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Thread: Should I just wait and see?

  1. #1
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    Default Should I just wait and see?

    My son is 12 . When he was 9 years old he developed a coughing tic. He had other ones, humming and clicking but people worried he was contagious when he was coughing a lot. We saw a pediatric neurologist who explained to him about tics and put him on Zoloft for a few months. The coughing stopped.

    He had a physical a few months ago and I described some behaviors he does to his pediatrician. He chews his shirt and discreetly wipes food on his face. It seems to soothe him. I had been ignoring it but his pediatrician suggested I take him to therapy.

    I liked the therapist but he didn't tell me much. He did observe some tics. But my son would go but he didn't want to and wouldn't do any relaxation exercises. I talked to the therapist and he said we should discontinue therapy for now because he isn't ready. I am not sure what to do now, if anything. He does well in school and has lots of friends. I just don't want him to get teased. He doesn't think it is a problem.

    he is very overweight and I have had doctors suggest that he may feel upset about his weight and be anxious or depressed. He lost 10 lbs in the past 2 months which is great. He doesn't think it is a big deal, but he had to make changes.

    i called his pediatrician today to ask if I should do anything else at this point or not, but he hasn't got back to me.

  2. #2
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    Default Re: Should I just wait and see?

    Lori,

    If your son is not ready to or unwilling to do the work recommended by his therapist, then there is little point is making his continue, and it would seem the therapist made the right decision.

    You said your son doesn't have a definitive diagnosis at this time, so this might be a good time to pursue that task, to get a clear idea of what your son is actually dealing with.

    Tic disorders can cover a spectrum and not all tics represent Tourette Syndrome.

    If his tics do not cause him any discomfort, distress or impairment, then there is no medical reason to seek treatment for the tics; however if there happen to be comorbid conditions to the tic or unrelated issues that are not tic related, then these would warrant evaluation by a medical (mental health) professional to determine if a treatment might be indicated.

    It should be said that about 30% of kids experience tic symptoms during their growing up years that resolve themselves by the time they become adults, which is why tic disorders need to be evaluated and followed by a medical professional with an understanding of tic disorders and a clinical interest in treating them.

    Incidentally, your son's therapist seemed to be on the right track to propose relaxation exercises for your son, and stress, fatigue and excitement can often be at the root of triggering tic activity. an organized relaxation program that includes progressive muscle relaxation, directed imagery and most important deep breathing (diaphragmatic breathing) (See Here for Info) can often diffuse the bouts of tics that might occur. The exercises have to be continued for at least a minute or until the urge for the tics dissipates.

    There are several other strategies a therapist can offer in behavioral therapy and habit reversal that could benefit your son, but he has to be motivated to benefit from the therapy.

    Have you been in contact with any local support groups, particularly a local Chapter for Tourette Support?

  3. #3
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    Default Re: Should I just wait and see?

    Thank you Steve

    No, I haven't been in contact with anyone, this is my first step at reaching out. I am in the US

    I agree, his therapist was right that if he won't follow through with the exercises it isn't going to be helpful (and I don't want him to have a negative feeling about therapy). When we first saw a pediatric neurologist he told us that tics are common and they usually go away. His haven't gone away, but have changed.

    What type of professional would you recommend? I see a psychiatrist for myself and he didn't know much about tics. My insurance for behavioral health is different than for physical health. I do wonder if he has a co-morbid anxiety issue or anything else. I liked the therapist he saw, but he spent the whole session with my son and didn't tell me much.

    The tics don't cause any problems. He gets irritable when I want to talk about anything to do with doctors or if you look at him when he is doing some movements. I used to chew things when I was his age and it did soothe me so I do understand how that could feel good to him. Mainly, I don't want anyone to bother him about it. And, I don't know if anything is bothering him, he won't tell me. He has changed and I don't know how much is normal 12 year old behavior. He wants to be with his friends or in his room. He has some facial hair that we aren't supposed to look at or mention or he gets angry.

  4. #4
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    Default Re: Should I just wait and see?

    Lori,

    To help you locate a speciliat in your area of the U.S. call the National Office of the Tourette Syndrome Association

    They maintain a list of known and accredited specilists across the Country plus they can point you to the local Chapter in your area. If you click HERE you can search for a local TSA Chapter as well.

    You can ask the TSA National Office for Behavioral Therapists accredited to treat kids as well.

    Many medical professionals have neither the training nor clinical interest in treating kids with tic disorders and Tourette Syndrome, so you need to do some research on your own by asking around your local Chapter, the TSA or by calling local teaching hospitals departments of neurology or psychiatry.

    Generally the medical professionals that frequently treat TS could be a neurologist, a psychiatrist, a psychologist, a pediatrician and some GP's. Other medical professionals could also be occupational therapists in some cases.

    Tic activity in children with Tourette Syndrome is involuntary, but is also influenced by internal and external factors.

    • Internally, stress, fatigue and excitement are typically tic triggers.

      Externally, things that happen before tics (antecedents) or things that happen after tics (consequences) can also affect tic activity.


    As your son's advocate, you need to work with your son, his school and his lifestyle to ensure that these factors are kept to a minimum or to teach your son how he can minimize the impact of these factors on his own response to them.

    Paying attention to your son's tic expressions might actually be adding to his external triggers, contributing to his stress and consequently increasing his symptoms.

    It sounds like, as his self awarenes id developing, plus the fact of just being a young teeneager, whose body is changing, he may be struggling with the involuntary tic symptoms that seem to be exacerbated by both internal and external environmental factors.

    Many of these issues can be addressed by an accredited behaviour therapist trained in dealing with kids with tic disorders......which the TSA can help you locate.

    In the meantime, we will be pleased to continue our discussion and provide you with the help and support you might need in working to help your son.

    How is your son doing at school with his teachers, and fellow students? Is he involved in any extra carricular activities? What about his social contacts?

  5. #5
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    Default Re: Should I just wait and see?

    He is a good student. It doesn't come easy to him, but he works at it and gets As and Bs. He is very social, has lots of friends. He does boy scouts, chess club flag football and playing games with his friends. He is very nice.His teacher likes him and i like her. She is patient and seems to understand that somethings, like art, are hard for him

  6. #6
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    Default Re: Should I just wait and see?

    He is a good student. It doesn't come easy to him
    And this is a good thing, because if he has to work at getting good grades he is learning to study, to organize his work and to plan his work..all important skills for higher education and eventual workplace skills.

    Tic disorders have no relationship to intelligence, IQ, social skills and creativity though some of us have aptitudes that come easier than to others, but the fact is your son has opportunity to achieve anything he wishes to do in life, and if, by chance his tic disorders persist, he can learn strategies to manage his symptoms to make them less bothersome.

    I would urge you to see about determining exactly what his diagnosis or diagnoses might be so that a plan of action can be made. Knowing what has to be dealt with can provide your son with the opportunities to learn the strategies he needs to manage his diagnosis.

    If it happens to be some form of tic disorder, then it would benefit him to participate in and meet other young people living with similar symptoms, to allow him to gain the right perspective of how he can deal with his own situation. Based on your earlier remarks:

    He gets irritable when I want to talk about anything to do with doctors
    he needs to recognize that he may require professional help to deal with his symptoms. Acceptance is a first step to being able to successfully deal with any issue.

    Why do you think he rejects discussion about doctors?

    He has some facial hair that we aren't supposed to look at or mention or he gets angry.
    Would you elaborate a little on what this involves?

    I just don't want him to get teased.
    This is where advocacy on his part is critical and another reason for you and for your son to know exactly what's going on. Using this knowledge, he can then simply explain to anyone who challenges his symptoms, the actual reason for the symptoms or behaviours.

    I see a psychiatrist for myself and he didn't know much about tics.
    Only if you feel comfortable to answer, what kinds of issues are you dealing with yourself?

  7. #7
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    Default Re: Should I just wait and see?

    thank you for all your advice. I requested a list of doctors in my state that treat tic disorders through one of the links you posted.

    the facial hair comment was off topic. Just that he gets irritable about different things and I don't think he is comfortable with some of the changes he is going through.

    i am not sure why he doesn't want to discuss things to do with doctors. I guess because he thinks i am making a big deal about things. he has been seeing a dietician to help with weight loss and then with the therapy i think it a lot for him. He has become more private, too.

    I have schizoaffective disorder which is like a combo of schizophrenia and bipolar. I am fortunate that I respond to medications and I haven't had psychotic symptoms in 7 years. I had a psychotic break in 2003 and for the first few years I had a lot of psychotic symptoms like hallucinations, delusions, paranoia. My son, Jonah, was 2 when I first got sick. I have a daughter also who is 3 years older than him.

    he had a severe speech delay and was making vowel sounds and gestures at 2 . He could say mama but he was pretty quiet. With speech therapy he was caught up by the time he started kindergarten. Off topic again, sorry, just trying to give a clearer picture.

    My sister thinks I should just let things be for now since he isn't having problems. I like your idea of getting some sort of assessment. I didn't realize these behaviors were tics until recently when the therapist said he could see some tics he has after I described what he does. He also does this thing where he is counting his fingers and he doesn't want me to see that either. I don't know if that is related, but he does it often.

    He did understand about how his coughing was a tic when he was 9 so I think he would understand the concept of some other behaviors being tics, too. I haven't talked much about it with him because he doesn't want to talk about some things and I need more education.

  8. #8
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    Default Re: Should I just wait and see?

    Quote Originally Posted by lorib64 View Post
    i am not sure why he doesn't want to discuss things to do with doctors. I guess because he thinks i am making a big deal about things. he has been seeing a dietician to help with weight loss and then with the therapy i think it a lot for him. He has become more private, too.
    It could also be where he is developmentally - I remember getting very private when I started in to puberty, and I suspect it's because the changes make a person awkward.

    If I may, I'd like to suggest two activities that I've found worked well for me on both the weight loss and the relaxation fronts. The first is yoga. The focus on breathing and meditation does wonders for the mind, and the stretching is a surprisingly good workout. The second is Aikido, which is a Japanese martial art. The reason I suggest Aikido specifically is that it has a focus on co-operative development, rather than competitive development. It's more of a workout than yoga, and (depending on the teacher) less focused on meditation, but the philosophy behind it is a good one.

  9. #9
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    Default Re: Should I just wait and see?

    Thank you Matt. I think some of his irritability and wanting privacy is his age. I will look into those activities.

  10. #10

    Default Re: Should I just wait and see?

    Its a good ideal to wait but not for long! I'm a lot older and had all the symptoms. My parents and doctor didn't want to treat because of the label of Tourette's! But I was also diagnosed with ADHD, no label there either. Now all of the hardships has rushed back on me because of a stressful job making my life miserable! I lose more friends than I make, I get in trouble with law enforcement a lot than I'd like. My GP, neurologist, neuropsychologist and psychiatrist confirmed Tourette's along with ADHD! I remember days of rage, defiance and just ignoring everyone. I couldn't take it anymore, I waned out until I met Dawn Roy my new doc. She knew the signs and in her words Jerry, you'll die if we don't fix your anger, anxiety, depression, cognitive behavior, she sent me to Dr. Becker a psychiatrist who specializes in mood behaviors ad my final diagnosis Tourette's and ADHD! This sounds like your son, ignore the naturalist and get him evaluated ASAP! My life would have been better if my dad and mom would have done this for me!!!!! Praying for you!!!! Jerry a Touretter and ADHDer!

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