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Thread: Are These Tics?

  1. #1
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    Default Are These Tics?

    Hello there,

    Thank you for letting me join!

    My son is three nearly four. He has been having tics for over a year I think. So I'm just starting to video and record what is happening.

    He has had eye twitching, rubbing nose up and rubbing nose down, shoulder shrugs, clearing throat and something based on get hair out of eyes even though he had hair cut moths before.

    The difficulty im having is knowing when something is a tic or not. For example at the moment he is putting his toung over his top lip countless times a day. But is that a tic or a habit? He also does this weird chomping air noise ever so often but only when he is eating so I don't know if that is one or not. All of his tics so far have looked like they could have a common explanation like itchy eyes or something it's just that they don't stop and happen so frequently - they seem to mutate too so they don't quite make sence after he's had them a week or two.
    Some times it will be the same tic but different hand so I don't know if that 'counts'
    If anyone has any thoughts on how to recognise a tic in a three year old that would be very helpful

  2. #2
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    Default Re: Are These Tics?

    Welcome to the Tourette Canada Forum, Ktpooncat! Thank you for joining us. I see you are from the U.K. and we're pleased to have you join our Forum.

    You are doing the right thing to maintain a detailed diary of your son's symptoms, along with videos, discreetly recorded to preclude your son's being embarrassed by them. This information will be valuable when you have your son assessed by his paediatrician, and/or in a referral to a specialist in movement disorders like a neurologist.

    If your son requires a consultation with a specialist, be sure to qualify whether that consultant has clinical experience in treating Tourette and associated disorders. If you are unsure, a call to the Tourettes Action Helpdesk in London can provide you with the names of qualified consultants in your area.

    Not all tic symptoms point to Tourette Syndrome, so your son would benefit by being seen by his paediatrician to rule out any medical conditions that can cause tic symptoms. This would give the doctor to document your son's symptoms for future follow up.

    About one third of children exhibit tic during their growing up years, without developing into anything further.

    You would want to monitor your son's symptoms and behaviours and report to his doctor any symptoms that have to do with obsessions, attention, learning, mood or sensory issues.

    A Tourette diagnosis is often combined with associated disorders like those listed HERE

    There can be cautious optimism about the long term progression of tics, but if associated disorders are detected, they should be diagnosed and treated and associated disorders can be lifelong.

    At your son's age of four, it is likely that he knows that he tics, but unlikely that he knows when he tics or when he is about to tic. The ability to detect the urge to tic happens when a child is at least ten years old. Self awareness typically matures at around that age, so trying to persuade a younger child to stop or to manage tics is actually counter productive as it only serves to increase stress and anxiety, which in turn triggers more tic activity.

    Tourette tics, while involuntary are influenced by both internal and external environmental factors. Internal factors would include stress, anxiety, fatigue and excitement while external factors are people, places or situations that exacerbate and maintain tics in a predictable way. The environment does not cause tics, because tics are involuntary, but the environment influences tics.

    Of course the only way to receive a competent diagnosis is for your son to be seen in a face to face interview by a qualified medical practitioner, as mentioned earlier.

    To help you gain an overview of Tourette symptoms and tics, please see the Forum section titled The Tic Parade. There you will find a helpful post titled Common Tics of Tourette Syndrome.

    Has your son been seen by a doctor to assess his symptoms so far?

    Any other members of your immediate or extended family ever exhibit signs of unusual movements and or sounds?

  3. #3
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    Default Re: Are These Tics?

    Thank you so much for your comprehensive answer, I shall be looking over the information slowly over the next few weeks.

    I think I call the helpline this week and see who I should see. My son had a new movement this supper time that scared me a bit because it was so dramatic and 'out of character'. I thought he was choking at first so asked if he was ok and he said ' I just have to do this' - we didn't ask anything else just got the phone out subtly. I don't know if it is a tic or a one off 'session' but the movement happened in time with the eye blink tic he has right now. Again the movement seemed to mutate rather than stay the same. I am just looking forward to having someone who knows what they are looking at look at the videos because I feel very confused as to how to classify a tic!

    No family history although my mum said we all had tics when little. And no we haven't been to Dr before because I read little kids get tics but now it has been a year it feels different. Plus he starts school in September. I'm a bit frightened after tonight's funny movements to be honest. Makes me suddenly scared about how far the tics could go. I'll stop panicking tomorrow I'm sure.

  4. #4
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    Default Re: Are These Tics?

    Quote Originally Posted by Ktpooncat
    I feel very confused as to how to classify a tic!
    Tics are related to muscles movements, so any part of the body that functions with a muscle is susceptible to the involuntary "escape" of an involuntary muscle movement.

    The obvious muscle movements involve the visible parts of the body, such as eyes, face, arms and legs, but vocal cords, lungs, breathing diaphragm, abdomen are all potential tic expressors. Breathing, snorting, throat clearing, barking, sounds that might be interpreted as choking can all be expressions of tics. When reading Common Tics of Tourette Syndrome the kinds of tics will become clearer.

    His involuntary tics likely do not alarm him, even though they may sound alarming from your perspective, so paying a great deal of attention to his tics would only heighten his anxiety, which in turn has the potential to trigger further tic activity.

    His tics, particularly at his young age, are, in his perception, just part of who he is...just like ordinary breathing, so paying undue attention at this point, can be confusing and anxiety provoking for him.

    Quote Originally Posted by Ktpooncat
    he starts school in September.
    This is the reason to have a professional and competent assessment done to establish your son's symptom history so that an eventual diagnosis can be made. With a firm diagnosis, you would have the tools to proactively work with your son's school to provide him any accommodations he may require due to his special needs.

    Tourettes Action can be helpful in assisting you with your dialogue with the school. The TA website provides information you can use here: Advice for teachers

    Remember, you are your son's best advocate, and the skills he will learn from you to advocate and negotiate for his needs will be the skills he will need as he grows and becomes more independent.

    Using the resources of Tourettes Action and those we can provide here should get you started to help your son get the support he deserves.

  5. #5
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    Default Re: Are These Tics?

    From your description, these behaviors do ring a bell with me, as a parent of a child who tics. Of course, as Steve mentioned, not every child who tics will get a Tourette diagnosis. However, many of the Tourette management techniques that have been discovered and described can be helpful for a child who tics, regardless of the child's diagnosis status.

    By the way, on the topic of diagnosis -- some doctors will look at a child of that age, document the tics, and ask you to come back after some specified time. Some doctors are comfortable taking a tic history and giving you an opinion. Some parents find it helpful to see a doctor in this gray area age; some decide to wait. Factors that might help you weigh that decision: level of Tourette awareness of the child's primary care provider, distance to drive to see a specialist, child's level of comfort with doctor visits.

    If you think your son might have ADHD as well as tics, that might be an easier way to approach an evaluation with a pediatrician or a generalist. ADHD is more common, for one thing, and is also more commonly understood and recognized by non-specialist medical providers.

    I know what you mean about parental fears about some tics -- I've been there! I wish I had figured out what my kid was doing earlier. (He was ten when we figured it out.) Understanding that he was ticcing, and understanding what a tic is, really helped me take things more calmly -- which in turn was very helpful for the child!

    Here's a checklist that I was able to fill out in about 20 minutes that helped us document the child's tics. I found the format quite helpful and easy to work with.

    Checklist for Motor Vocal Phonic combined-1.pdf

    Of the tics you've seen so far, are any of them causing your son any discomfort? Are any driving you nuts? My guess would be the one with the tongue and the upper lip, because of chapped lips, maybe?

  6. #6
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    Default Re: Are These Tics?

    Thank you so much for taking the time to reply.

    I have now been to the Drs although they want me to go back in with my son, as I didn't take him. From the video I showed her she is thinking of making a referal to a peaditric neurologist but want to see him in case she thinks he needs to be seen urgently ( if she suspects seizures I'm guessing, which I doubt). She warned that the waiting time will be up to four months. But that's ok as long as something is happening and we are seeing the right person.

    He has started some sniffing and sucking type tics now which are new. They are all very focussed on when he eats.
    He doesn't seem to have any ADHD traits luckily. We are about to take him to the speech therapy drop in as he has some strange quirks with his talking, I don't know if that can be connected.
    Last edited by aparente001; January 9, 2017 at 02:50 PM. Reason: fixed typo (has -> as)

  7. #7
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    Default Re: Are These Tics?

    I had another question if anyone could help.

    My son has been having these eye squeeze and grimace tics when he is eating- it seems to mostly be just as he is about to put the food in. If we have asked him if he is ok, he tells us that his eye hurts or one eye hurts and there is something in his throat. Could this mean it is not a tick or could he be trying to make sense of it all. So confusing!

  8. #8
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    Default Re: Are These Tics?

    Could this mean it is not a tick or could he be trying to make sense of it all
    Your insight is probably accurate in that at his young age of four, he is interpreting his symptoms from his own limited perspective.

    As was mentioned in my earlier response where I provided several links to articles that would elaborate on the questions you raised, at your son's age of four, although he knows that he tics, he is not aware of when he tics or when he is about to tic.

    Knowing when one is about to tic requires awareness of the premonitory urge that precedes tics. The sense of awareness that recognizes the premonitory urge doesn't mature until about age ten, so younger children generally are unable to articulate what they feel as the urge.

    Young children talk about weird feelings, various descriptions of discomfort, uneasiness, even "pain" even though the premonitory urge is not usually associated with pain, but these descriptions reflect a young child's limited ability to express self awareness with limited vocabulary.

    Please review the various links I've provided for you in this and earlier responses regarding premonitory urge.

    Here is a list of frequently reported sites of where premonitory urges are sensed:

    Premonitory Sites.jpg
    Source: Managing Tourette Syndrome, Woods et al

    As a neurotypical person, it may be difficult to imagine what a premonitory urge may feel like. The way you can simulate a premonitory urge might be to recall what it's like when you know you are about to sneeze, and you cannot prevent the sneeze; or when you get a mosquito bite, and have the urge to scratch to relieve the itch. Try holding your eyes open without blinking for 90 seconds, and try to find the words to describe the sensations you feel while trying to keep your eyes from blinking.

    Your son's body is responding to the involuntary movement that is slipping through the "emergency braking system" of his brain (basal ganglia), and at his young age, the process is just part of who he is.

    During this time he needs your support to provide him the accommodations he needs so he does not identify himself by his symptoms, but rather as the wonderful, charming and creative young man that he is.

  9. #9
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    Default Re: Are These Tics?

    Ktpooncat, have you ever had the experience of just sitting and watching people go by? Maybe in an airport, or a bus or train station? Or watching a bird feeder, relaxing near a window and noticing the different types of birds that visit the feeder?

    That's how I find it helpful to notice my son's tics. I watch them occur; I watch them come and go over time. I learn to recognize them as tics.

    Sometimes I have to point out to a family member that something was a tic. Occasionally another family member will point one out to me that I hadn't figured out was a tic. But my spouse and I usually try to tell each other that such-and-so behavior is a tic when my son is not in hearing, for example, when he's asleep. Because my son sometimes reacts defensively if he hears me tell someone that such-and-so utterance or song snippet is a tic. My primary goal with him is to make sure he has someone in his life that he can completely relax around. At the same time, I also want to protect him from other people's criticisms and expressions of intolerance--so that's why I discreetly tell family members when there's something they haven't recognized as a tic.

    When my son develops a tic that harms him in some way, then I try to help him re-engineer it. Otherwise, I just let it be. I wasn't able to do that before I understood his quirks to be tics, that he couldn't control. Now that I understand the way he's wired, it's much easier for me to take the approach I described, of watching the tics go by.

    Of the tics you've seen so far, are any of them causing your son any discomfort? My guess would be the one with the tongue and the upper lip, because of chapped lips, maybe?

    Are any of his tics driving you nuts? There are certain song snippets that drive me nuts! When that happens, I ask my son if he's ready to sing something else for a while. He can usually make the switch, if I've allowed him to sing the annoying one several times before I make my request.

    My son has speech tics too. Let me know if you want me to describe them.

    I wanted to make a comment about specialty therapists. My son has writing tics. There was one occupational therapist who tried to work with him on the writing tics, but who didn't understand tics, and I had to stop the services because they were doing my son more harm than good. However, there was a wonderful occupational therapist at his previous school who was very understanding, and the work they did together was quite helpful for him.

    I hope your son has a good experience with the speech therapist!

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