brought me to this website and forum. I was encouraged to see the doctor about my suspicions so we went to the gp in June, he referred us to a ped and we finally were able to get in yesterday.

    Just like the gp, when he saw the video on the laptop he suspected autism, but after talking with my son the ped said his verbal and communication skills are advanced for his age, for this reason he said no way is it autism nor is it Tourette with just grunting while he jumps and runs. He said it isn't Tourette because he's not uttering phrases or nonsense words.

    His did say my son is obsessive compulsive. I told him I could see the compulsiveness but what is his obsession? He said he is obsessed with keeping his little body moving. He enjoys it so much he wants to do it all the time and it?s my job to distract him with other things so it doesn?t get out of hand. Which makes me feel not so well, I have tried to distract him, his compulsion to do this behaviour is very strong. He didn?t mention ADHD or Sensory Integration disorders either. We talked about his sensitivity to textures and noise but the ped didn't relate it to his apparent OCD.

    Can a doctor really diagnose my son in one 45 minute appointment? He said he could refer us to a child psychiatrist but that it wasn't necessary.

    I don?t know exactly how to help him, all the ped said was to distract him when he?s been jumping and leaping too long or if it gets disruptive. Oh ya, and to get him preschool because ?kindergarten will be an awful shock? if I don?t. I said I might home school, he said it's not a good idea because he needs social interaction. This bothers me because he gets plenty of social interaction. Just speaking with the kid you can tell he's well adjusted socially.

    I will make an appointment with my gp for a referral to someone who can help with OCD, because clearly I don't have a clue.

    Day

  • #2
    Results of visit with pediatrician...

    nor is it Tourette with just grunting while he jumps and runs. He said it isn't Tourette because he's not uttering phrases or nonsense words.
    Phrases and nonsenses words are not required to meet the criteria of a vocal tic. If your son is only grunting while he jumps/runs, I can see why the pediatrician may rule out that as a vocal tic. Usually the vocal tics occur on their own.

    A simple vocal tic can be sniffing, coughing, whistling, hissing, grunting, syllable sounds ("uh uh", "eee") etc. Complex vocal tics include phrases and nonsense words. The simple vocal tics are much more common than complex vocal tics.

    If you think what the doctor is saying does not fit what you are seeing with your son, then continue to push for a further assessment. Unfortunately not all doctors are familiar with TS, OCD, and other neurological disorders. There are many kids who have been to several specialists before a proper diagnosis was made.

    I am not saying your son does have TS, or that the doctor is wrong. Not being a medical specialist, I cannot make that determination. What I am saying is that you are the expert on your son. If you think parts of what you are seeing were not addressed in the assessment you got, then try to get more answers.

    Did you ask about ADHD and the sensory issues?
    Cathy
    Forum Moderator

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    • #3
      Results of visit with pediatrician...

      Hi Cathy, I did ask about sensitivity issues, he agreed that my son has sensitivities. I asked if he knew much about sensitivity integration disorder he said he knew a little and that it on that subject.

      I didn't ask about ADHD. The receptionist mentioned though, when we were waiting to go in, the doctors deals mostly with ADHD and autism, so if he suspected I'm sure he would have mentioned it. He started discussing my son while he in the room, going from asking my son questions and evaluating him, then onto me asking questions, etc. It was pretty hectic, I forgot a lot of things to ask and wasn't very comfortable with the format.

      The ped is retiring on Friday so basically this is our only chance to speak with him. It would have been really helpful to be able to see him a few times. Or to be referred to someone else who specialises in movement abnormalities. I can still take the psychiatrist referral, if anything the doctor may refer us to someone else.

      In my opinion my son has a Sensory Integration Disorder and this is related to his apparent Obsessive Compulsive tendencies. Ive seen a couple video clips online of people with Tourette and my son doesn't do what they are doing. Mostly I've seen a person sitting. My guy is fine while sitting, just fidgety.

      Regardless, I will be seeing someone else, if only to help us deal with his OCD because I received no good information from the doctor for dealing with it.

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      • #4
        Results of visit with pediatrician...

        Hi Day:

        I think you are right to pursue the referral to the psychiatrist. It sounds like you need more information and more time to ask questions.

        Don't be afraid to write down your questions and take them in. I use a binder as a journal of all my son's 'medical stuff'. It has checklists of his symptoms at various times, lists of medications he has tried and the results, plus results of assessments. I take it with me when we go to the doctor so I can check details as I need to. It also has all his developmental milestones -- when he walked, talked, rolled over, etc. He is 18 now and these still get asked when we see a new specialist.

        I put any questions that come up between visits in the front of the binder. That way I have a good chance of remembering to ask it when I am in the office.

        About the TS videos -- remember that tics will show differently between people. The videos can give you an idea of what some tics look like, but will not cover all possible tics. Just fidgetting is not usually a tic -- but if he can never sit still at all, he may be dealing with something like ADHD. It could also be a sensory issue.

        I was not 'officially' told my son had ADHD for several years. The doctor suspected it, but monitored him for awhile before she included that in the diagnosis.

        Let us know how things are going and if you get the answers you need at future appointments.
        Cathy
        Forum Moderator

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        • #5
          Results of visit with pediatrician...

          Thank you for your time, Cathy, I really appreciate your input and feedback.

          Well, I did have questions written down. Problem is I didn't I do what you do, as the questions come to me write them down so I had things occur to me after the appointment. This is only our second appointment, I'm sure I will get better. The format had me all confused too, I would rather not try to talk to the doctor with my son in the room.

          I realise Tourette shows up differently, I guess what I'm saying is I'm not convinced Tourette is his disorder. But I can't rule it out until I feel comfortable with the evaluation my son gets.

          I'll let you know how the psych appointment goes.

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          • #6
            Results of visit with pediatrician...

            Day, personally I think that doctor is wrong when he rules out autism that quickly. Doesn't he know anything about high functioning autism or Asperger Syndrome? That's autism, too, with an average to above average IQ and excellent speech and language skills. And EVERY autistic person will also have some tics as well, and some OCD and ADHD issues usually as well. I certainly do. I also have severe sensory issues.

            I am not sure a child psychiatrist is such a great idea. Personally, I think most psychiatrists are nut cases, and should themselves be evaluated (actually, research supports me in this). Why don't you go to your local autism society and find a good doctor through them? It might be worth a try.
            German citizen, married to a Canadian for 28 years, four daughters, one son, eight grandchildren (and one on the way).

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            • #7
              Results of visit with pediatrician...

              Hi Uschi. I agree with you, I'm pretty sure my son doesn't have a mental illness, how is a psychiatrist going to help? Which is why I said, 'no thanks' to the referral.

              There are so many things the ped said I just don't agree with.

              What you say makes sense because I have a feeling it's something in addition to/causing the OCD. I didn't mention Asperger although I meant to. :roll:

              The minute he asked me if my son got out to play with other kids and I said, "Not a whole lot but some." He had it pegged, it was odd. Like he was sure my guy wasn't getting out enough and that all he needed was preschool and for his parents to distract him more. We see our neighbours and go to the pool, park and library. It's not like my kid doesn't get out I just mentioned he doesn't do it a whole lot because it's not organized, like preschool or daycare.

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              • #8
                Results of visit with pediatrician...

                Uschi's suggestion of contacting an Autism or Asperger's group is a good one. Also, if there is a TS chapter in your area talk to them. Finding a doctor of whatever speciality who is knowledgeable about neurological disorders is your best route to getting a proper diagnosis.
                Cathy
                Forum Moderator

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                • #9
                  Results of visit with pediatrician...

                  Hi Day

                  We have shared stories already in how similar some of the things are between my 7 year jumping bean and your son. One of the things that I found helpful in trying ti figure out what was happening with my son was all the checklists available that list the various symptoms for TS and the associated disorders. These are readily available through the TSFC site and I know Uschi has posted some links to Autism or Asperger's that came give you what to watch for. When you use these resources based on what you see over time, and have his Dad complete them indepently from you and have his teacher complete them... you will get a big picture of what is going on and that is documentation that will assist you in any future meeting/ appointments you have. Keep in mind that if you have a concern with sensory issues you should get a referral to occupational theorapy because they assess and work through those issues.
                  Janet

                  TSFC Homepage

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                  • #10
                    Results of visit with pediatrician...

                    I'm off to get me some check lists, honestly, some of these things just occur to me. It's so helpful to have your adivice. Thank you so much, ladies!

                    I am looking for an OT in m area, my husband and I are prepared to see one without a doctor's referral if necessary.

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                    • #11
                      Results of visit with pediatrician...

                      Day:

                      child psychiatrist is a very good idea and most importantly a pediatric nerulogist, (sorry for the spelling)
                      There are scans and tests that can be done without pain to your child that can measure brain waves and reactions.
                      There is blood work that can tell you imbalances in levels and the scans can tell you if any glands in the brain are not functioning correctly, all giving you more answers.
                      We have a pediatrician here that focuses on children with disorders and spends a lot of time monitoring them and testing them to determine the real answers. 45 minutes with a GP or Pediatrician is not enough to give you any answers but is enough time to get referrals. It is your right as a mother to have the answers you need to offer the best to your child.

                      Some doctors out there forget that and do not go home to it first hand or just can not relate or get excited about helping.
                      Sometimes money is the big issue or space for testing and time.
                      push for the answers and fight for results. Your child will thank you years from now and you will know that no matter what you did the best you could for him.

                      As a mother with a boy that has multiple disorders I know I have to push the system to get the help and answers we need as a family and for our son.
                      It is a hard job and road but you have everyone here supporting your efforts. :D
                      PJK

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                      • #12
                        Results of visit with pediatrician...

                        Glad to hear you're going to see another doctor... no offense, but the last one sounds like he has no clue what he's talking about. He obviously doesn't know what a vocal tic is... and giving you an OCD diagnosis and saying his obession is with 'keeping his little body moving'??? I'm sorry, but that's bizarre.
                        I'm glad to hear he's retiring! Yikes!

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