My 11 year son has tics that come and go (sometimes they disappear for months) but over the last month or two they have become more pronounced(clicks, sqeaks, clearing the throat). Although still pretty mild, his friends and kids at school are starting to notice when he's having a bad day. Our counseling center recommended that he be medically checked out. Our peditrician just refered us to a neurolist.

We've been debating whether we should start with a neurolist vs. a pyschologist. We'd appreciate words from the wise.

Hi there.
Tricky question without knowing more details such as how long your son has had these tics, and if your pediatrician has ruled out other conditions where tics might be present or if he has suggested that your son does have a tic disorder but wants a Neurologist to sort out the diagnosis.

Usually a Neurologist is the one to see for a diagnosis if that is where you are at the moment. I am aware that some people don't want an actual diagnosis, and are willing to concentrate more on any difficulties that may arise as they happen. Lots of children have mild tics and they cause them very few problems. Many go undiagnosed, so it really depends on your actual individual situation.

If your son is experiencing difficulties at school as you mention, then it might be helpful to speak with a psychologist to get some insight into ways of helping him deal with that. I mean, are they just noticing or are they bullying him or copying his tics or something?

It would help to talk with your son about what tics are. I believe it's best to do that as early as possible.

So really there are several things that I think...

The first one is that we saw both a psychologist and a neurologist. Neuro for diagnosis and checkups afterwards. My son had numerous tests but that was because his health situation was somewhat complicated and the Neuro. wanted to rule out other conditions first. My daughter didn't ever see anyone. We knew she had tics. Her tics stayed mild, and we were willing to deal with issues at school later if we needed. A few years later, when my son was having some other issues I organized some one-on-one counselling for him. That seemed very helpful at the time. Psychologists here where I live cannot diagnose Tourette Syndrome. I found one very helpful though as a back up support system, which the Neuro. definitely was not.

Second one is that if your son has another tic disorder or if he has tourette syndrome (tics) then it would help him to know what they are and a little (age appropriate) about why he has the tics. That'll ease any worries he might have about his own health. It'll also ease him into an acceptance and understanding hopefully and then will be better equipped to deal with what his peers might be saying. Children are interesting little people, and I've found that there will always be the children who accept quite easily the differences in others. They might ask a few questions, but then once that's done, it's like end-of-story. Other children, and they're the minority thankfully, can be more prone to point out differences in others. Preparing your child for that can be helpful.

Third thing is whether your son has any other issues happening beside his tics. Is he doing well in school and has friends and is doing ok generally, aside from having the tics?

Then there's school. Wondering if you've spoken to staff at school about his tics. You may have done all that 'cause your son is 11 and maybe has had tics for years, but if they're fairly new, then it would be worthwhile speaking with his teacher to begin with and seeing how he's doing in class and outside class generally.

Well, sorry to waffle on. I have forgotten a few things I wanted to say I'm sure.

Edited to add: I forgot to mention. Knowledge about Tourette Syndrome and quality of care has increased incredibly in the past 10 years. It used to be difficult to find knowledgeable specialists and it still depends a lot on your actual location or where you live. Where I live, it's still difficult to a degree, but in the USA and Canada now it's so much better. I just wanted to mention this because in some areas there are fewer specialists and often it'll be a Psychiatrist who might be called upon for diagnosis (and to talk about treatment options if that need ever arose), rather than a Neurologist.

Hi Schuler and welcome

Lara really has summed things up so well that I dont have much to add, other than that do just remember if treatment is needed, there are options other than medications, which are ussually the first choice for neurologists and psychiatrists

do take a look at our useful websites link at the top of this TS forum for some informative sites on TS

let us know how things go and again, welcome to Neurotalk