Tics ????

[shellyd67]

difficult child may be developing a tic. I have noticed he is biting on his shirts around the shoulder area on both sides to where they are wet from his saliva. Also notice he is jerking his neck around (similiar to someone trying to get water out of their ear) but this is very slight. Not sure if these are tics are not? Any advice ? I am going to call psychiatrist in the AM but from research I have done, Tics usually have to run their course ... One more thing to worry about ... On the brighter side of things, difficult child has been an absolute angel since school let out. Keeping him nice and busy is helping. Thanx !

 

[tictoc]

Hi,
I'm not an expert, but my son has Tourette's Syndrome and I've seen a lot of tics...So, subtle head jerking is a very common tic. Biting his shirt sounds less like a tic or, if it were a tic, I would expect it to appear after a lot of other more minor tics have occurred for a fair amount of time. Perhaps he is anxious and the shirt biting is a way to relieve the anxiety. There could be more than one thing going on here. Did both behaviors start at the same time?

Tics usually begin in the face and head, e.g. blinking, grimacing, licking lips, head shaking. They often then progress to other parts of the body, e.g. arm jerking, kicking, etc. Vocal tics, when they appear, usually come after motor tics have started.

Has your son recently switched medications or had an increase in his Concerta? Stimulants often can lead to tics and/or increase anxiety.

A call to you doctor is a good idea. As you already know, tics do just have to run their course. Our difficult child doesn't like to talk about his tics. Sometimes I check in with him if I see a new tic that looks like it might hurt or be uncomfortable for him. Has your difficult child mentioned either the head jerking or the biting? Does he seem bothered by either?

My son started having tics when he was three and a half, but we didn't really talk to him about them until he was almost six (when he was diagnosed with Tourette's Syndrome). At that point, he seemed bothered by some of his tics and it seemed like the time to tell him what a tic is and that he has something called Tourette Syndrome. We approached it in a very low-key way and we talked about my brother, who had a tic disorder as a child.

Good luck.

 

[smallworld]

Did the movements start soon after he started Concerta or after a dose increase? Stimulants like Concerta can exacerbate anxiety and underlying tics. It happened to my son, who has a tic disorder. My son's tics, however, come and go regardless of whether he's on a stimulant or not. They do tend to kick up when he's more anxious. He also used to chew his shirt collars, and that was not a tic, but a nervous habit. It stopped on its own.

 

[shellyd67]

Thank you for responding to my post. The shirt biting started shortly after he began the Concerta. He has been on 36 mg for several months now. The head jerking just recently (within 2 weeks or so) He has had several habits through the years. We usually do not make mention of them and they go away on there own (finger snapping, stretching lips by opening his mouth as wide as it will go, etc.) The head jerking seems to be low key today however. I spoke to soon about how well behaved he has been though. LOL I always jinx myself !!!

 

[smallworld]

Instead of tics, they might be stims related to an autistic spectrum disorder. It really is best to have the movements evaluated by a professional such as a neurologist who can differentiate what they truly are.

 

[jal]

Our son developed tics after a psychiatric hospital stay and being placed on Nortriptaline (sp). That made him constantly drool and scratch/rub at his face/head. Once removed, it stopped completely. It appeared pretty quickly after being placed on that medication. Could it be an Obsessive Compulsive Disorder (OCD) thing?

 

[susiestar]

Regardless of the start of the concerta, the shirt chewing is probably a stimulant or a sensory issue, or both. For my youngest it is both. I rarely pay more than fifty cents or a dollar for his shirts because he chews through them very quickly, regardless of the temperature. He has done this for years. I replace them when holes appear or if they have a substantial amount of certain artificial fibers. For some reason the shirts with lots of certain artificial fibers get oddly crunchy after being chewed on for a couple of weeks (washed after each wearing, of course! ).

Has your son ever been evaluated for Sensory Integration Disorder? He should be evaluated by a private Occupational Therapist (OT) to identify and help any sensory problems. They are a sign that his brain does not process info from the senses the way most people do. It cannot be punished out of a child but it can be helped by certain types of therapies. Schools do have OTs on staff, but their evaluations are designed to find problems that impact his education. Many times problems that might not be an issue at school but are a problem in other areas of his life are not evaluated or not addressed by the evaluation of a school Occupational Therapist (OT). Most of the kids I have known have enjoyed the Occupational Therapist (OT) evaluation and often like the therapy too. Our entire family enjoys some of the things we have done to help my youngest!

Stims are also common. They are motions that make the person feel more able to handle situations. Hand flapping is a classic stimulant, but there are MANY others. If one stimulant is forced away the child will either find another or be totally unable to soothe himself. Often he will be unable to keep calm in most circumstances. I don't know if I have ever heard of a child that chewed on clothing as a stimulant, but anything is possible. Sometimes a child must be gently guided to another stimulant if the action is dangerous or truly inappropriate. One little boy in my son's daycare (in a younger class) would play with his privates as his stimulant. It felt comforting to him. There was no abuse at any time that caused it - the parents were very upset by it esp when he did it in public and at daycare so they had child protection evaluate him. The daycare worked with them to find another stimulant to replace that one. It took a few tries to find something that he would accept, and time to make the transition, but eventually it worked.

For the most part shirt chewing is gross but not dangerous or on a level with fondling yourself in public. You can get chewy items from Occupational Therapist (OT) supply stores. I think they are called chewy tubes or hammers. They do make a necklace that can be very helpful. My son likes the necklace but loses it often. I like it because it can go through the dishwasher!!

I do not know much about tics except that often they are thought to be harmless. They should be checked out by a doctor in case they are caused by something that requires treatment. If they are painful or causing problems like teasing or bullying then they NEED to be evaluated. Tics are usually treated by a neurologist, but I am not positive.

My advice for the shirt chewing is to hit up garage sales to find some inexpensive replacement shirts so that you have a stash to replace ones that get all chewed up. I also keep any dress clothes in my closet so they are still in good shape when we need them. It can be helpful to have the shirts handy because there will likely be a day where it is important (to you) for him to look nice and you realize that all of his shirts have holes. When school starts try to keep a clean shirt or two in his cubby or his backpack. Sometimes a teacher will let you keep them in a drawer or shelf. I always kept them in zipper bags so that they wouldn't get stuff spilled on them and so the wet shirt could be sent home with-o getting germs on everything. This is esp important in cold weather. (Be aware that if he has a long sleeved shirt on the cuffs will also get chewed on.)

 

[BusynMember]

I thought of autistic spectrum disorder too, especially if he has trouble socializing with his same-age peers or has obsessive interests. ADHD is often the first diagnosis, but not the final one. My son, who is on the spectrum, used to chew his shirt, lick his lips until th skin around them were so sore he needed special cream, and he STILL stomeimes makes weird throat noises that have been evaluated carefully and are NOT tics, but part of the spectrum. In general though because of all the help he has gotten he is doing really well. He never does those things in public. Does yours?