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Old 09-11-2007, 12:14 AM #1
davidsmom27 davidsmom27 is offline
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Question Hello Im new and have some questions re: my 3 yr old

Hello everyone

I happened to stumble on my site. Really quick intro. This July my son started with shoulder shrugging and hand waving bilat (down to the ground). He has been seen by a pedi, pedi neuro and child psych. They say its not Autism. His pedi neuro says the shoulder shrugs are tics, and the hand movement, is stereotyped movement disorder. Otherwise he has hit all the milestones. Talking, walking etc...Tonite he said a phrase " I have something for you" and although its something I have said to him many a times, it was strange the way he kept repeating it. I am interested in someone who has TS and has vocal tics if they can tell me more about it. Or any of you for that matter who just want to comment. I do want to add along that the shoulder shrugging did stop about 3 weeks ago, I didnt notice anything "new" until today, and he did twirl a few times... The hand waving downwards still occurs but definetly not as frequent as it was when it first started. Your wisdom will be much appreciated. Thank you
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Old 09-11-2007, 06:37 AM #2
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Hi again davidsmom

Both my husband and son have TS, and yes, it is characterized by both motor and vocal tics, usually only being diagnosed when these have been present (characteristically waxing and waning) for at least a year

Very few docs will give a TS dx after just a few months of tics, as so many children can have transient tics that clear up on their own.

Also, tics can be a result of other issues eg strep/PANDAS, allergens, food reactivity, photosensitivity, toxicity etc and so sometimes, especially when there is no family history of tics and TS, these need to be considered as possibly being the underlying cause of the tics

here is an article at Latitudes on Finding Triggers for Tics

It may be helpful for you to keep a journal and document the tics, when you notice them, what foods, illnesses etc...........this can often help to fit the pieces of the puzzle.

I know many parents (me included) who have found that, whatever the root cause of the tics, maintaining as healthy a diet, free of artificial additives, and trying to also maintain the lowest stress possible, can be big strides in improving things.

hope this gives you some pointers
Cheri
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Old 09-11-2007, 04:12 PM #3
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Hi davidsmom,
Just wanted to mention a couple of things.
I'll post a site that has a list of some of the more common types of tics. The arm one your son is doing that reaches the ground sounds a lot like something my son did when he was little and was put down as being a complex motor tic. He had some very complex tics which would involve doing quite a routine of movements and often involved both arms or hands and an evening up process... i.e. if the right hand did the movement then the left hand would follow. (But... my son is on Autism spectrum as well as having had TS so I'm not 100% sure to this day if this was actually autism related stereotypic movement or a tic. All I know is that eventually he stopped doing it.)

Here's a list of fairly common tics...
http://www.tourettesyndrome.net/Files/CommonTics.PDF
vocal/phonic tics included. Of course there are many more but this gives an idea of what is termed vocal/phonic tic...

Simple Vocal/Phonic Tics
Throat Clearing
Grunting
Yelling or Screaming
Sniffing
Barking
Snorting
Coughing
Spitting
Squeaking
Humming
Whistling
Honking
Laughing
Complex Vocal/Phonic Tics
Making Animal-like Sounds
Unusual Changes in Pitch or Volume of Voice
Stuttering
Echo Phenomena:
- Own Words or Sounds
- Others' Words or Sounds
Coprolalia:
- Obscenities
- Socially Taboo Phrases

I'd also like to mention (seeing as you write that Autism has actually been ruled out) that there is another condition which is always worth reading about and mentioning to your child's doctor if the tics do not seem to quite fit the TS diagnosis... that is Stereotypic Movement Disorder.

This from Dr. Freeman's site... Dr. Freeman is a past member of the Medical and Scientific Advisory Board of the TSA-USA as well as having held other positions. He is currently Clinical Head of the Neuropsychiatry Clinic at British Columbia Children's Hospital in Vancouver and is highly respected and regarded.

http://www.tourette-confusion.blogspot.com/
Tourette syndrome: minimizing confusion
Quote:
Stereotypic Movement Disorder can be confused with tics and TS. SMD is an official DSM-IV diagnosis, but it's rarely made. There are only 2 case series of children published (Tan et al., 1998; Mahone et al., 2004) . Repetitive movements usually start before age 2, and consist of intense patterns (like hand-flapping, pacing, running, bouncing, with or without vocalizations and facial grimacing) in longer runs than tics (can be up to 10-30 minutes). This can be stimulated by excitement or less often boredom. When older, they often say they like it, it's fun, they have to do it before they do something else, and that it stimulates their fantasies, yet they can usually be easily called out of it. It often looks very odd. They typically shape their patterns later so that the movements are done in private or within the family. The main problem is that if you're not familiar with it, you're likely to think it's a symptom of an autistic spectrum disorder or Tourette's. The pattern itself can look indistinguishable from autistic stereotypies, but is much more prolonged than tics. Comorbidity (other disorders) are common, including tics, just to confuse everyone... Usually no treatment is indicated. A videotape of the pattern is very helpful for diagnosis. We are following 36 cases and will submit for publication
.

Your son is still very young at 3 and I'm sort of wondering how it came to be that Autism was thought about and actually ruled out? Bear in mind that some children on autism spectrum will have regular milestones. My son hit all the milestones way early but he is still on autism spectrum. Actually has Asperger's Syndrome diagnosis now since he was early teenager, but it's his autism qualities that have more impact on his life than any tics or movements despite how difficult they have been for him in the past.

Also, with your child being so young, I'd really suggest doing what Chemar suggested and keep a diary of any pattern of tics or movements and also of different behaviours.

Hope I've not written too much.
Keep asking questions. I love answering them.
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