What to Do If You Think Your Child Has a Tic
My 9 year old girl’s record for clearing her throat was 33 times in one minute. I counted. This noise is so distracting that sometimes it’s impossible to do anything other than counting how many times it happens.
This has happened from time to time since she was six years old. At first, my wife and I thought it was an allergy or a sinus infection. She eats a lot of dairy products, so the slimy was a very likely cause, except that it happened at the weirdest times: first thing in the morning, before she ate; while she was eating; while she went to bed for the night.
We asked our pediatrician, and she offered one of two explanations: it could be an allergy, but rather, it was a behavioral tic. She explained that one of her own children had one and that he came and went during times of stress. To be on the safe side, she suggested allergy medications for a few weeks, but it quickly became clear that we were dealing with teak.
What are tics?
Tics fall under Tourette’s syndrome. Modern medicine defines them as involuntary, repetitive movements or sounds, which can include blinking eyes, twitching of the mouth, wrinkling of the nose, snorting, clearing the throat, coughing, and grunting.
More common in boys than girls, it may be a coping or coping mechanism associated with attention deficit hyperactivity disorder (ADHD) or anxiety. According to the American Tourette Association , tics can fuel a routine or ritual associated with obsessive-compulsive disorder (OCD).
Tics are diagnosed based on their duration. Children who develop and clear tics are usually diagnosed with a temporary (or transient) tic disorder. These tics usually go away within a year. Doctors also estimate the period of time the child is experiencing tics; if there is no break in any three-month period, it is considered a persistent (or chronic) motor or vocal tic, according to Dr. Jerry Bubrick, Ph.D., a clinical psychologist at the Institute of the Child’s Mind in New York.
“The only difference between chronic motor or vocal tic disorder and Tourette’s syndrome is that TS has children who have both motor and vocal tics at the same time,” says Bubrik, who treats tics at the Institute’s Anxiety Disorders Center.
In the Paventi family, this is a series of guttural coughs interspersed with coughs, none of which serves any physiological purpose.
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Diagnosis and treatment of tics
One of the challenges for us was identifying when coughing up and coughing became more than just the possibility of an allergy. This went on for most of the winter and spring before we took him to the doctor. In our case, we misjudged coughing and throat clearing as allergies to dust, pollen, and all the other things we were allergic to as children.
Parents who suspect tics should consult their pediatrician, especially if their child has already been diagnosed with OCD, ADHD, or anxiety, as changes in the child’s therapy may be required.
A child with a motor or vocal tic that occurs less than one year of age may be diagnosed with a temporary tic disorder. And Bubrik says that ticks, like yawns, are suggestible. Adults should ignore the tic when interacting with children, as eliminating it can aggravate the situation, but monitor the tic to determine its frequency and possible triggers.
If the tic lasts longer than one year, the diagnosis is updated to a persistent tic disorder. At this point, Bubrik advocates a type of cognitive behavioral therapy called complex behavioral intervention for tics (CBIT) . This is a high-intensity treatment, lasting 8 to 12 weeks, and is delivered by a board certified behavioral professional — usually a psychologist, behavioral or occupational therapist, or social worker.
CBIT starts by educating the child about tics as most of them are not aware of the tic or its magnitude. The idea is for the child to see what is happening before the tic actually occurs and intervene without causing further anxiety or embarrassment, which could make the situation worse.
“We ask them to look in the mirror when they have a tic, and we can discuss if they noticed it,” he said. “Then we ask them to raise their hand the next time they notice an approaching tick.
Bubrik said the goal is to find where the urge to tick begins. If the tick is an eye blink, but before that they roll their shoulders, then he focuses on what is causing the shoulder roll.
Once awareness is established, doctors try to understand the tic process. The first step is to look for the cause of stress and anxiety.
“Tics and stress are best friends,” Bubrik said. “Thus, the more stress a child experiences, the more tic he or she will have. If you know that you are really worried about a math lesson, you will probably have more tics than in science, where you feel more comfortable or confident. “
With this awareness, Bubrik switches to relaxation therapy because a calmer body and mind are less prone to tics.
“When they sleep, nobody ticks,” Bubrik said. “When your body is completely relaxed, you are not ticking. The more stress your body has, the more likely a tic is. If you are sitting in class and experiencing stress, then you are straining your muscles and it will not help you. “
Relaxation therapy involves a combination of deep breathing, guided meditation, and a therapy called progressive muscle relaxation, which involves tensing and relaxing the muscles so that the child learns the difference between tension and relaxation.
The final phase of CBIT treatment involves offering a competing response, such as people trying to quit smoking, sucking hard candy to mimic the physical movement of bringing a cigarette in and out of the mouth.
Bubrik gave the example of a child who could press hard on his eyes and keep them closed, as if they were watching a scary movie.
“A competing answer would be to use the same eyelid muscles, but in the opposite direction,” he says. “Instead, they opened their eyes wide until the desire passed. And as soon as the desire passes, they can return their eyes to normal, and then move on. “
He says it sounds simple, but it takes a lot of practice, patience and understanding on the part of the parents and other adults around the child.
How not to lose your damn mind
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The Tourette Association of America tells parents they don’t have to be perfect when dealing with teak. They just need to know their own level of patience. This is important to keep in mind after you have experienced your own stressful day and are faced with a tic that you cannot control.
I asked Bubrik what to do when my daughter’s tick starts to get on my nerves. He reminded me that the tic was not because of me or something she was trying to do to me.
“She is doing her best to control a neurological condition that is difficult for her to cope with,” he said. “So that could mean you need to be alone and calm down after a long day, get grounded and return to a neutral place. Or even do something together, like taking a walk where you both can relax. “