Tourette, Tics & Repetitive Behaviors

Parent Q&A

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  • The most recent posts I came across regarding Tourette Syndrome are from five years ago, and don't address the following question -- how and when to educate my 8 year old son's teacher/school community/friends and their parents about TS? 

    Context: my son has a number of motor (blinking, mouth stretching, some should shrugging, arm extending), and aural tics (clearing his throat, clicks jaw) . Most are pretty subtle; in fact if you ask people they would say they haven't noticed anything, or might mention his blinking or his throat clearing but not realize those are tics. So, at this point, his tics are not impacting his public life. However, they are becoming more noticeable/frequent, and he has asked me about them, wanting to know if they'll ever go away, and very anxious that he will be made fun of. I've worked with a pediatric psychologist at Children's Hospital, who diagnosed him and has helped me talk with him about it. She has given me suggestions about how it might be addressed at school including 1:1 with teacher, via a workshop on diversity that included TS among other topics, etc. When I volunteer in his classroom I rarely see any of it, and when I've asked his teacher she said what most say (that he blinks a lot, so she figures it is a nervous habit). I let her know he has tics and that emotional and physical excitement including anxiety can trigger them but he can't help it. I gave her examples and said I'd be happy to talk to her more about it. I did not get into the diagnosis or try to educate her. Yet.

    Other parents I'm close to I've told. But with parents of his other friends ... I have been hesitant to draw attention to him if it's not even noticeable (kind of like breaking his confidentiality?). On the other hand, if they are noticing something and just not saying anything/wondering I'd rather there be clarity. 

    Have you had experiences communicating with your child, his/her friends or teachers about TS? The internet is full of advice regarding kids with very prominent tics, which feels like it requires a different approach than this. Suggestions? Thanks!

    You raise a lot of issues here, which may be better addressed on one of the many online TS groups. But in short, the TAA has some handouts that you can download for teachers/principals/other school workers with talking points. What's important is what your child is comfortable with. When my son was in 3rd and 4th grades, he wanted people to know he had Tourette Syndrome (mild tics, such as you describe) because  he had questions from classmates, and he was terrified that a sub would think he was clowning around. So I read "Tic Talk" out loud to the class (there's a few other options for elementary age kids). The third grade teacher led a bit of a discussion afterward, the 4th grade teacher moved it right along, and my son has felt comfortable enough now that everyone knows. Anyway, this question comes up a lot on the TS facebook forums, so check some out.

    I would also encourage you to talk more specifically with your son about if the tics bother him a lot, or otherwise interfere with his daily life. Our pediatric neurologist (who, by the way, is the medical professional who should be diagnosing TS, not a psychologist) advised us early on to not consider medication until needed - meaning, quality of life was being affected. I can't tell from your post if your son is at that point or not, but our son was worried enough and building up anxiety about it, that he has taken medication for tics and/or anxiety since age 8 (now he's 11) and it seems to have helped him and kept the ticcing within what he feels is a nonobtrusive, non-anxiety-inducing level.

    There is a NorCal TS group on Facebook that you might also want to check out, where people get specific about school districts and medical professionals. Good luck with everything! When my son was 8 it felt like TS was going to consume his life and now we barely think about it. It's just a medical condition that is manageable, like - not sure of a good parallel - high blood pressure?

    I recall an article Oliver Sacks wrote about a surgeon with Tourette's. Somehow he was able to control the Tourette's during surgery, adjusting his neurological state to his situation. Perhaps your son is able to achieve the same kind of modulation.

    It sounds as if so far people accept him for himself, rather than as "that kid with Tourette's." As you describe it, he's not being ostracized or punished, and his behavior is not disruptive.  So you don't need to explain him to people. This isn't something shameful to hide, but is it the most important thing for other people to know about him upfront? He's more than his tics. I know you wonder if making the diagnosis public will help, but labeling him won't save him from being teased. It's mostly useful if the teacher can't understand his behavior and decides to discipline him.

    This may change over time. The tics could get worse, or better, or he could become more anxious about them. Adolescence is rough even without Tourette's. But to a certain extent he needs to figure out for himself what he wants to tell people, while knowing that you are ready and able to go to bat for him if need be. My guess is that it's better for you and he to learn strategies and language, so you'll both be able to handle whatever comes up. Investigate whether he needs alternate learning strategies and find ways to manage anxiety generally and increase his confidence. If the tics create an issue, you've got a diagnosis; if not, you've got a slightly atypical kid with a lot to offer the world.

    I'm not a TS expert. My 2 cents.

    This is something that we've dealt with a little. My son has ADHD and some subtle tics.  Until he was about 8-9, I didn't really discuss the ADHD or the tics with him, but always mentioned both things to teachers. I realize ADHD is different than tics, and the ADHD part has always needed to be addressed.  When I did talk with my son about it when he was 8-9, he seemed really relieved and interested to have a reasons for what he's experience.  Since then, I've talked with him about how much he wants other people to know (teachers, other parents, friends). He doesn't get a choice about teachers for the ADHD, but it's good for him to know that they know. For other adults he has some input (although I have told some of my close friends without asking him because I need support). For friends, it's always up to him what he shares.    I wonder if that would be helpful for your son. Especially if he's anxious about it and since anxiety could make tics worse, it could be a relief for him to know that others know about it and will understand what's going on (if they notice it). My son doesn't talk about it to all his friends, but has told several close friends and that was good for him.  Also, I found that it was great to set this stage for being open about it in elementary school because it's an easier and less self-conscious time than middle school.  For my son's issues, teachers always need to know and it's completely up to him how much he tells others. He talks about the ADHD more than the tics, but at times when the tics are more prominent, he is relieve when others know.   I know that 8 is still young, but you could ask him if he has a preference.  Sometimes I think that the more that these kinds of things are kept private, the more stigma they have.  Instead, if it's just talked about as a way that your brain/body/wiring is different than other people, it can make it seem less like a big deal. And having him have some control over the flow of information could be useful. 

    Hi, I just wanted to chime in and say that when my child was in 2nd grade a fellow student had similar, subtle tics and had Tourette’s. I guess they were at a similar point where people were starting it notice more and ask more questions, so she put together a presentation for her classmates and explained what her tics are. The teacher said it was a really touching moment for the class and that the kids had a few questions, and were very sympathetic to the student. Then, things kind of went on like normal but the students had a better understanding. Good luck to you and your child, there are many ways to do it, go with what feels best to you and yours.

    I just wanted to make sure you’re seeing a pediatric neurologist, not simply a psychologist. Tourette’s has a neurological basis & treatment is by a physician, not a psychologist. 

    Thank you for your responses! Question -- I have heard conflicting recommendations to get care through a pediatric neurologist vs psychologist. Thoughts on this? When I look at the Tourette Association of America provider directory, as well as other online resources, I see both fields represented. Thanks again.

    When my daughter was younger, we would always talk with her teacher about her tics at the parent teacher conference in the fall. I kept it very generic, "you may have noticed she's a little twitchy..." Most of her teachers hadn't noticed, a few did. Lots of elementary school kids have tics so it never felt like a big deal. It wasn't until she reached middle school and had some significant events at school that we told teachers and administration it was Tourette Syndrome. We also put a 504 plan into place so she had some backup. 

    I've let her take the lead in telling friends. She's been pretty open about it which has helped kids at school to be accepting of her. If she's particularly twitchy, she'll just say she has Tourette's when someone asks what's wrong (in that snarky middle school kind of way.) Being so upfront seems to have diffused a lot of middle school unkindness. 

    You also asked about neurologist vs psychologist. My understanding is that a neurologist will diagnose TS and not a psychologist. We saw the neurologist once for a diagnosis when we first noticed it and then one more time when things escalated.  Regular follow up has been with a psychologist which has been really helpful in helping her cope with all of this. Stress reduction has also been key as anxiety causes her tics to be much worse. 

    (In response to OP's follow-up Q) Tourette should be diagnosed in a child by a pediatric neurologist. That doctor will be your main care provider for the Tourette piece of the puzzle. However, people with Tourette generally have one or more co-morbid diagnoses, which can include ADHD, learning differences, depression, anxiety, and OCD. Therefore often more than one professional is part of the care team. But it would be critical to have a neurologist lead, since they would be the professional up to speed on current treatments and options, such as clinical trials, non-medication therapies, etc.
     

Archived Q&A and Reviews


Questions  

First Grader With Tics & Speech Issues

Sept 2014

Hi BPN community - our first grader has manifested a variety of motor & verbal tics, ongoing for 3+ months. Some days it's bad enough to really interfere with speech. Kaiser says a) tics are relatively normal in childhood at this age, and b) we can go to Richmond Mental Health dept without a referral. Does anyone have experience with Kaiser Richmond's Mental Health for young kids? We are also getting a speech evaluation through the schools, although my concern is that addressing speech without the underlying cause may just shift the problem (new tics popping up elsewhere). What else should we consider with tics? What local therapist/group might be a resource? Thanks for your thoughts and experiences.


Check for Tourette's Syndrome. It's more common in boys, and frequently starts to manifest at 5-7 years. http://ts-stories.org/ Jessica


Tics are common (25%) in kids ..but it sounds like your child has more going on than that. If it had been a year then it sounds likeTourette's. It requires 1 year of vocal and motor tics to be diagnosed. Kaiser has terrible mental health services. I have Kaiser and a son with Tourette's. I have a great deal that I can tell you about Kaiser. Too much to fit here. We have seen doctors in Richmond, SF, and Oakland. I volunteer forTourette Syndrome Association, NorCal Hawaii Chapter Lauryn

 


Would you recommend a doctor for tic disorder?

Oct 2010

Somebody have a child with tic or tourette disorder? I am looking for the doctor or parents group. My son set up tic disorder severely, but I don't have any information about it.


My son saw Dr. Thomas Lowe at the UCSF Tic and Tourettes Disorder clinic. He was very helpful. If you want to consider medication, it is important to go with a doctor that understands the options and the way different medications interact, and he had that knowledge. He also developed a good rapport with our son, who saw him from about age 13 or 14 to 17 or 18. (He has outgrown most of his Tourettes manifestations).

My son also went to a social skills group run by Mariah Antonides, in Berkeley, where he learned a lot of basics on interacting with others, that have helped him in putting others at ease. When he became more relaxed in social situations in general, the tics became much less apparent. a parent


Is your child taking the prescription allergy/asthma drug Singulair? Tics are one of the possible side effects of the drug. In my son's case, his tics escalated to violent head-snapping. After consultation with Kaiser, we were told that, since he was in his early teens, this was all part and parcel of those years for pubescent kids with previous tic syndrome, albeit low level. We were left with the choice of either using very strong prescriptions to subdue the tics, which would have unwelcome side effects, or just riding it out - being told that as the teenage hormones waned, so would the violent muscle spasm tics. This was completely erroneous advice. We researched the internet and discovered that his allergy medicine might be behind these tics, which began to escalate about the time he started his medicine - coinciding with the onset of puberty. Once we stopped the Singulair, and the drug left his system, the tics subsided to their previous low-level expression. Barbara


8 year old diagnosed with Tourette syndrome

Aug 2010

hi, my 8 year old son has tourettes syndrome. he has multiple tics throughout the day that get much worse at night. it has gotten much worse over this summer. i am really freaked out and extremely stressed by this development. i have been through a lot with him but this somehow is the most scary for me as it could potentially be extremely debilitating for a lifetime. i don't want to go the medical route with medication. what alternative healers out there that you know who have experience with working with children with tourettes syndrome? the few alternative practitioners that i spoke to do not really have experience in this field. would love some advice


I am a well adjusted man, 51, had ticks that came and went when i was young, on and off through adulthood. I remember the ticks in the summer months of my youth the most. head nodding, blinking. Maybe it was stress over the coming school year, maybe because i didn't feel confident.. i don't know.

From my shallow research on the subject, 50% of humans have a tick of some nature. I survived it because i had a loving mom and dad. I used to blink, shake my head, occasionally make guttural noises. But, i had friends, and have life long friends.

Anyhoo, i have survived and thrived. I know it can be disconcerting to others and to me. My kids know i have a ''twitch'' or two. I say all this because there are some things we can't really change. Maybe the folks around us will be more accepting of differences... or not. I don't twitch much now, BTW.

I was late 20's when i read Oliver Sack's book: ''The Man Who Mistook his Wife for a Hat'' and there was a story about a man who took drugs for his tourettes but it made him feel dull. The fellow was a professional and played drums as a hobby which was an outlet for his nervous, twitchy energy.... He quit the drugs because of the side effects. I was supporting a young family and the time and twitching was pretty bad then... i was working and feeding wife and baby as a sole bread winner.... hard stuff.

So, advice might be for mom, or the son... life will continue. Twitching, like many behaviors, can be disconcerting to others... only he will learn to fit in to society... and that will likely be to control his twitching. I equate the twitching to how most of us learn to get along with other people. My twitching has gone up and down over time... but i lead a normal (ok, normal is relative), happy and productive life. I am sooooo glad i wasn't put on drugs for my twitching... i like my energy level and fear that the drugs that would have squashed my energy. As for talk therapies... well, my advice: focus on the positive, build on his strengths.

PS - i always wanted to see the documentary ''Twitch and Shout'' but it is hard to come by. I actually met the film crew for that documentary on a subway in Boston. I was with a friend from the company i worked for at the time... and we joked they could turn the cameras on me... suit and tie at the time. Oren


Sorry to hear about your son. There's a well-known professor in my field with a facial tic (not sure whether it's Tourette's, but...), so it doesn't necessarily do as much harm as one might think.

I don't have much advice, but Oliver sacks has an interesting book that includes numerous Tourette's and related case descriptions (written for the general public), which may help you/people in your family/others understand the issues...let's see...(Google)...hmm, I think it might be ''The Man Who Mistook His Wife for a Hat,'' but I've read too many of his books...Google ''Oliver Sacks Tourette'' if you haven't already.--Steve


I'm sorry to hear that your son has Tourettes. I wanted to let you know that a good friend of mine also has Tourettes and despite the ticks etc. he has managed to become a successful corporate lawyer and set up his own international company. He also acts as a mentor for children such as your son. I asked him what advice he had, his response. ''If the mother is, from the start, opposed to medicine, I don't have a whole lot to offer. The meds today are terrific. One thing that I know works in some cases is fish oil/Omega 3 fatty acids. At a minimum, she should try that.'' becky


I didn't see your original post, but wanted to share a resource with you. A childhood friend of mine with Tourette's started a summer camp for kids with the same called Camp Twitch and Shout http://www.camptwitchandshout.com/. It is located in Atlanta, but they have campers come from everywhere. It seems like an amazing experience for kids with Tourette's to meet one another in a comfortable, fun environment. My friend is now a public school teacher in Atlanta, and the Hallmark Channel made an inspirational movie of his life story called the Front of the Class. I believe it is out on DVD now. I wish you and your son all the best. Stacy D


Diagnosis for possible Tourette's Syndrome

Aug 2008

Hi there ~ we are trying to find out the best approach for diagnosing and seeking treatment for our son who may have mild Tourette's Syndrome and/ or ADD. We would like to get a name of a doctor that specializes in children with these issues. We are not sure if we should go through a neuropsychologist or psychiatrist. We are wondering if any doctors at Children's Hospital, UCSF or Stanford might specialize in this area? A response from anyone who has travelled down this path and may have some information for us would be appreciated. Thanks!


Try Dr. Herbert Schreier @ Children's Hospital Oakland. You can find his number by googling Children Hospital psychiatry or calling their main number I'm sure. Sharlene


13 year old son blinks excessively

Oct 2007

Has anyone had experience with a child or teen who blinks excessively? My 13 year old son started blinking a lot this past August. The problem seems to have increased. He also exaggerates his blinking by closing his eyes tight. He does not appear to be under any unusual stress. He does well in school. He is well liked by teachers and students. He is certainly not an overscheduled child. He does have bad allergies (this could be adding to the blinking) and takes Zyrtec. Blinking as a nervous tic does run in my family. My grandmother, brother and two nieces had it. Aside from grandmother, everyone else's blinking went away after several months. The pediatrician said it's probably a tic or allergy related and to let it go for a month. Anyone have a child with a blinking tic? mom


I have an adult friend who at this same age began the same thing. She has what is called Tourette's Syndrome. Tourette's can be manifested in a myriad of ways, blinking being one of the many. After years of doing this(40+) her eyes become very tired and extremely painful. In fact she goes to get shots to help with the blinking and the pain. It does not affect her vision nor her normal life. She did have a few seizures in her late teens which was related. I would definitely have it checked out. I understand


my son also had some tics, although he was younger when they first started. I was very freaked out by it and did a ton of research included taking him to kaiser, finally i got help with it forma homeopathist who is very highly regarded including on Berkeley Parents Network recommendations, her name is Christine Ciaverella(sp?) and she is located in el cerrito at Hanneman clinic her number is 524-3117, she is also trained in western medicine as a nurse practioner and I swear the remedies help my son and curbed the tics.....he takes a remedy every day. Note that I was not the kind of person who was even into this alternative medicine but when it came to helping my kid I was willing to look anywhere and I swear this is what helped...good luck! been there solved that!


You son's eyes may not be producing enough tears for his comfort; as a consequence, he may be blinking in order to hydrate his eyes or deal with the discomfort. The Zyrtec may be contributing to the dehydration. An optometrist can do a simple, painless test to determine how much fluid his eyes are producing. If he needs to have his eyes hydrated, the optometrist can recommend simple ways to accomplish this, like over-the-counter artificial tears, silicone plugs or prescription eye drops (like Restasis). Good luck. hollis


I missed the original post, so I'm sorry if I'm misunderstanding the problem. But some of the responses reminded me of a phase I had as a preteen: a teenage cousin of mine had a way of blinking forcefully with both eyes pretty frequently--I guess you could qualify it as a tic. And I thought she was the coolest thing ever, so I started doing it too, and it became unconscious pretty quickly. We both somehow kicked the habit after a while, so that's to say certain weird blinking tics could be pretty harmless. --I was a preteen blinker too


Motor tics in 2 year old

April 2007

My 2 year old daughter started having what appear to be motor tics- she started with scrunching up her left cheek to a winking of her left eye- then that behavior went away and was replaced a week or so later by a face wiping behavior (like when kids wipe their mouth/nose with their sleeve). This behavior was so repetitive one day that she broke her skin and was bleeding on her lip! She continues to wipe episodically but it is less severe- does anyone have any experience with young kids who tic? She doesn't have any vocal tics (which would qualify her for Tourette's) but I'm apprehensive about how much worse her motor tics could get. Her MD is sending her in for an EEG to rule out a seizure disorder. I understand that there is really no treatment for tics and that only meds are offered for severe tics when they impair social or occupational functioning. What does a parent do for a child with tics? Concerned parent


My husband's family has a history of Tourettes, so I shared all the same worry when my son started blinking. Yet, many people have now told me about ''traveling tics'' which are tics kids pick up and then lose as they get older. Sure enough, he blinked for 3 mo. in kindergarten, then 2 mo. at the onset of 1st grade (both probably stress induced since the tics started at the beginning of the year in each case). They were strong enough that the teachers were getting judgmental and starting to tell my child to ''stop blinking'' (!, we asked them to not do this) and then the tics gradually went away!

Sure, your daughter's tics could be something different and more serious. So, sure, rule out seizure disorder, but then ignore it if it's nothing more serious. And, while she's young, you could have her evaluated in a low-key way by a homeopath recommended to us (www.healthyhomeopathy.com - Dr. Ulman does phone consults).

Here's why you don't want to bring attention to it or try and control her behaviors : my husband, had mild tourette's as a child (just tics, but no shouting or swearing). Though, it was just tics, he was horribly teased as a child (less awareness then). Here's what he taught me: ANY attempt to stop the tics INCREASED the tics, turning the whole thing into a maddening cycle. So, even if your daughter does have TS, you'll want to empathize with the ''impulse'' to tic, and not make her bad for it. No matter how well intended, your attempts to help her ''get rid'' of it will make her feel shamed, and make the tics increase. She'll need you as an ally in understanding that tics are truly out of her control!

All my understanding - sistersue


Pre-teen has developed severe eye-blinking

Feb 2002

Does anyone out there have children who have been treated for tic disorders? My pre-teen child has developed severe eye blinking and I am afraid this will affect self esteem and erode confidence. Thanks


Both my daughter (8th grade) and I have Tourette Syndrome, the classic tic disorder (it's a genetic disorder). Contrary to popular legend, most people who have TS have relatively mild tics in comparison to the swearing and strange antics of those with severe cases that are portrayed in the media. The onset of TS is always before the age of 18 and often occurs around 12. Whether or not your child has TS, you owe it to yourself and him/her to diagnose it early. I urge you to run, don't walk, to a neurologist with some familiarity with tic disorders! I personally was not diagnosed until I was in my 40s, and suffered greatly in self-esteem and self-confidence because of this. Going through most of your life knowing every minute that something is wrong with you, constantly being asked why you are acting that way, and being pressured (even by my parents) to suppress tics (pure torture for a TS sufferer), is tough to say the least. In contrast, my daughter has known since the onset that she has TS. She understands that it's no big deal, is able to explain it to people, and I believe she has a high level of self-esteem and self-confidence. I would suggest that you also check out the Tourette Syndrome Association website for information (www.tsa-usa.org). If it turns out that your son/daughter has TS, it might be worthwhile to rent the neat movie The Tic Code starring Gregory Hines and Polly Draper. Good Luck. Please feel free to contact me to discuss this, or perhaps arrange for your son/daughter to discuss things with my daughter, Dave


In response to the parent asking about tics or eye blinking. There are two neurological disorders that can cause this. One is Tuerette's syndrome, (spelling?), and the other is bletherospasm which is particular to just the eyes. Both of these are medical conditions (not psychological) and it would be worth talking to a decent physician about these possibilities just to make sure. Judy


My child has had tics since age 5 (now a teen). I would be willing to discuss with you individually if you email me. The most important thing is to get a good evaluation to determine whether it is a transient tic, chronic tic, or symptomatic of other disorders. It depends on who your health provider is, of course, as to who you can go to for evaluation. There are also some good websites I can give you. You can email me at:


Between 10 and 20% of all children have transient tics, that last less than a year. Another 3-4% of children have chronic motor tics, which last more than a year but eventually fade. An even smaller percentage have Tourette's Syndrome, which consists of both vocal and motor tics -- vocal tics can range from sniffing to coughing to growling, yelps, and various kinds of word phrases (Tourette's is known in the popular culture as a disorder in which people curse involuntarily, but that symptom only affects a minority of children/adults with Tourette's). So if your daughter is blinking a lot (which is probably a tic but could be a sign of allergy?), and you've just noticed it, and she has never had other unusual movement habits that could be tics, she might just be in that category of transient tics.

It's hard to take a wait-and-see attitude -- I know, because my daughter was diagnosed with Tourette's about 5 years ago, and while we were waiting to see if the tics would go away or not, I was quite anxious (more anxious than my daughter was). Over the years, some tics have bothered her a lot, and others bother me much more than they bother her. When we've thought about medication it's been important to figure out if we were responding to her needs or to ours. The advice in the web site is generally good: behavior modification and punishment don't work, ignoring the tics is usually best if it's possible.

In terms of her self-esteem, if you can model calm and matter-of-fact acceptance of her symptoms, that will help her out a lot. And it's always good to contact her pediatrician or nurse practitioner if you have any concerns. I'm willing to take more questions by e-mail if the anonymous parent so desires. Naomi


If you are interested in complementary medicine, I would suggest talking to Mitchell Corwin of Berkeley. He is licensed as a chiropractor, but does this wonderful work with muscles, the jaw and cranial work. I know that he has quite a few children as patients. My son developed not a facial tic but a twitch, which we had problems getting a diagnosis, but Mitchell was able to treat it easily in 3 treatments. He ascribes some of these issues to traumas to the head. At first I didn't bellieve it, but in reconstructing my son's summer, in fact, he had gone body surfing, and had hit his head a number of times, not enough to cause him to mention it or complain, but enough to give him a twitch, 3 months later. yogreening


10-year-old blinking, nailbiting, finger tapping

Nov 2001

Well, I have a good one. Our almost 10 year-old daughter, who is otherwise charming and self-possessed, has, for the past couple of years, gone through an array of nervous tics that are REALLY starting to irritate my husband and myself. First it was nail biting. She gave that up for blinking--constantly. This was driving us crazy when she was in a choir, and we would go see her perform (this is now on videotape for posterity). There she was up on the stage, blinking away nervously, like someone was shining a flashlight in her eyes. That went away. And was replaced by--finger movements. So I asked her about that. I'm playing piano in my head, was her response. That went away and was replaced by sniffing. And now she has been sniffing so much that friends comment on her constant allergies (she doesn't have them). I think I have a somewhat nervous girl (I was rather high strung myself and bit my fingernails as a child). My husband is getting so upset that he wants to start taking privileges away, but I am not sure this is the way to handle something that she must be doing to let off nervousness. I have asked her if she is aware of when she is doing this, and her response is, Sort of. Mostly I get a blank stare. I have the feeling that if she gives this up, she will move on to something else. So--how to channel this in a way that is non-irritating? Are there any other parents out there who have experienced this and who can offer some advice?


What you call nervous tics may be Tourette's Syndrome. My ten year daughter was diagnosed with the disorder as a 5 year old. I would never have thought of this as the explanation for her strange behaviors had it not been for a cousin that has the disorder. She has displayed the simplest tics, eye rolling and blinking, to some very complex tics - sniff, blink, chest heaves, facial grimace, finger twirls, coughing; all in order, one after the other. The tics change constantly and are very annoying to her two older sister and myself at times. My solution to her hand tics was to give her a book to read. This has turned her into a prolific reader and somehow calms the the hand and eye tics. She has also taken up drums recently and is able to channel the tics in a very creative way. Characteristic of this condition is the involuntary nature of it. My daughter is not aware of the tics when they occur except that she has to get it out, like scratching an itch. Punishment does not stop the tics it only increases them by adding stress. I suggest you consult your daughter's pediatrician after you have scanned the web for information on the subject. You can start looking at http://www.tourettesyndrome.net

-- Mom of a talented, well adjusted and loved 10 year old with Tourette's Syndrome.


Please do not start taking priviledges away or punishing your child in any way for the tics. There is loads of historical data on how detrimental that can be to a child's self-esteem. Being the mother of a 7 year old with tics, I know how hard it is to hold your head up and smile as though nothing is amiss when the tics are going on, but that is exactly what you should be doing. She'll hear enough from everyone else about how weird they are. You really need to be her advocate. If you hear kids (or adults) saying something to her, tell them it has a physical basis and is something she can't help. Rather than trying to encourage your daughter to conform to the norm, try to engender tolerance of difference in others (God knows, we could use more of that in the world). If she can't depend upon her parents to support her, who can she depend on? Most tics are neurologically based and cannot be helped. The reason nervous has been applied to them is because they do often accelerate under times of stress. This doesn't mean the child is nervous. It means that the greater physiological stimulus triggers the neurological reaction. You may want to see a child neurologist to explore the actual neurological causes. My daughter has been diagnosed with Tourette Syndrome and I do find that people more readily accept the tics with an official diagnosis. But there will always be those who are disturbed by them. Please show your daughter by your good example that these people aren't worth worrying about. And that those who are worth caring about will not be put off by a few tics. There is a lot of good information regarding tic disorders on the net. Try www.tsa-usa.org Cathy


A child with persistent tics/nervous habits could have a medical problem like Tourettes Syndrome, or obsessive-compulsive disorder. Before you start using behavior modification or punishment, she needs a thorough evaluation. Depending on your health insurance, you will probably need to start with your pediatician, but then you might need to see a pediatric neurologist or a psychiatrist.


It sounds like your daughter is likely to have a nervous habit of some kind to let off tension, at least for the present. I strongly recommend against any punitive response like taking privileges away. I have two sons with nervous habits, one of whom has been diagnosed with Tourette's syndrome. The one with Tourette's over the years has learned to control the tics at school and in other public places, and has periods at home when he really lets them out. If the current tic is irritating, we will point out that we know it is a habit and is hard to control, but ask him to try to control it or to do it somewhere else. He is pretty good at this. It sounds like your daughter may be able to control habits over time, too. You could ask her to go out of the room, for example, when she needs to sniff--or to try holding her breath briefly instead. That might make her more conscious of the habit and might help her control it. Some habits, like eye-blinking and head jerking, we found quite upsetting, but we found that if we ignored them and didn't mention them to him, they eventually went away. If it is REALLY driving you crazy, you might talk to the pediatrician to see if the tics come from a neurological condition. There are medications. But punishment (which our older son got in school a bit, since some habits, like growling, just don't cut it in the classroom) can have devastating effects on self esteem--don't do it. With our younger son, we've just let well enough alone. So he likes to slap his heel as he walks down the street or will drop to all fours in the midst of running around the house (he's 10). I'm willing to be amused rather than irritated by these little ways. They don't bother anyone else. Poking his friends is another matter, and we've told him very clearly he needs to control that habit--which he does when I'm around, anyway. (Calling it a habit seems to help both boys recognized and control an irritating behavior without taking it very personally as criticism of THEM).


i do not want to presume to diagnose your daughter, but our daughter, same age group, had similar tics. we, too, were constantly on her to stop sniffing!, stop clearing your throat! stop blinking! then our very astute physician observed these behaviors and labeled it tourette's syndrome -- either a mild form or the beginning signs of more pronounced tourette's. he said we could have her evaluated, or wait awhile and see what happens.

i was just amazed. i thought of tourette's as such a radical thing. i came home and started reading -- mostly the stories and exhanges on the internet between parents of children with tourette's. the majority of parents described the same tics -- often appearing around age 8-10, mainly in girls. sometimes the tics went away entirely, sometimes they were replaced by more radical tics. but the thing they all said was: telling your child to stop will not help. they can't help it, any more than they can help breathing. you will only make them feel bad about themselves and aggravate the situation.

we ceased even mentioning the tics, and, if anything, consciously tried to be more loving and understanding toward our daughter. it's now eight months since our doctor mentioned tourette's. our daughter's tics have decreased (the blinking has ceased entirely). this may have been the natural course of things, so i can't say it's a direct result of our response. but from what i read, it can't have hurt, and may have helped. best wishes.


Your post was difficult for me to read, as I have had nervous tics at two times in my life--when I was writing my dissertation and when I was divorcing. Rather than concentrating on how irritating your child is to watch, why not try to help her? She clearly is under stress. Perhaps you should consider some family counselling, as it sounds like the root of the stress might be in your family dynamic.


Your daughter sounds like she's dealing with some underlying anxiety. Your husband may be on the right track with trying some kind of behavior modification, but I recommend you proceed very carefully because you can easily make it worse. I would start with a psychological evaluation for her and lots of research on anxiety issues for you and your husband. Louise


Both my kids experienced benign tics that eventually went away. Do be aware that you can made them permanent by the way you handle them. First, 70% of school age kids exhibit benign nervous tics at some time. So don't think she is totally out of step.

If you punish her for something she can't control, you let her know that it is bad and she will find it harder to let go of. I took my daughter to a neurologist who suggested relaxation exercises. One that we used -- and did with her -- was our quiet face. You relax all the muscles in your face and let your jaw go slack. Your daughter has to develop ways to relax. You should jump in and be as like her as possible -- talk openly about when you feel nervous and do something in reaction -- are you short tempered or do you stop to have a glass of wine? Be honest, adults get nervous. You can say, Hmm, guess I better stop and do the quiet face -- or some other meditative behavior. Then when she has a tic, you can say: honey, want to do our quiet face for a couple minutes?

Consider taking her to a neurologist. The doc might recommend a biofeedback box. My son was really proud of being better at it than Dad -- Dad sure couldn't get the feedback as slowed down as he could! She is probably also embarrassed by the comments about allergies, etc. The sooner you and your husband normalize her fears and anxieties, the sooner she'll get past the shame and not need to dissociate from them. I know, the tics are maddening for the parents -- especially when other adults comment on them. But just hang in there. She's just at the age to conquer them.


I have a now 18yr. old boy who, like your daughter, progressed from one nervous tic to another - sniffing, lip licking, blinking etc. Friends suggested therapy, constantly pointing out his tics to him and other remedies. While I was not sure what I should do, I did feel that their suggestions might make the situation worse. I tried to ignore his tics as I was sure that his peers were only too happy to point them out to him. He grew out of all his tics in time and I suspect your daughter will too. If children are not accepted by their own parents, warts and all, where can they expect acceptance? Taking away priveleges seems way too punitive for something which right now is probably out of her control. Be kind and patient and time will take care of the rest.


Please do not blame your child for Tics, in fact the phrase nervous tics implies they are intentional. They may very well not be. My youngest son (age 10) has tics and it can be hard to witness. We took him to a neurologist at Kaiser Oakland and she said something to the effect: Many young children exhibit tics. It may be a condition like Tourette's or not. It may go away or not. There are medicines that can have a positive effect or not. For my son, we are trying to take it in stride and not blame him. We tried 3 different medicines (briefly) but none had a positive effect. Please seek medical advice. Do some research on tics. Love that kid - it can't be easy having them. Mary


I've seen constitutional homeopathy work wonders with this type of situation. It sounds to me like her behavior isn't conscious, but an expression of a more internal imbalance. For this reason I don't think that taking away privileges will help very much -- it will probably only make her frustrated beause it's a behavior that she can't control. A good homeopath will do a very detailed interview -- with lots of seemingly bizarre and unrelated questions -- and be able to prescribe a remedy that matches your individual child. It's always hard for me to explain how it works, but homeopathy can work miracles! There have been several homeopaths recommended on this list in the past; the Hahnemann clinic is a great place to start. Good luck! Tara


I can't offer advice from successful experience, but I can tell you from my own experience what didn't work for me. I had a series of unpleasant tics for several pre-teen years and I really don't know why--though I do recall that I got glasses, braces, and grew 7 inches between the ages of 10 and 11--so how was I supposed to know how to live in my body?! ;> I was quite aware of my tics (jerking my head/throwing my hair back, blinking/squinting my eyes, etc.), but didn't have much help in the way of problem-solving skills or practical suggestions to help. The tics came and went in stages, lasting many months each, and eventually went away altogether. In the worst times, my family made fun of me by imitating me, teasing me, and humiliating me and that did very little to help--if anything, it made me more prone to the behavior. Now I have a very high-energy four-year-old child whose nervous system was exposed to toxic drugs in vitro with her birth mother, and I see much in her! const itution that feels familiar. I am already teaching her to focus, breathe slowly, be aware of her body, gain control of herself--all skills I hope will help if she encounters the tic syndrome when she's older.

I'm middle-aged now and when I see myself on video and pay attention to myself in meetings, I notice that I still move a lot more than most people. (For example, I clench and flex my fingers without being aware of it, touch my face, chew on pens, jiggle my legs under the table, etc.) I am a high-energy and fast-talking person and I have had to consciously slow down and become aware of the average amount of movement and speed most people use.

I would suggest the following: talk gently with your daughter about the behavior and let her know it distracts you from paying attention to her and what she might want to communicate to you and others. If she still lets you (I hear that's the don't touch me! age), be physical with her in ways that connect you with her and might help her be aware of her behavior and relax--hugs, pats, little shoulder massages, etc. See if she is willing to designate a word or signal from you and your spouse that you can use to alert her that she is exhibiting her current tic--confidentially and respectfully, even in company--so that she can develop an awareness of it. I used to have problems with my contacts and I learned some exercises to relax my blinking--perhaps these would be useful to her. Put your fingertips lightly at the outside corners of your eyes, and when you close your eyes in a relaxed way (as if you were falling asleep), you should not feel the muscles tighten up. If you blink in a protective response way (like when something is coming toward your face), you can feel the muscles contract. I had to learn how to blink and this exercise helped--blink slowly, as if I were falling asleep, ten times in a row several times a day. Perhaps you and she could some acupressure points that would link to the parts of her body your child moves inappropriately, and she could privately push on the points to increase awareness and relax. Does she get enough vigorous exercise? She may have pent-up energy which could benefit from being released in another physical way. Hope this gives some ideas which are helpful...


First of all, please don't punish your child for something she obviously can't control. Chances are, by letting her know that you are irritated, you will only humiliate her and maybe even exacerbate the tics. Why not talk to her doctor if you are concerned; Maybe she/he can help find out the cause for the tics in the first place.


I used to have a series of nervous tics as a child, and it drove my parents crazy. They took me to the doctor, and found out it was the result of having had scarlet fever. Apparently some of these illnesses cause tics later on. My second thought is that she could have some obsessive/compulsive issues. Does she also count her actions and do things in threes, for example? My son (now 14) had (and continues to exhibit) tics and the like -- particularly swaying and hand rubbing/wringing. He was diagnosed with a seizure disorder when he was 6, and then started with the tics at around 9. Not sure if the tics are related to the seizures even now, but his UCSF neurologist is very casual about it. Told us to leave the kid alone -- that if we bugged him it would make it worse -- even said his own son has a tic that drives them crazy but they just let it go. He said it might help relieve nervous energy. I'd suggest having a bit of testing done just so you know there is nothing serious behind it. I bet she will just grow out of the ticks -- maybe they are just a coping mechanism. Good luck!


Our son had what we called snorting. It got so bad that a child in his class begged me to do something about it one morning when I dropped my son off at school. My son also exhibited some other ticcing behaviors and was diagnosed with nervous tics by a behavioral pediatrician. The snorting problem went away after we began using Nasalchrome regularly. My son adds a personal warning that you have to use it regularly, if you stop--or even cut down the dosage (we use it twice daily) it will stop working and will take a few days to become effectual again. Nasalchrome is available over the counter and is safe to keep using indefinitely. For help managing the underlying causes of nervous tics, I would advise a visit to Christine Ciavarella at the Hahneman Medical Clinic in El Ceritto. And please remember that your child is not to blame!


The symptoms you describe sound very much like the tics that can come with obsessive-compulsive disorder. It would be a very good idea to have her checked out for this by a neurologist or pediatrician used to dealing with this disorder. I am not a fan of pharmaceuticals but OCD can be controlled with certain drugs.It sounds very much like compulsive behavior, not deliberate behavior, and I am sure your daughter would be glad to have it controlled!


11-year-old squinting, eye-rolling, lip-pursing

July 1999

I found the page on nervous tics very helpful and saw a lot of similarities there with what I am dealing with. I have been through the lip licking, then squinting the eyes, then rolling the eyes, and now pursing her lips. I have assured my daughter that these things come and go and they're no big deal. At my house, she rarely exhibits these behaviors. At her father's house (and they are very loving and concerned - but I feel sometimes limited in their ability to grasp some things) she exhibits the behavior so much that they are always calling attention to it and calling me to say that it's going on. Now she's almost 11 years old. She knows they're looking at her and they're worried about school. (She's been previously home schooled, and in private school, but will attend the public school in September). I've tried to explainto them that if they just let it go, it will go away. She did have a concussion, which was followed by EEG for over a year and there has basically been complete resolution of the slight memory deficit that resulted. I have no intention of putting my child on medicine because they're embarrassed by her behavior. If anyone has any ideas as to how to deal with them (ever so gently of course) I would greatly appreciate it. The stress she goes through trying not to have them notice it, causes her to do it even more.


You might want to do some research into Turret's Syndrome. It is commonly known for people who exhibit spontaneous behaviors like yelling out, but many people simply have 'tics'. These tics can be exacerbated in stressful situations. I even think the tics can change over time. I'm not sure if there is medication to treat it. People with Turret's (I think that's the spelling) are a cross section of society and don't seem to have any mental disabilities associated with it. (my business school professor had it - very successful, established man). The reason I know only a little bit about it is because I saw it on 20-20/60 Minutes and have heard people speak on the subject.


I was very interested to read the posts regarding tics in small children. I never would have referred to what happens to my daughter as a tic but it sounds very much like some of the others that have written in. Ever since my daughter was several months old she will do this thing where her back stiffens, her mouth opens and contorts and her hands open and shut rapidly. It only occured when there was some excitement going. At first I thought she was having some kind of seizure. The doctor said it wasn't a seizure because she doesn't ever lose consciousness (her eyes don't glaze over). She still does it at 5 under exciting or stressful conditions, but I notice she's more self-conscious of it - even though my husband and I have made a concerted effort to not draw attention to it. If she sees me seeing her doing it she immediately tries to stop, although stopping seems difficult and she kind of convulses while trying to stop (the way your head might convulse or shake when you drink a strong drink). Now that someone has mentioned Turret Syndrome it made me wonder if there's actually something that can be done. I must admit I'm concerned that she may be the object of ridicule for it when she starts Kindergarden in in the Fall. Does anyone know any more about Turrets and whether this sounds like it may be Turrets? (July 1999)


Could 8-year-old's tics be genetic?

I was so relieved to see the posting about this subject today. Thank you. My 8.5 year old daughter has suffered from these for over 2 years. She has had all but the eye-rolling, but also had a way of distorting her mouth, opening it really wide about every 3 seconds.

We have a history of tics and stuttering in our family. My daughter sucked her thumb until about 2 years ago, and I did it until I was ten!! I also had severe tics at the age of 7.

We are also in a joint custody situation and try as I will to make it her father or the other household's fault, her ups and downs with this seem to not always be traceable to specific occassions or locations. Her father does point it out to her way too much in my opinion, and I agree with the posting that it's something best left alone.

Recently her father divorced again and for a month or so this made the tics worse. I put her into a group for children of divorce in in Lafayette, and the therapist carried on about it to an extreme, I thought, saying that she was in crisis. Well, having been a single parent and had a great deal of emotional upheaval for 8 years, I am loath to run out with a firehose anymore on each crisis that a specialist identifies. Her moods, appetite, energy, sleep, are all GREAT, and those are my gauges. She also opens up about various stresses in her life to the divorce group, which I find comfortingly healthy.

To make a long question short: Could this be genetic? Any history in your family of nervous tics?


As a contribution to the discussion of nervous tics. According to the research on Tourette's Syndrome, it certainly can be a genetic factor. There is a lot of information on this condition at the Tourette Syndrome Association web site--tsa.mgh.harvard.edu . However, keep in mind that Tourette's Syndrome involves both verbal and motor tics, and that many children develop nervous tics that go away over time, without ever having a diagnosis of TS. As a parent of a child with TS, I certainly have found that downplaying the tics (motor and verbal) works best. If it's something very irritating, especially when it's first beginning, you could just mention that they seem to be forming a new habit and maybe suggesting something to do instead that's less obtrusive, irritating. (This works well for things like chewing on clothes, while ignoring tics and working on the stress is probably more effective for things like eye-blinking and head jerking). ONe teacher suggested giving our son something to play with in his hands--wax, clay--as an alternative when nervous habits were a problem. (July 1999)


Oliver Sacks has written some interesting case studies of adults with Tourette's Syndrome. He also gives a fair amount of detail on TS in a form that even a non-biologist like myself can understand. I believe they were published in An Anthropologist on Mars.


There's a wonderful documentary on Tourette's called Twitch & Shout. It's on PBS and is available (I think) through the Berkeley Public Library.


Could tics be genetic? From my experience, I would tend to guess yes. Regarding your 8.5 year old daughter, it sounds like you know her best and would be the one most likely to know when she would be in need of more help. I personally have dealt with maybe 8 different tics throughout my life. They too come and go. They only really bothered me. Only a few people in my life ever said Hey what's wrong with you or something to that effect. I also have obsessive-compulsive disorder. I've tried medication, but I'm the only one who really realizes I have it. The medication's side effects far outweighed any benefits. I would call my case mild. It doesn't affect my ability to get on with my life in any serious way. It's more bothersome to me. I will say that I'm late for just about everything because of the rechecking of the stove and the door and things like that. I check my alarm clock about 10 times before I lay my head down. So I waste about a minute. Sure beats the side effects of the drugs. The way I see it, I'm happy that these are the only problems my daughter and I have and in the grand scheme of things, that's not too bad. I just encourage my daughter to talk to me about her feelings and have told her in no uncertain terms that this will go away. That's they way she sees and believes it and the incidence has certainly decreased in my presence. I have no concern what other people will think, (but I know people who do) all I'm concerned about it how my daughter is feeling, period. When I was in therapy, the counselor said that some of my compulsions may have been my safe reaction to things I couldn't do anything about. Not having any other coping mechanisms. I wonder if this may be true about tics. Best of luck to you and your daughter.


6-year-old licking her lips compulsively

1997

This is a problem that I intend to deal with in counseling, for sure, but I thought I would run it by The Crowd here and see if anyone has been through anything like this. Thanks.

I am a single parent with a six-year old only child. We divorced when my daughter was 15 months. Her father remarried immediately and his new wife has two children, now 14 and 12. The stepfamily members are wonderfully loving and accepting of Halle, which is glorious for us all, and i have a good relationship with the stepmom and kids, too. Her father and I have very little contact and never fight around our daughter. He also NEVER sees Halle. She goes to their house every other weekend, Fri eve to Sun eve, yet he works Fri night and all day sat and sun. The stepmom picks up all of the slack.

Over the past six months, Halle has developed a severe facial tic and licks her lips until they're raw and look like clown's lips. Kids shun and tease her, leaving her out of their games. It's pitifully sad and of course I do a fair amount of projecting my own insecurities onto her situation, which helps not at all. I try very hard not to nag her about her tics, but she looks attrocious and in fact I worry about scarring. I keep urging Vaseline and Carmex, etc., but she licks right through them.

Anyway, I am writing not for suggestions on creams, etc., but to know if anyone has been through a similar nervous manifestation with their child. I intend to seek private counseling for Halle, because I cannot claim to be able to help her with her father's absence or whatever is causing this nervousness. In the meantime, any ideas as to how I can at least not make her feel worse and maybe even help her? She is in pain right now and does not want to go to school even. Mary


On the girl with nervous tics, I would only add that, in addition to counseling (and has she seen her pediatrician?) her mother should enlist the schoolteacher's and maybe the principal's help, if she hasn't already. My daughter went through an awkward phase like this at the same age: she developed a nose-picking habit, and her classmates were merciless. She became an untouchable in her class; it was social suicide to admit any acquaintance with her. Her teacher and the vice-principal responded on two fronts: the vice-principal had a talk with her about using a Kleenex, and her teacher had a talk with her class about ostracizing people. Without this comprehensive approach, she certainly could not have recovered from this as quickly as she did. John


My heart goes out to Halle. When I was six I began shaking my head all the time. I remember going to the hospital to have an EEG. Nothing physiological was wrong and the problem cleared up when my father stopped traveling five days a week.

Here is a resource that everyone should know about: The Planetree Health Resource Center, 2040 Webster St., San Francisco, near California Pacific Medical Center (or whatever it is now called after a merger). (415) 923-3680.

They have up-to-date information on everything from traditional medicine to aromatherapy, both for physical and emotional problems. You either can go and do your own research (with the help of staff), or, for a small fee, they'll do a computer search. For a larger fee, they'll do an extensive search. The staff is warm and helpful. Stefanie


I would like to put in my two cents worth on this concern, but preface it with this: Have your daughter examined by her physician to determine if there is any physical problem causing these symptoms (in a similar situation, I made it a point to speak to the doctor privately first so he/she knew the family situation and other relevant info); then get her counseling (be cautious and take time in selecting the counselor-- your dr. may have suggestions; it is best to get personal referrals, if at all possible.)

I have no previous experience with a child who has a nervous tic. However, the lip licking sounds like it's so frequent it could be compulsive. Both of these symptoms together would cause me considerable concern.

It is extremely painful for a child to be subjected to the rejection she has received from her father. This could be traumatic enough to cause these symptoms, or there could be something else in addition. Does she talk about the fact that her father is never there? What responses does she get from her step-family when she asks why her father isn't there? Has this neglect by her father been going on even since the divorce? If so, that's a lot of rejection. She's going through the motions of visiting her father on weekends, but never having a relationship with him. This must be very frustrating for her. All children need and want a father who will actually parent them and be interested in their lives and who they are.

Until you have more information about what causes the symptoms, try hard not to nag her about her tics and lip licking. She can't help it. It's a sign of her pain. Make a list of things that are soothing to her and do them; give her a lot of hugs and cuddle times. Read to her daily. Seek out group experiences (your family, community, church, etc.) where she will experience acceptance and have fun. Don't let discipline go down the drain; she still needs it.

I wish you the best throughout all this. Hang in there! Things will improve once you get more information and a good therapist. Linnea


Teen's tics brought on by asthma, cold medications?

Feb. 2002

Thanks to all of you who have responded to my query about my Pre-teen who has developed severe eye-blinking . I have one more question. Do any of your children who have tics/ts also have asthma? My child does and I am curious how/if asthma meds affect tics.


With regard to tics and whether asthma medicine may affect/cause them: this is slightly different, but you may be interested. About four or five years ago my son had a major systemic reaction to an antibiotic. Among other things done for him, he was put on Benadryl for about six weeks following the acute problem. During that time, he developed a jaw tic. (He would open his jaw wide and move it side to side for no apparent reason many times a day.) I asked a couple of doctors if this had anything to do with any of the medications he'd been put on and all said no. Finally, one allergist we saw said that an uncommon reaction to Benadryl is to develop facial tics of that type. The tic went away within a short time after stopping the Benadryl and has never returned. (Please post anonymously. Thanks.)