Does That Tic Mean Trouble?
Throat-clearing, twirling, eye-blinking -- an odd childhood tic is often just a passing phase. Here's how to know whether your child's habit is a sign of something serious.
By Linda Formichelli
Olga Lis
When Amy Rea's son, Michael, was 10 years old, he started making a funny little sound in the back of his throat. The Eden Prairie, MN, mom chalked the sound up to a sore throat or the common cold, but it persisted for several weeks, and Michael claimed he felt fine. Then Amy learned that one of Michael's classmates had asked to be moved to another desk on the other side of the classroom because the throat-clearing was disrupting his concentration. Another classmate commented that Michael sounded like her cat. Amy started pointing out the noise to Michael whenever he made it at home, and asking him to stop, but focusing on the habit only seemed to make it worse. That's when she decided it was time to take her son to the doctor.
"I was afraid Michael had Tourette's syndrome," says Amy. "I was so relieved when the doctor said that lots of kids develop tics, and that if we ignored it, it would probably just go away." Ignoring it was hard at first, but after a while, the family got so accustomed to Michael's throat-clearing that they stopped noticing it altogether. One day, about four months later, Amy realized he had stopped.Ten percent to 20 percent of school-age children will exhibit transient tics, which can range from something as seemingly harmless as blinking or throat-clearing to more disruptive habits such as twirling or head-jerking. Tics are experienced as a buildup of tension -- a physical need to perform the tic -- that goes away only after that urge is satisfied. Fortunately, the majority of tics are transient; they typically disappear on their own within weeks, says Lawrence Scahill, Ph.D., a professor of nursing and child psychiatry at Yale University. In fact, less than 1 percent of kids actually have Tourette's syndrome (TS), a lifelong neurological disorder characterized by persistent ticcing.
What to look for: If a tic lingers for several months, if it becomes more frequent, or if it moves to another body part -- for instance, sniffling turns into yelping -- it may signal TS, so see your pediatrician. She'll take a history of your child's behavior and, pairing that with what she observes during the exam, determine whether it's necessary to see a TS specialist.Tics are also sometimes associated with other disorders, such as attention deficit/hyperactivity disorder, or ADHD(it's estimated that tics appear in less than 5 percent of ADHD cases), and obsessive-compulsive disorder (OCD), which affects less than 1 percent of young kids. Both are treatable with drugs and behavioral therapy, so see your doctor if you notice other telltale symptoms. For instance, kids with ADHD tend to be restless and overactive, whereas those with OCD are unreasonably anxious.
No matter what's behind your child's tic, chances are that a year from now you'll remember it as just another part of his growing up. But the wait-and-see period can be trying for him and you. Here, some tips to help the whole family cope.
Don't tell your child to stop ticcing.
"They don't know what they're doing, and they can't control it," says Tracy Marsh, author/editor of Children With Tourette Syndrome: A Parents' Guide. "Telling kids to stop ticcing makes them feel like there's something wrong with them, and that stress can make tics worse." Try your best to ignore the tics -- when one happens, remind yourself that "This too shall pass," and reflect on one of your child's most endearing traits (such as the way he protects his little sister).
Find ways to tame kids' tension.
While experts are still working to understand why tics develop in the first place, they do know that both excitement and stress generate physical and emotional arousal and make tics worse. "For kids with tic disorders, Disneyland is as tough as a test at school," says psychiatrist John T. Walkup, M.D., of Johns Hopkins Children's Center. So reduce stress by making your home a place where your child can relax and totally be himself -- which means letting him know that he doesn't have to try to squelch his tics. Some parents also find that their kids' tics decrease when they're listening to music or concentrating on a puzzle, says Marsh, so experiment with different activities until you find the ones that soothe your child, and try to give him an hour each day to enjoy them. And when there's an exciting or stressful event coming up, prepare your child by walking him through it ahead of time: Explain what to expect, and what he can do to stay calm, such as taking deep breaths or listening to his MP3 player.
Steer clear of caffeine.
Anecdotal evidence from parents suggests that eliminating caffeine and excess sugar from kids' diets, as well as encouraging them to stay active, may help reduce tics. The reason: Caffeine causes jitteriness that can make tics worse. And exercise is proved to help relieve stress, another tic intensifier.
Teach teachers about tics.
Helping teachers distinguish between a tic and bad behavior will make it easier for them to be sensitive to the situation while still treating your kid like any other -- which is what he really wants and needs. Set up a meeting with your child's teachers to explain what tics are, and ask them to alert you if your child is having trouble concentrating or is being teased. Also, point out that holding tics back can build tension and eventually make them worse, so it's important to let tics happen without classmates making negative comments. You and your kid's teachers need to remember that not all misbehavior can be attributed to a tic: Your child should get a little extra leeway, but not a free pass to act out.
Help kids handle teasing.
A tic can be a bull's-eye for a bully, and any subsequent name-calling, mimicking, and abuse can do lingering damage to your child's self-esteem. "When a child realizes others are noticing the tics, he gets the notion that tics are 'bad' -- and that he's bad for having them," says Scahill.To help your child deal with bullies, start by suggesting that he ignore any teasing. If that doesn't work, he can try using a neutral statement, such as, "I don't jerk my head on purpose -- my body does it on its own, like the hiccups." Role-play different scenarios to help him practice responses.And remind your child that everyone has quirks -- even point out one of your own: Knowing that he's not so different will make getting through the tic period easier
How real moms help their kids cope with tics.
"I've told my 7-year-old son, Max, to say, 'It makes my body feel better' if anyone asks about his head turning. I don't even think he knows the word 'tic' -- he just knows he needs to move sometimes."
-Debbie Feit, 39, Farmington, MI
"My 12-year-old daughter, Madison, was diagnosed with Tourette's when she was 5. We've taught her that while some kids need glasses or leg braces or have problems with their heart, she has tics. It's part of who she is, not unlike having vision problems. She explains it this way to kids who ask about her tics or make fun of her, and they almost always understand."
-Tracy Johnson, 38, Casa Grande, AZ
"At first, I told my 9-year-old daughter, Kim, to handle her tics however she needed to. So when she was having her arm tic she would act like she had dropped something, or during a shoulder-shrugging tic she'd pretend she had a muscle cramp. But it got to the point where she was spending a lot of time coming up with ways to hide her tics. So I told her to just explain that she had to do these things, just like others had to blink or sneeze sometimes. That advice did work for her, and as she gained acceptance from her peers, she quit trying to hide her habits. And the tics seem to have passed now."
—Brenda Ramont, 31, Vandalia, OH
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