Thank you! My understanding is that tics are a diagnosis of exclusion. So, while we work on excluding the other possibilities I think your recommendation to treat this as a tic and "ignore" is a good idea, too. The pediatrician gave us a handout about tics, which I glanced over, but we so rarely get to have something normal going on that I hardly pay attention to handouts from the ped. Thanks for the reminder about how to approach tics at home.

I do believe it's most likely a tic as his father has some OCD-like psychological issues going on (yet to be formally diagnosed).

Because of his medical history I feel we need to be extra careful in excluding the possibilities. Cardiac anomalies are a feature of his overall diagnosis, although he has never had that particular feature presented. My husband and I were talking last night and have decided we will work on getting another cardiac evaluation done as soon as possible. Although he had a cardiac work-up done as a newborn, we have been sorely disappointed in other areas managed by that particular hospital, so we feel it's more than warranted to get this area re-evaluated. Besides, ECG and echocardiogram are easy, painless tests.

We have, for the most part, been ignoring the yawning as much as possible...if yawns weren't contagious that would be a whole lot easier!

His prior surgeries did not penetrate the diaphram. Three were through the abdominal wall, one along the gluteal cleft, and another through the lumbar spine...the others were exploratory. So, I don't imagine this is a diaphragmatic spasm or whatever.

Another concern of ours is his pulmonary function. He has multiple vertebral anomalies (hemivertebra, kyphoscoliosis, rib fusions, etc), so thoracic insufficiency is a general concern. However, his spine and rib cage has remained stable at every 6-month check-up with the orthopedic surgeon. I cannot imagine that things would deteriorate so quickly and suddenly in this area. So, I feel this is far down on our list of issues to exclude.

Thanks again to everyone for the thoughtful (and very helpful!) replies!

- Rebecca